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RIO – With their sights set on a market of more than 180 million Brazilians who do not have health insurance, companies are launching cheaper products during the pandemic. There are plans from R $ 125 (but offering a smaller accredited network of hospitals and clinics) to other models, which are not health plans, such as monthly subscription services that entitle you to discounts of up to 80% in one. limited number of appointments and exams.
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Offering more affordable products is an old discussion in the complementary health sector, but it has become a more pressing issue with the pandemic. Since 2014, operators have accumulated more than three million user losses.
From March to July, 327 thousand people dropped out of coverage. In August, however, the sector experienced a recovery, with an increase of 77.4 thousand users.
Traditional companies in the sector, such as SulAmérica and Qualicorp, launched lower-value plans. They are subject to the same rules as the more expensive products, such as offering tests and treatments for more complex diseases.
The difference is that the user may have fewer hospital, professional or clinical options. It is an adaptation to the recessionary scenario with a high number of unemployed and the prospect of a slow recovery in the economy.
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Currently, 80% of beneficiaries in the health sector have business plans. Leonardo Giusti, leading partner in the Health sector of KPMG Brazil, recalls that the plans are today the second highest cost of companies in human capital after salaries. For him, the regulation of telemedicine during the pandemic was fundamental.
Restricted network
Leonardo Nascimento, founding partner of Urca Capital Partners, affirms that mergers and acquisitions in the health sector grew by 60% from 2018 to 2019. On the one hand, operators bought clinics, hospitals and laboratories.
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Of other, healthtechs offer digital platforms for health care and management. All to reduce costs, he explains:
– The third wave is the launch of cheaper products, with volume gains, a movement that we need to see if it is successful.
A year ago, SulAmérica launched its first popular plan, Direto, which costs approximately 35% less than the entry fee of the operator’s traditional collective plan. And that value may fall even more, says Ricardo Soares, the company’s director of prices.
The plans have regional coverage and a smaller support network. The big change was in the form of payment for service providers, says Soares:
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– We pay a per capita amount for the number of plan users. At first, the partners were concerned with how this joint venture would work. Today there is a queue of suppliers interested in collaborations. The challenge is to get inside.
The largest benefits administrator in the country, Qualicorp has signed alliances to offer membership plans at more affordable prices, with monthly fees starting at R $ 125. This year, with the pandemic effect, it has already launched 18 accessible products; last year there were four.
– They are plans with different partners, with more restricted networks, regional coverage, but they cover everything that is contemplated in a traditional product – says Elton Carlucci, vice president of Qualicorp.
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Vera Valente, executive director of the National Health Federation (FenaSaúde), which groups operators together, insists that changes in regulation are needed to develop the market for popular plans. The federation advocates the sale of plans only with consultations or examinations:
– Individual plans are a path of growth, since with the economic crisis many Brazilians are informal. But with the current rule they are not viable.
Discount card assistance services, on the other hand, are not subject to the same rules of health plans established by the National Supplemental Health Agency (ANS). They are generally limited to consultations and exams, do not offer emergency care, and provide payment, even a small one, for each procedure performed.
The risk in this case, according to experts, is that the consumer confuses this type of basic service package with a traditional plan.
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– Discount cards are cheaper services than a plan, but less complete. They can be useful in specific situations, but for highly complex and expensive examinations and procedures, the consumer has to resort to the SUS or is forced to make large outlays – says Ana Carolina Navarrete, lawyer at the Brazilian Institute for Consumer Protection (Idec).
The insurance company Porto Seguro, which has traditional health plans in its portfolio, has just launched Porto Cuida. It is a digital subscription service, with a monthly cost of R $ 19.90, which offers the holder, and even two other people, four free annual telemedicine consultations, in addition to discounts of 40% to 50% on consultations. and exams and up to 70% with medications.
– The target audience is those who do not have health insurance, regardless of income range. With the limited sale of individual plans, those who lose their jobs do not have access to a plan – explains Marcelo Picanço, vice president of Porto Seguro.
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Health insurance operators are prohibited by law from selling discount and prepaid cards. In the case of Porto Seguro, it explains that Porto Cuida is not a plan and that it is linked to Porto Seguro Serviços e Comércio, unlike its health insurance operator, linked to another company in the group and that it follows ANS regulations . The two companies operate independently.
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The drop in the sales of its travel insurance during the pandemic made Ciclic, a digital platform for the sale of insurance and services, think about new businesses and launch, in June, Saúde Protada. Includes discounts on medicines and unlimited consultations, with a monthly subscription of R $ 29.90, for individual plans and R $ 49, for family members.
In August, the company launched Plano Plus, which offers discounts of up to 80% on consultations and exams at 3,500 clinics and laboratories across the country.
– The product will evolve, but without becoming a health plan. One of the options under study is the association with an insurance company that allows compensation in the event of a diagnosis of a serious disease, such as cancer, to pay for treatment – anticipates Raphael Swierczynski, CEO of Ciclic.
Questions about the sale of health cards ended up with the Administrative Council for Economic Defense (Cade), which in June decided on the legality of the offer of these products.
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– The agency understood that the offer of these cards comes at a time when people have lost income, are without access to a plan and without medical coverage. However, Cade noted that consumers should be well informed that there is no insurance coverage. That is, whoever sells must be careful to explain to the consumer so that they do not believe that they will have the protections and guarantees of a health plan – says José Alexandre Sanches, Litigation partner at Machado Meyer Advogados.
According to ANS, any link between products such as the discount card and the health card with the brands of the plan operators is prohibited.
