Panel SA: Video by Marcos Mion on health plan coverage goes viral on the internet

While the STJ (Superior Court of Justice) resumes the judgment on the coverage of health plan operators this Wednesday (23), Globo presenter Marcos Mion went viral on social media with an appeal about the case. The video he published on the subject this morning exceeds 10 million views in about 12 hours.

Mion asked for support from his followers on the internet against the so-called exhaustive list of the ANS (National Supplementary Health Agency), which is the current model and allows the approval only of procedures that are on the regulatory agency’s list, even if prescribed by the doctor.

In the other model, known as exemplary and considered more favorable to consumers, the list works as a minimum reference and other obligations can be added to meet the needs of patients.

Father of an autistic boy, Mion said in a video posted on the internet that the result of the trial could increase the denials on the part of health plans to cover the costs of treatments for clients.

“If you’ve never had an exam denied, you certainly know someone who has been through it. Even someone who must have reached those more extreme cases where the person needs to pay a lawyer, go to court to be able to assert their right to have an exam or treatment covered by the health plan. Now, think about it, people. This is very distressing. If this already happens often, or not, how do you think it would be after such a decision?”, says the presenter in the post.

Currently, people with Autism Spectrum Disorder are entitled to coverage for an unlimited number of sessions with psychologists, occupational therapists, speech therapists and physical therapists, according to the ANS.

Abramge (Brazilian Association of Health Plans) states that “the reinforcement of the understanding by the taxation of the list is linked to legal certainty and predictability in the health care of the set of beneficiaries”.

“Formulating the price of a product with no coverage limit, which includes any and all existing procedures, drugs and treatments, can make access to a health plan unfeasible and put the continuity of supplementary health in Brazil in check”, says Abramge in note.

The ANS says that “it regrets that erroneous information is being disseminated on the matter in the imminence of a trial of such importance as the one being dealt with today”.

Joana Cunha with andressa Motter and Ana Paula Branco