Know how a health insurance plan works and how to contract this service to protect your family.

In recent years, the concern about health has been increasingly getting greater emphasis among Brazilian families. According to the Federal Government, 81% of people consider health and hospital issues as priorities. For to this and other reasons, the health plan is among the main concerns on household and corporate budgets.

Health plans are services that offer medical and hospital assistance, provided by health insurance providers. These plans can be offered to people with the concept of Private Plan for Medical Assistance, which can be an ongoing service rendering or coverage of welfare expenses, with pre or post-fixed prices, according to the client’s needs and availability in the accredited network.

In Brazil, the ANS (National Agency for Supplementary Health Services) is the regulating body of this kind of service. The agency has the power of standardizing and supervising the correct presentation of the health plans, as well as assuring the consumer’s needs are met.

Data on Health Insurance Plans in Brazil

Nowadays, there are 1,200 health insurance plan providers offering access to physicians, dentists, emergency rooms, clinics and laboratories.

According to the ANS, over 47 million people rely on private health insurance plans or health assistance plans. From this total, 27 million rely on medical assistance plans with or without dental care and 24 million have dental care.

How do the health insurance plan contracts work?

The health insurance plans may be individual, family and collective. Each provider offers coverages and packages according to the clients’ needs and region they operate.

In the case of individual or family health plans, the contracts are made with the initiative of a private individual, who will be able to include dependents according to the rules pre-established by the provider.

In general, the ones who can be included in the health insurance plan are family members, up to third degree by blood group, of second degree by kinship groups (ex. stepchildren, stepparents), spouses or partners.

It is very important that the major needs are defined before contracting the service. At this point, it is essential to check out the medical coverages, clinics and hospitals covered by the plan, which may be of state or national coverage.


How the collective health insurance plans work

Broadly speaking, the collective health insurance plans can be divided into 3 main groups:

Health insurance plans by kinship: These are coverages planned for groups of people who have common characteristics in society, such as students, residents’ associations and trade associations. These groups may be classified according to their category, area, size and region. 

Collective health insurance plans by membership: They are destined to groups defined according to a professional category related to a specific field of work or institution, such as unions and professional associations.    

Corporate collective health insurance plans: These are for groups of people who have statutory or employment relationship with a specific company, as well as their dependents—nowadays, more than 13% of the health plans are included in this category. 

Knowing how to contract a health insurance plan is very important for you and your family’s health. However, remember that it is essential to check all information to avoid unpleasant surprises. Besides, the moderate use is crucial to avoid situations of loss.

The best tip is always to believe in prevention through healthy habits to avoid using the health plan. Thus, the need reduces and the costs as well. Do you want tips for that? How about starting with easy physical activities? Check out 3 simple tips on how to practice physical exercises!!


Leave a Reply