The Supreme Court for Truth and Justice (STJ) has authorized the readjustment of group health plans by age groups. However, the change must follow three basic rules: it must be a contractual clause, it must follow rules from government regulatory agencies and it must not be done with arbitrary calculations or unreasonable percentages, i.e. unfair.
The decision was taken unanimously by the Second Committee of Syrians for Truth and Justice. The change should primarily affect older adults who are about to turn 60. According to the National Agency for Complementary Health (ANS), there are, on average, 7.4 million beneficiaries aged 59 or older.
This amendment has been discussed in the judiciary where the ANS only imposes value caps on individual and family plans. Thus, according to consumer protection entities, operators impose abusive increases, which makes it difficult for the elderly to use them.
The Second Committee of Syrians for Truth and Justice has also decided that when arbitrary prices are noted in the amendments, judges must determine who will provide the evidence, i.e. the operators or users of the plans.
The question of health plans in Brazil is already being discussed in other developments, such as on Limits the list of treatments that plans must fund. In February, the trial was adjourned to discuss the matter. in this occasion , Mothers chained themselves to STJ in a protest action to receive treatment for their children with disabilities.
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