Podcast explains the health plan crisis – Folha – 06/14/2023 – Podcasts

The maximum readjustment rate for individual health plans, announced on Monday (12) by the National Supplementary Health Agency (ANS), was met with criticism from both sides involved in the equation. The situation once again highlighted the crisis that is emerging in the sector — made worse by the Covid pandemic.

The Idec (Brazilian Institute of Consumer Protection) said that the readjustment of 9.63% “extrapolates the reasonable limit”, because it is 67% higher than the accumulated inflation in 2022. The Brazilian Association of Health Plans claimed that the value is “below the real needs of cost recomposition”; Abramge expected something between 10% and 12%.

Another concern of companies is fraud, which may have generated losses of BRL 3.5 billion between 2019 and 2022, according to an unofficial estimate of the sector. Although there is no precise number of irregularities, the plans examine the jump in reimbursement requests in the period, which was well above the growth in assistance expenses.

On the customer side, the Sheet also showed cases of collective plans canceled unilaterally by operators. In São Paulo, the Public Prosecutor’s Office launched an investigation to investigate occurrences of this type involving Unimed; the company says that unilateral termination is provided for in the contract.

This Wednesday’s Café da Manhã (14) analyzes what is behind the crisis in health plans today in Brazil and tells how this impacts the consumer. Reporter Claudia Collucci discusses what underlies the complaints from patients and operators.

The audio program is published on Spotify, streaming service partner of Sheet in the initiative and which specializes in music, podcast and video. You can listen to the episode by clicking above. To access the application, just register for free.

Breakfast is published from Monday to Friday, always at the beginning of the day. The episode is presented by journalists Gabriela Mayer and Gustavo Simon, with production by Carolina Moraes, Laila Mouallem and Priscila Camazano. Sound editing is by Thomé Granemann.