Four proposals presented by ANS generated discontent among sector representatives
A Abrahamwhich represents health plan operators, asked the National Supplementary Health Agency () to interrupt a public consultation scheduled for January. “The large volume of data and information with high impact on each regulatory topic requires greater detail on each proposed change, especially because each thematic axis has specificities that significantly modify already consolidated market practices, with the potential to change the regulatory horizon in a decisive way ”, says Abramge.
This consultation addresses changes to price rules and adjustments to medical insurance plans, with implementation scheduled for January 2026. The four proposals presented by ANS generated discontent among sector representatives. One of the proposals suggests a limit of 30% co-participation for each medical procedure. However, there are exceptions for treatments of chronic diseases, oncology, hemodialysis and some preventive exams.
Furthermore, the sum of the amounts paid with co-participation cannot exceed 30% of the monthly fee or 3.6 monthly plan payments throughout the year. Another proposed change concerns health plans for small and medium-sized companies (SMEs). ANS intends to increase the user limit from 29 to up to 1,000, with the aim of diluting the risks associated with accidents. This change aims to provide greater security for operators and contractors.
The third proposal establishes a minimum accident rate of 75% for calculating adjustments to collective health plans. This measure seeks to ensure that negotiations between operators and contractors are not affected by external interventions. Finally, the ANS proposes the mandatory online sale of health plans, which is currently an optional option.
In addition to these changes, the ANS is reviewing the readjustment guidelines for individual health plans, with the expectation of a new regulation to be launched in 2025.
*Report produced with the help of AI
Published by Fernando Dias
