The differences between health Care, Health Insurance and Health plans

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The differences between health Care, Health Insurance and Health plans

In the current scenario, caused by the Covid-19 pandemic, concern and health care has been growing and, with this, the search for prevention mechanisms such as health insurance and health insurance has also increased considerably.

A study carried out by Veja Saúde shows behavioral changes impacted by the pandemic. Almost 70% of the survey participants were willing to review and change habits in order to preserve health in general.

Also according to the research, Covid-19 has rescued the importance of being aware of when to look for a medical center. Within these possibilities, doubts about the best medical assistance , health plans and health insurance have increased considerably.

Among the most common questions are: what are they for and what makes them different? To help you, let’s clarify them right now, keep reading and check it out!

Health care

Medical assistance is nothing more than disease treatment, prevention and health care, through pharmaceutical, medical and other health services. That is, they are all those services that aim to promote more health and well-being to patients.

Having access to good medical care means being supported in situations of health risk , as it has professionals specialized in different areas of health, clinics, laboratories, hospitals and professionals 24 hours a day for emergencies.

How does medical care work?

Medical care can be made available publicly or privately:

1. Public medical assistance

Public health care is offered by the Federal Government and paid for by taxes paid by the population. In other words, this assistance is available in basic health units, emergency care units and in public and private hospitals that serve the SUS (Unified Health System) .

2. Private medical assistance

Private medical assistance is offered in private laboratories, clinics and hospitals. That is, a fee is charged to use the services. It is possible to hire them directly or through health plans and health insurance.

Health plans

Health plans are an alternative to medical care, offered by private companies, which offer a portfolio of professionals from various specialties , assistance in clinics, hospitals, laboratories and various places that provide health care.

The National Health Agency (ANS) regulates the supplementary health market through various laws, regulations and technical standards , however, operators are free to offer plans according to the age of the contracting party, pre-existing diseases and several others. factors.

How do health plans work?

The operation is through a contract between the health plan operator and the contracting parties . From this subscription, the operator offers an accredited service network so that the patient can choose the one that best serves him.

In this way, the contracting party pays for the health plan to maintain a service network in hospitals, clinics, laboratories and the like.

shortage

The laws that regulate health plans allow operators to have a grace period , that is, a predetermined time for coverage to start being made.

This period is a maximum of 180 days , with exceptions for childbirth procedures ( 300 days ), urgency and emergency ( 24 hours ) and coverage of pre-existing diseases ( 24 months ). In addition, they are covered by consultation plans, investigative exams and diagnostics recognized by the Federal Council of Medicine .

Health insurance

Health insurance is a service offered by insurers that allows policyholders the possibility of choosing doctors, laboratories, hospitals and the like according to their preference, thus guaranteeing the reimbursement of medical expenses for customers in accordance with what is provided for in the contract.

With this type of insurance, the contracting party does not depend on the options, dates and times established by the agreements, as is the case with health plans. Therefore, the insurance covers medical and hospital care risks and is also supervised by the ANS and governed by law.

Some insurers still provide referral services , that is, a small network of recommended doctors and collaborators, where payment is made directly to the medical service provider by the insurer itself, without having to request reimbursement.

If you want to deepen your knowledge about health insurance, access our complete content “ Health insurance: understand how it works and why invest in one ” for more information about the type of insurance.

But after all, health plans or health insurance?

Both health plans and health insurance have the same objective, which is to facilitate beneficiaries’ access to medical care. But even with the same objective, each modality has different features and benefits.

To choose the ideal one for you, you need to identify and analyze your needs and which option best fits your profile . Here are some tips for you to know how to choose your health insurance.

Check out some of the main benefits of each:

Benefits of health insurance:

  • Freedom of choice for doctors, hospitals and laboratories;
  • Quality in service, with the possibility of looking for reliable professionals who meet your real needs;
  • Cost-effective, as insurance can suit your family budget and usage needs;
  • Flexibility to discuss service clauses.

Benefits of health plans:

  • Tranquility and security, with the guarantee of quality service when you need it most;
  • Possibility of carrying out the portability of the plan if you need to move, without having to meet new grace periods;
  • Access to an accredited network that offers all the mandatory procedures defined by the ANS ;
  • No cost at the time of service.

Conclusion

There are many benefits of having a good medical assistance service through good health insurance , especially at the moment we are facing.

We hope you enjoyed this content and that you understand better what health insurance and medical care are.

Big hug and until next time!

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