[ad_1]
Accustomed to high levels above inflation, health plan customers should prepare for an increase of up to 35% in monthly rates over the next year. The percentage is an estimate of the Twitter for the readjustment planned for 2021 added to the maximum approved for 2020, but which will only be charged from next month.
Due to the new coronavirus pandemic, ANS (National Health Agency) suspended the readjustment of 8.14% in individual plans and 15% in group plans (covering 81% of users) that would be applied this year.
It was decided that the increase that would be valid for September, October, November and December will be charged in 12 installments starting in January of next year, the month in which the readjustment of 8.14% (individual plans) and 15% (collective) it will also be effective.
Understand the calculation of group plans.
Total expected increase in 2021: 35%
Why? Starting in January, the user must pay 15% of the average adjustment suspended in 2020. Also starting in January, they will pay the first of the 12 installments of the increase that was no longer charged between September and December, an increase equivalent to 5% per month on the amount paid today.
It turns out that the plans will also readjust the monthly rate in 2021, an increase that is usually added to the ticket on the anniversary date of the hiring of the plan. OR Twitter considered the repetition of the average readjustment of this year (15%), the same as in previous years, according to Idec (Brazilian Institute for Consumer Protection).
A 34-year-old user, who pays around R $ 393 for the plan, according to the ANS table, will arrive at the end of next year paying approximately R $ 530, an increase of R $ 137, or 35%.
Understand the calculation of individual plans
Expected increase in 2021: 18.9%.
Why? Starting in January, the user will have to pay 8.14% of the adjustment suspended in 2020. Also starting in January, they will pay the first of the 12 installments of the increase that they stopped charging between September and December, an increase equivalent to 2.71 % on the amount paid today.
As the plans will also readjust the monthly fee in 2021 on the anniversary of the plan’s hiring, the Twitter considered the repetition of this year’s readjustment (8.14%), although the average increase was 9.9% in the last 10 years.
A 34-year-old user, who pays an average of R $ 458 per plan, according to the ANS table, will reach the end of 2021 spending approximately R $ 544, an increase of R $ 86, or 18.9%.
Entities try to cancel the increase
Many people are not realizing that this retroactive charge will arrive in January along with the correction. And, in the course of 2021, a new index will be applied and added to these values that will begin to be charged in January. It will have a profound impact on the accounts of Brazilians in the midst of a pandemic
Rafael Robba, lawyer specialized in health law in Vilhena Silva
Dissatisfied with the readjustment applied this year, Idec joined the Public Defender’s Office and requested the ANS to open the financial data of the sector to demonstrate the need to split the 2020 increase over the next year.
In October, Idec also requested the cancellation of all the adjustments approved between March and August.
The justification is the profitability of the operators during the health crisis, which already reached R $ 29.8 billion between March and September, according to the latest newsletter of the agency. In the period, the companies received a total of R $ 101.3 billion in monthly payments from their policyholders, but they transferred R $ 71.5 billion to hospitals and clinics.
The extra money is due to cancellations and postponements of medical services due to the pandemic. Also according to ANS, the rate that measures the number of times the plans were activated fell from 79% (average of the last four years) to 62% in June (the lowest of the year), when it began to slowly recover. reaching 73% in September.
For the Idec Health Coordinator, Ana Carolina Navarrete, ANS should revoke the payment of the adjustment so that operators “socialize this record benefit with those who are unemployed and without income.”
What the ANS and the plans say
According to ANS, it did everything possible to postpone this year’s adjustment and “dilute the payment” in 2021 in order to “minimize the impact on beneficiaries and preserve the contracts.”
The agency says in a note that the readjustment respected the expenses of 2018 and 2019, “the period prior to the pandemic”, and that the reduction in the supply of medical services will only be noticed “in the readjustment referred to 2021”
It is also what FenaSaúde (National Federation of Complementary Health) defends, which brings together the 16 largest plans. For the entity “it does not make sense” to suspend the adjustments “defined by ANS” for economic results, “which are partial, registered by some operators in the pandemic.”
The non-application of readjustments, as Idec aims, converges to unbalance existing contracts, compromise the provision of services and penalize precisely those who are supposed to defend themselves: consumers
FenaSaúde (National Federation of Complementary Health), in note
Like Navarrete, of Idec, Abrasco (Brazilian Public Health Association) shares responsibility for the increases with the regulatory agency.
“The ANS omitted and acted only when it was pressured by political questions,” says José Sestelo, researcher, public health physician and member of Abrasco. It refers to the suspension of the readjustment in August, which occurred only after the mayor, Rodrigo Maia (DEM), put pressure on the ANS.
Businesses are taking advantage of a calamity to maintain their income levels at the expense of a slaughtered population. If health is a public good, it cannot be treated as a commodity
José Sestelo, member of Abrasco and researcher at UFRJ (Federal University of Rio de Janeiro)
FenaSaúde responds: “Since the beginning of the pandemic, the operators associated with FenaSaúde have been making their best efforts so that the beneficiaries maintain their plans, having even voluntarily suspended the readjustments for 90 days between May and July”.
