Health plan: readjustment to be announced this Monday – 06/11/2023 – Market

The ANS (National Supplementary Health Agency) should announce this Monday (12) what will be the maximum index of the annual readjustment of individual and family health plans in the country.

Approval of the ceiling is among the items planned for the agency’s collegiate board meeting. The start of the meeting is scheduled for 10 am.

The maximum readjustment percentage will be valid for the period from May 1, 2023 to April 30, 2024. The annual increase is applied by operators on the anniversary date of the contracts (month of contracting services) and does not involve collective plans, whether they are corporate or membership.

According to the projection of Abramge (Brazilian Association of Health Plans), the readjustment to be authorized should be between 10% and 12%. The estimate takes into account sector data available on the ANS portal and calculation by specialized consultants, says the entity.

The expectation is that the announcement will be made by the agency this Monday. This would just not happen in case of some atypical factor, such as a request for a view at the meeting, which is considered unlikely.

In April, Brazil had a total of almost 50.6 million beneficiaries of health plans, according to data released by the ANS.

Of this contingent, 8.9 million were users of individual or family plans. The number is equivalent to 17.6% of the total – that is, the minority in the sector.

Meanwhile, beneficiaries of collective plans (business, membership or unidentified) reached 41.6 million. They represented 82.3% of the total.

The ANS annually approves the limit for individual and family plans. The percentage of revision of the collectives is determined from the negotiations of the operators themselves.

In April, a report by Sheet showed that, among the collective membership plans, there were increases that reached almost 60%, which generated complaints from customers. At the time, sector representatives mentioned that the increases were necessary to ensure the balance of the system.

In 2022, ANS approved a maximum annual readjustment of 15.5% for individual and family plans. It was the highest increase authorized since 2000, when the current readjustment model came into effect.

The advance came after the plans had a negative readjustment (-8.19%), for the first time, in 2021. The agency’s decision was taken at the time due to the drop in the use of supplementary health services and the consequent reduction in assistance expenses in 2020, the initial year of the Covid-19 pandemic.

The sector came out of the health crisis with accounts in crisis, a situation that still persists. In 2022, there was an operating loss of BRL 11.5 billion. It was the worst result since the beginning of the historical series, in 2001.