Individual health plan may rise 16%, the highest in 23 years

Individual health plans are expected to be nearly 16% more expensive, according to industry estimates. The official adjustment for the period from May 2022 to April 2023 has not yet been released by the ANS (National Supplementary Health Agency), but should be announced by June.

If confirmed, this would be the biggest increase since 2000, when the current adjustment model came into force. The highest percentage authorized by the ANS to date was 13.57% in 2016.

In 2021, for the first time, individual plans had a negative adjustment (-8.19%). This was mainly due to the drop in the use of supplementary health services and the consequent reduction in care expenses in 2020 due to the pandemic.

To determine the annual readjustment, ANS takes into account the variation in expenses with assistance to health plan beneficiaries (with a weight of 80% on the calculation) and the inflation accumulated in the previous cycle (with a weight of 20%).

Once the maximum percentage of adjustment has been announced, operators will be able to raise the prices of individual plans from the anniversary date of the contract — that is, in the month of contracting the plan. The high can happen until April 2023.

The readjustment released by the ANS does not apply to collective business plans and membership plans. According to the regulatory agency, 8.9 million people have individual health plans in Brazil.

Abramge (Brazilian Association of Health Plans) estimates that the readjustment for 2022 will be 15.8%.

“In 2021, expenses far exceeded those of 2020, as a result of the high hospital occupancy rate caused by two main reasons: the resumption of care postponed the previous year and the second wave of Covid-19, much bigger than the first one. “, says the association.

According to Abramge, the global inflation of inputs (materials, equipment and medicines) and the high dollar also impacted the sector.

FenaSaúde (National Federation of Supplementary Health) projects a readjustment of 15.7%, based on the current calculation methodology and information from operators until the fourth quarter of 2021.

“The increase in various items, such as the price of medicines and medical supplies, the strong resumption of elective procedures, the impact of long-term Covid treatments and the incorporation of new mandatory coverage to health plans, such as medicines and procedures, directly impact the readjustment”, he says.

FenaSaúde also states that, if the projection is confirmed, the total adjustment in the last two years would be 6.22% (considering the price drop in 2021), below the general inflation accumulated in the period, which exceeds 16%.

See the history of readjustments of individual health plans by the ANS