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Scope of the health plan: understand once and for all!

Scope of the health plan

Health

Scope of the health plan: understand once and for all!

A very common doubt of those who are getting information to hire a plan is about the scope of the health plan. 

That’s why today we are going to address this topic and solve all related doubts!

So stay with us and you can check out the following topics:

  • After all, what is the scope of the plan?
  • What types of scope?
  • Does the scope of the plan affect pricing or coverage?
  • Does the plan cover emergency care outside the coverage area?
  • How to know the scope of the Unimed, Bradesco, SulAmerica and Hapvida plan?

Let’s start!

After all, what is the scope of the health plan?

First of all, the geographic scope of the health plan determines in which areas the available services can be used. 

In other words, it is the delimitation of the coverage area.

There are several types of geographic scope of plan, let’s talk about that next!

What types?

At first glance, the types of scope of the plan can be:

National

The health plan with national coverage is the one that provides the insured with care anywhere in Brazil.

Regional 

The regional, on the other hand, allows the use in a certain region, such as the south, midwest, southeast, north and northeast.

Or even a region created by the plan itself, such as a grouping of municipalities or a specific state.

The local deductible health plan provides care only in the city where it was hired.

On to the next question!

Does the geographic scope of the plan affect pricing or coverage?

Similarly to the types, many people have doubts whether the scope interferes or not in the price of the health plan.

And the answer is yes, the coverage of the health plan directly interferes with its value. 

This is because the wider the scope, the greater the network available to the insured.

In other words, someone who hires a local health plan can only be served in one city or state, while someone who hires at a national level can use the services throughout the national territory.

Thus, the health plan with national coverage will tend to be more expensive than a regional or local one. 

Does the plan cover emergency care outside the coverage area?

According to the National Health Plan Agency ( ANS ), urgent or emergency care outside the geographic coverage area provided for in the health plan contract is not mandatory.

However, if there is any contractual provision that guarantees this right, then attendance is mandatory.

How to know the scope of Unimed, Bradesco, SulAmerica and Hapvida?

To find out the scope of any of the health plans listed above, just look at the contract.

We work with the best health plan options on the market!

If you want to get a quote on health plans or answer any questions about the topic, talk to our team! 

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