Health plan charges nearly R$ 40,000 in co-payment for parents with autistic children in MT | Mato Grosso

A health plan in Cuiabá charged nearly R$ 40,000 in co-participation from parents who have children with Autistic Spectrum Disorder (ASD). According to the parents, based on a court injunction, the plan needs to provide the appropriate treatment for these children. They created a group to try to resolve the situation without the plan being cut or charging extra money.

In a statement, Unimed informed that the co-participation in consultations is provided for in the contracts.

“The Cooperative is forwarding the collection of beneficiaries who made use of the plan for therapies without due payment of co-payments. In accordance with the principles of management, Unimed Cuiabá is proceeding strictly according to legislation that provides for a statute of limitations of five years. , opened a specific negotiation channel for customers who prefer debt installments”.

Attorney Mayara Cintra Rosa is the mother of 4-year-old Davi Rosa Franco. She said that she has a medical report where she says it is necessary for Davi to undergo therapies with a psychologist, speech therapist, music therapy, hippotherapy and occupational therapy.

When she decided to seek a health plan, according to her, she was informed that this treatment was not included and that they did not have professionals with the ABA technique, which was recommended by Davi.

A year ago, she went to court to get these treatments and won. In September, she learned that some parents were receiving a payment slip for co-payment of therapies.

She received a payment slip worth more than R$ 18 thousand in co-payment for the months of June, July and August. Other parents who are part of the group reported that the charges have reached almost R$ 40 thousand.

“I have an injunction for over a year and I have never paid. Parents are unable to afford the amounts charged, so we decided to unite and try to solve, together with the health plan, the best way not to default on the plan and continue the treatment of our children,” he said.

According to the lawyer, because it is ASD and several hours of treatment, the co-participation cannot be excessive.

“We parents had with this injunction the salvation of our children and it is through it that our children can evolve and thus get as close to normality. Now with these values, many are unable to pay, and thus will not have access to treatment. I think this attitude is disastrous and very inhumane,” he said.

Lawyer Samuel Sampaio is also going through the same situation. He has two children with autism and was charged R$16,000 in co-payment.

“The treatments are vital, the evolution of the children is sensational, my children are already talking, they are independent, they can communicate, but this only happened through a lot of therapy. The treatment is vital and necessary,” he said.