PLANOS DE SAÚDE COM COPARTICIPAÇÃO, COMO FUNCIONAM?

Summary

Roberto Drops, a technical expert, discusses health insurance plans with co-participation in this video. He clarifies misconceptions, highlighting that despite the fear of high co-pays, these plans can save up to 20-30% on premiums compared to non-co-participation plans. Drops explains that co-participation costs are nominal and provides examples of象征性 costs for elective consultations, emergency visits, and complex exams, emphasizing the overall cost-effectiveness and preventive benefits of such plans. He also mentions that some plans, like Porto Seguro, Golden Cross, and Central Nacional Unimed, have no co-participation for hospitalizations and surgeries, making them even more advantageous.

Takeaways

• 😀 Roberto Drops, the technical director of Seguros, discusses health insurance plans with co-participation.
• 🤔 Many people are unaware or have misconceptions about co-participation health plans, leading to reluctance to adopt them.
• 💰 Co-participation plans can offer savings of about 20-30% compared to non-co-participation plans.
• 🏥 Despite the fear of high co-participation costs, the actual co-participation amounts are symbolic and much lower than out-of-pocket expenses.
• 📉 The script dispels the myth that co-participation plans are expensive, showing that they can be more economical.
• 📈 Co-participation plans often have a fixed co-payment amount per service, which is significantly lower than the cost of the same service paid privately.
• 🏥 The script provides examples of co-participation amounts for elective consultations, emergency room visits, and various medical exams.
• 💉 Co-participation for complex exams like CT scans, MRIs, and 3D ultrasounds can range from 50 to 150 reais, which is a fraction of the cost if paid out-of-pocket.
• 🏢 Some health insurance providers, like Porto Seguro, Golden Cross, and Central Nacional Unimed, have plans that only require co-participation for elective consultations and emergency room visits, not for hospitalizations or surgeries.
• 📅 Co-participation payments are not made at the time of service but are billed by the insurance company 30 to 90 days after the service is used.
• 💼 The script encourages viewers to consider the long-term savings and peace of mind that co-participation plans can offer, especially in emergency situations.

Q & A

What is a health plan with co-participation?

A health plan with co-participation is a type of health insurance where the insured shares the cost of healthcare services with the insurance provider, resulting in reduced monthly premiums.

Why do some people have a misconception about health plans with co-participation?

Some people may have misconceptions about health plans with co-participation due to a lack of understanding or a preconceived notion that these plans involve excessive out-of-pocket costs.

What is the average percentage of cost savings with a co-participation health plan?

With a co-participation health plan, one can save approximately 20 to 30 percent on monthly premiums compared to a plan without co-participation.

How do co-participation costs compare to out-of-pocket expenses for medical services?

Co-participation costs are significantly lower than out-of-pocket expenses for the same medical services, making it a more economical choice for insured individuals.

What is the approximate cost of elective consultations under a co-participation health plan?

The cost of elective consultations under a co-participation health plan typically ranges from 15 to 30 reais, which is considerably lower than the average market rate.

How much does a co-participation plan usually cost for emergency room visits?

The co-participation cost for an emergency room visit can range from 30 to 60 reais, which is a fraction of what one would pay if they were to pay out-of-pocket.

What is the co-participation cost for complex medical exams like CT scans or MRIs?

The co-participation cost for complex medical exams such as CT scans or MRIs can vary from 50 to 150 reais, which is significantly less than the cost if paid directly.

How does the co-participation cost work for hospital stays?

For hospital stays, the co-participation cost is usually a fixed amount per period, regardless of the length of stay, and it ranges from 100 to 450 reais.

Do co-participation health plans cover the full cost of surgeries?

Yes, co-participation health plans typically cover the full cost of surgeries, including medication, nursing care, and other necessary procedures, with the co-participation cost being a fixed amount.

When are co-participation costs paid by the insured?

Co-participation costs are not paid at the time of service. Instead, they are billed by the health insurance provider 30 to 90 days after the service has been utilized.

What is the transparency like regarding co-participation costs in health plans?

Health insurance providers usually offer detailed reports for co-participation costs, ensuring transparency about the services used, the provider, and the amount charged.