National Supplementary Health Agency

ANS is the acronym for National Supplementary Health Agency, an autarchy created to implement regulation of the private health market in the country.

Linked to the Ministry of Health, ANS was created by Law 9.961/2000, with the aim of “Promoting defense of the public interest in supplementary health care, regulating sectoral operators – including terms of their relations with generation and consumers – and contributing for the development of health actions in the country.”

Supplementary health is the branch of activity that involves the operation of private health care plans and insurance, regulated and supervised by the National Supplementary Health Agency (ANS). It is composed of operators, professionals, and beneficiaries. Its actions and services included are not linked to the Unified Health System (SUS).

The Brazilian supplementary health system is one of the largest private health systems in the world, corresponding to 30% of the Brazilian population. Due to supplemental health, health plans assist so that the citizen does not lose the right to be served by the SUS.

The regulation of the operators guarantees the provision of health care to the patient. At the same time, the control of commercialized products requires the coverage of basic procedures, generating a standard that all plans must respect.

When contracting a private health plan, the beneficiary chooses supplementary health not dependent exclusively on the Unified Health System (SUS). The idea is that the agreement, with more excellent conditions than the public system, can ensure a good and quick service. Medical appointments, hemodialysis, and laboratory tests are services covered by most insurance plans. They are in the List of Procedures and Health Events, published and updated by the ANS. The ANS Procedure List is nothing more than a list of procedures, exams, and treatments with mandatory coverage by health plans and is usually updated every two years.

However, if the patient insured by the private health network receives a high-cost medicine as a medical recommendation for the treatment of an illness, depending on the case, he may also count on the insurance coverage. For the health plan to provide the medication, it must have a valid registration with the National Health Surveillance Agency (Anvisa) and for the indication to appear on the package leaflet. This indication prohibits, for example, the use of medicines on an experimental basis, without scientific proof or still in the testing phase, without having registration with Anvisa.

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Fonts:
https://blog.samisaude.com.br/ans-agencia-nacional-da-saude-suplementar/
https://laramartinsadvogados.com.br/artigos/o-plano-de-saude-e-obrigado-a-cobrir-tratamentos-para-doencas-raras/
https://vilhenasilva.com.br/medicamento-de-alto-custo-pelo-plano-de-saude/
https://blog.samisaude.com.br/plano-de-saude-cobre-medicamentos/