The measure should affect 17.6% of the total number of consumers – nearly 9 million beneficiaries – on individual and family plans; The increase will apply to contracts concluded from January 1999
Starting next Monday, 12, National complementary health agency The ANS will determine the maximum percentage that health workers will be able to exercise in readjusting their individual and family plans. The expectation, according to the Brazilian Association of Health Plans (APHPA) projection, which uses a methodology similar to that adopted by ANS and advisory calculations, is that the specific index will be between 10% and 12%. “The percentage is the maximum readjustment limit. Operators may apply lower rates, but are prohibited from applying rates higher than those set by ANS for individual or family plans,” ANS specified in a note. However, the readjustment may have inflationary effects since Extension of the national index of consumer prices (IPCA) – an index that measures inflation rates in the country – determined that the largest impact and the largest variance in inflation was specifically in the health and personal care sector in May. In the past 12 months, the general inflation rate was 3.94% and the accumulated total of agreements exceeded 17%. The measure, which should affect 8.9 million beneficiaries between individual and family plans, will be effective for contracts signed beginning in January 1999, with a readjustment scheduled for the “anniversary date” of contracting the plan.
Regarding the evolution of readjustments imposed by operators in recent years, there is a disparity that occurred in 2021. This is because in the year in question, ANS specified that there should be an 8.19% reduction in the monthly fee, a decision that was taken during the period of the coronavirus epidemic . COVID-19, where Brazilians postponed the search for medical services that considered unnecessary and non-emergency surgeries. However, in other years, there were no adjustments of less than 5%. Last year, in 2022, the increase was 15.5% – the highest in series history. From 2015 to 2018, the average readjustment rate was 13.56%. If the beneficiary has doubts about the applicable percentage of readjustment, ANS provides a service channel to collect complaints. For the hearing impaired, there is a possibility to provide a service through the center: 0800 021 2105. In addition to the options, there are ANS centers available in the five regions of the country, with face-to-face assistance through online scheduling. Monday to Friday, 8:00 am to 8:00 pm, excluding national holidays, it is also possible to request information through the ANS Dial, at the following phone number: 0800 701 9656.
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