The expert warns of some points of attention to avoid future headaches
The health plan has always been one of the priorities in the Brazilian budget, after all the poor service of the SUS makes citizens seek greater protection for the family. A study by the Institute of Supplementary Health Studies (IESS) reveals that the pandemic has solidified health planning as the third item on the priority list among Brazilians, second only to home ownership and education.
Given this situation, choosing a good health plan also raises several questions that need to be answered before signing a contract. But, after all, how do you choose the best health plan for your family?
First of all, you need to be aware of the different types of coverage that exist in health plans.
“The first point of attention is to know that when we talk about health coverage we are referring to the segmentation of assistance, which works as a sort of division of services. Currently the market works with three types of coverage: outpatient, inpatient and comprehensive. In this way, it is necessary, first of all, to understand the difference between each of them,” says Dr. Marcus Vinicius Gimenes, cardiac surgeon and CEO of take care of mehealth tech specializing in cheaper health plans.
outpatient plan
“In the outpatient plan, the beneficiary guarantees coverage for consultations in outpatient clinics and offices, tests, therapies and other outpatient procedures (dressing, removal of stitches, minor surgeries, emergency rooms), i.e. those that do not require a hospital facility. In addition, the customer is entitled to emergency care during the first 12 hours. After this period, the hospital coverage is paid by the insured person”, says Marcus Vinicius.
hospital plan
Here there is already coverage for emergency situations, when it is necessary to have welfare coverage.
“We can cite urgent occasions such as: hospitalization for an unlimited number of days, even in intensive care; elective and emergency surgery; and procedures such as chemotherapy, radiation therapy, and transfusions. It is also worth mentioning that the option for the inpatient plan still carries the possibility of having obstetric care, in addition to hospitalization and the delivery itself. The newborn is also entitled to the plan’s coverage up to 30 days after delivery, guaranteeing greater security both for the post-natal period and for the health and safety of the newborn”, says the doctor.
complete plan
It is what offers total coverage, both outpatient and inpatient and, in some cases, midwifery. Obviously, this is the most expensive plan of all.
How to choose the ideal cover?
The first step is to evaluate in detail the option that best suits the needs of the beneficiary and his family.
“When a person looks for a health plan, the main concern is to go through the accredited network, which includes clinics, laboratories and hospitals. Especially since it is the healthcare provider who will provide effective care when needed. In this sense, it is essential that the beneficiary tries to identify which units will be available in the plan and seeks references to ensure optimal support when necessary”, says the specialist.
You also need to pay attention to the coverage area of ​​the plan. For example, if the customer is not used to traveling in the country, it is not worth choosing one with national coverage. A plan with regional coverage is better suited to this type of case and costs much less.
You also need to think about housing.
If you needed to activate the health plan, then nothing more right than thinking about your well-being in times of need.
“The accommodation that will be made available in the event of hospitalization is a relevant factor in the decision-making process. For those looking for more privacy and the right to have a companion during their hospitalization, it is ideal to look for floor plans of apartments ― unlike the ward, where the patient shares the space with other people,” says Marcus Vinicius.
By looking at each of these options, understand your particular need. From then on, the question is to adjust the needs to the amounts you intend to spend monthly with the chosen plan.
“Nobody likes to anticipate the possibility of having surgery or emergency care. However, it is precisely in this type of situation that we remember the importance of having a health plan capable of meeting all our expectations. That is, only by doing this process assertively can we avoid future headaches and, therefore, ensure the best possible protection,” concludes the doctor.
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Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
