Health is at the top of most people’s priority list. As a result, the search for alternatives, such as health plans and the Public Health System, has been growing more and more. With the pandemic and care to prevent the spread of the new coronavirus, this concern only increases.
Counting on the help of a Health Insurance can be an excellent option for those who seek more tranquility and security in everyday life, especially in delicate moments like the one we are living.
Keep reading to learn how it works and the reasons to invest in Health Insurance. Check out this complete content with the main information on the subject!
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What is Health Insurance?
Table of Contents
Health Insurance is a product, offered by insurance companies, which gives policyholders autonomy to choose the doctors, laboratories and hospitals they prefer. The contractor has access to the options, dates and times established by the agreements.
Like health plans, Health Insurance is supervised by the National Health Agency, ANS , and governed by Law 9,656. It covers medical and hospital care risks and guarantees the beneficiary a set of rights regulated by current legislation.
Many confuse Health Insurance with the service offered by health plans. That’s why we made this content that explains, in detail, the difference between them.
What is health care?
Health care or medical assistance is the treatment and preservation of disease, the care of health through medical, pharmaceutical, nursing and other related services. All services used to promote the health and well-being of patients can be included in medical care, including preventive, curative and palliative services.
What is the difference between the Health Plan and the Health Insurance?
The Health-Insurance – unlike the Health Plan – does not limit predefined doctors, hospitals, clinics and laboratories to the insured. It gives greater freedom of choice to the insured, who bears the costs only to be reimbursed later, in whole or in part.
Individual and collective health insurance
Individual or family health insurance is paid directly by an individual, and may include family members or dependents, and opt for any plan.
Collective Health Insurance contracts, on the other hand, can be corporate or by adhesion , contracted by legal entities for a population with which they maintain an employment, statutory, professional, class or sectorial relationship.
Main differences between individual and collective contracts :
| individual plan | collective plan | |
| Hiring | by any natural person | Only with the intermediation of a legal entity (company, association or union) |
| prices | They are usually more expensive than collectives | They are generally cheaper than individual ones. |
| readjustment | Regulated and limited by ANS | There is no ANS regulation |
| termination | ANS prohibits unilateral termination by the operator | Operators can terminate the contract unilaterally |
| Contract duration | indefinite term | In corporate collective agreements, when the employee loses his relationship with the company, he can remain, for a limited period, with the plan’s coverage. |
Main types of Health Insurance
Each insurer offers different types of coverage, including dental care. The ideal is to research well to find an insurance modality that meets your needs and that best fits your budget.
Check out the main types of Health Insurance:
- Hospital Health-Insurance: guarantees hospitalizations in a hospital environment, with a certain number of days provided for in the contract. All costs related to hospitalizations are covered.
- Hospital Health-Insurance with Obstetrics: works like Hospital Health Insurance, but also includes procedures and exams related to pregnancy and the birth of the baby. For example: prenatal care and childbirth care.
- Outpatient Health Insurance: coverage of medical assistance in offices, outpatient clinics and clinics, in addition to emergency care. This modality allows the performance of imaging tests and special procedures, as long as they do not require hospitalization.
- Hospital + Outpatient Health Insurance: there is the possibility of contracting a Hospital + Outpatient Health Insurance. It guarantees consultations, procedures, exams and hospitalizations.
How does it work?
As already mentioned, allows the insured to choose doctors and institutions , as long as he pays the initial costs, being reimbursed later. Refunds can be full or partial.
But how does Health Insurance work? It’s quite simple: the insured performs the medical consultation or procedure at the place of his choice and, later, requests reimbursement of expenses, according to his contract.
Award
The monthly payment of Health Insurance is known as a “premium”, that is, the installment paid by the insured to take out the insurance. It is effected with the policy, the document that formalizes the contract.
As with other types of insurance, the value of the premium may vary according to the needs of the contractor, the type of insurance contracted, its coverage, the age of the contractor and their risk profile.
Insurers rely on professionals specialized in calculating the risk level of policies to determine premiums.
What is the best Health Insurance?
As with any other type of insurance, the choice will depend on your need. You must identify the coverages that fit your profile. Make a quote, choose the most important coverage and set a value that does not compromise your personal finances. If necessary, talk to an insurance broker.
Why take out Health Insurance?
Hiring a Health Insurance can be an excellent alternative for those who do not want to depend only on public services or want more urgency in their consultations, exams and/or treatments.
We list 4 advantages of taking out Health Insurance. Check out:
1. Possibility to choose doctors, hospitals and laboratories
Normally, in the health plans, the beneficiaries can only be attended by doctors, clinics, hospitals and laboratories that are in their accredited networks. In addition to limiting, this ends up causing a longer wait for calls.
In the Health-Insurance, as already mentioned, the insured has freedom of choice and greater flexibility to adapt his schedule to the times of consultations and consultations. It does not depend on an already defined network. As the insured has this option of choice, he can be attended by the professional much faster.
2. Quality of service
You will look for a better quality service, with professionals you trust to meet your needs. You can choose professionals and institutions that you already know or that have good references.
3. Great value for money
Another positive aspect of Health Insurance is its cost-effectiveness, as it can be adapted to your family budget and service usage needs. Thus, you invest what fits in your pocket and have quality service when you need it.
4. Service Customization
Unlike the health plan, you can discuss the terms of the service when contracting Health Insurance, and you can customize the contract according to your needs. It will be “unique”, thought of in the contracting party.
How to declare Health Insurance on Income Tax?
To declare Health Insurance, it is necessary to request proof of payment from the operator. The Income Tax program allows the import of this document, speeding up its completion.
Expenses with Health Insurance must be informed, under code 26 of the Income Tax , including the CNPJ and the name of the operator . If the reimbursement is partial, the deductible amount as a medical expense is the difference between the amount spent and reimbursed. It is necessary to inform both the total amount of the expense paid and the amount reimbursed.
Keep the receipts. If necessary, you must present them to the IRS . It is recommended to keep for at least 5 years.
Travel Health Insurance
There are specific Health Insurance coverage for national or international trips. If necessary, the insured uses the medical service during the trip and subsequently presents proof of medical expenses in order to be entitled to reimbursement.
Before closing the contract, clear all your doubts and check if it is possible to include coverage for travel abroad.
How to get Health Insurance?
Before hiring a Health Insurance, do a good research, including about the broker . This is the best way to find the most suitable modality.
Conclusion
Taking care of your health is, without a doubt, the best investment anyone can make. Understand what your needs are and look for a reliable company to help you hire the most suitable product for your profile.
We hope you enjoyed this content and that it helped you to learn more about Health Insurance, which is always a good investment.
