New Health Plan Portability rules come into force

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New Health Plan Portability rules come into force

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Health plan portability is the change from one medical coverage plan to another exempt from the need to fulfill a new grace period, regardless of whether or not you stay with the same operator.

The National Supplementary Health Agency (ANS) reformulated the health plan portability rules. Now, corporate collective health plan holders can also make the switch without meeting new loyalty terms.

With the new rules, companies also take advantage of this benefit, allowing the employee to choose and migrate to a plans with medical services more convenient and safe for him.

In this post we will present the new rules and explain in detail each ANS requirement, so that you can make your health plan portability smoothly. Check out!

What is health plan portability?

THE health plan portability it is the contractor's guaranteed right to change plans, within the same operator or in a new one, without having to comply with a grace period to use the services.

The waiting time in health plans is a minimum contribution period, which must be fulfilled before enjoying the services and assistance offered. This time is regularized by the Health Plans Law (9,656 / 1998), and occurs when a plan is contracted.

Portability eliminates the need to put this time into effect, because it is a transfer and not a new contract. However, there are some rules and requirements from the National Health Agency for health plan portability, which we will explore later.

What does it take to port health insurance?

Portability has some requirements to be performed, check out:

  • the current health plan must have been contracted after January 1, 1999;
  • the lack of the current health plan must have been fully complied with;
  • the realization of the first health plan portability can only be done after the term of 2 years in the contracted plan;
  • if your current plan is Temporary Partial Coverage (CPT), it will take 3 years instead of 2 years;
  • for future portability, the term is 1 year;
  • cases of special portability may be made disregarding deadlines (situations of clinical urgency).

How to request the portability of the health plan?

First of all, you need to keep in mind which health plan you want to employ. If you have any doubts, consult the ANS guide and look for the most advantageous options for your situation.

Then, as the National Agency requires it as a prerequisite, ask the operator of your current health plan for proof that the contract was concluded more than one, two or three years ago, depending on each case.

Also separate the ticket and the voucher for the last 3 months. Thus, you confirm the day's compliance with the payment, ensuring its responsibility and commitment.

If the new health plan you wish to hire is for membership, a proof of link to the contracting company must also be provided.

That done, the proposal must be signed by the new operator, who will have 20 days to give an official response to the portability request. If there is no answer, the proposal was probably accepted. But contact the company for security and keep an eye on the deadline.

After acceptance, you must also contact the old operator and communicate your health plan portability. The contract must be terminated on the new start date, ensuring that future problems with undue charges do not occur.

What are the new health plan portability rules?

The new rules for health plan portability will facilitate and streamline the transfer process. Check out:

Membership of beneficiaries of collective business plans

Until then, it was only allowed that beneficiaries of individual, family or collective health plans by adherence to portability. Now, since June 2021, users of collective business plans also earn this benefit.

Migration to other plans or operators, in cases of dissatisfaction or inadequacy of services, without the need to comply with the shortfall in the new plan, becomes a right for all.

However, the minimum term of stay in the new contract must still be respected. It is necessary to stay at least two years in the old plan to order the first portability and at least one year to make new portabilities.

Elimination of the 120-day window

In addition, beforehand, the request for the portability request should be made by no later than 120 days after the anniversary of the contract. After the deadline, only after 1 year, the order could be made again. The new rules eliminated the requirement for this 4-month window. Now, health plan portability can be done with more freedom.

Change to larger plans released

It was only allowed to transfer to plans in the same price range and services, now a change to a plan with greater coverage can be done.

Digital compatibility report

Before, it was also necessary to print a compatibility report. With the new rules, this document can be sent from electronic form, through the ANS Health Plans guide.

What types of portability can be done?

Migrations of the following types can be performed:

  • Collective Business Plan for Individual Plan;
  • Corporate Collective Plan for Collective Membership Plan;
  • Collective Business Plan for another Collective Business Plan;
  • Collective Membership Plan for Individual Plan;
  • Collective Plan for Adhesion to Collective Business Plan;
  • Collective Membership Plan for another Collective Membership Plan;
  • Individual Plan for Collective Business Plan;
  • Individual Plan for Collective Plan by Adhesion;
  • Individual Plan to another Individual Plan.

The new rules offer the option to migrate to a health care organization, where you can feel better, not only in terms of care but also cost and practicality.

Business plans represent about 70% of the market and now have the same assistance coverage as any other plan. With the new rules of health plan portability, competition in the sector should suffer some effect, stimulating further improvements for the quality of life of the beneficiary.

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