Individual health plans will have the biggest increase in 22 years, decides ANS

Individual and family health plans will be up to 15.5% more expensive, ANS (National Supplementary Health Agency) this Thursday (26). It is the highest percentage of annual adjustment authorized by the agency since 2000, the year in which the historical series began. Until then, the highest authorized readjustment had been 13.57% in 2016 (see readjustments by year below).

The measure will impact contracts of about eight million beneficiaries, which represents 16.3% of health plan consumers in Brazil.

The increase refers to the period from May 2022 to April 2023 and can only be applied in the contract anniversary month – that is, in the month in which the contract was signed.

The ANS says that the readjustment was motivated by the increase in care spending of individual plans last year compared to 2020. On the other hand, the frequency of use of health services did not grow at the same pace, with a more gradual resumption in relation to consultations and hospitalizations.

“Much of the positive variation in care costs in 2021 compared to 2020 is due to the strong variation in the price of these services. As the frequency in the use of services dropped quite sharply in 2020, the recovery in 2021, although gradual, was enough to that, along with a sharp increase in the prices of inputs and services, accelerate this year’s index to 15.5%”, says the ANS.

The adjustment only applies to individual and family plans. In collective and corporate health plans, operators are free to determine prices and readjustments, without needing authorization from the ANS.

Health companies claim that the sector ended up reducing the offer of individual plans precisely because of the ANS regulation, which sets limits for readjustments. The companies prefer to launch collective plans, with market prices.

In 2021, tuition dropped for the first time

Last year, the ANS determined a negative adjustment of 8.19% —in practice, the plans were cheaper to consumers for the first time. The agency said at the time that the reduction was due to the drop in demand for assistance and health services in 2020, because of the covid-19 pandemic.

Despite the high number of visits and hospitalizations for the disease, there was a reduction in the demand for consultations, exams and surgeries that were not urgent.

Increase must be described on the ticket

The annual readjustment must appear on the billing slip of individual and family health plans. If the charge exceeds 15.5%, the consumer must call the operator to ask for clarification, says the ANS.

If the problem is not resolved by the company, the consumer is advised to contact the agency by telephone 0800 701 9656 and 0800 021 2105 (for people with hearing impairment) or through the ANS “Contact Us”.

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