Self-management health plan: how it works

Self-management health plans are the only way in our country’s private health system in which health services preserve their quality without, however, costing more for it.

In this way, health operators do not gain anything from the operation, as they are not the ones who mediate the relationship between the health plan and the beneficiaries.

It works from a group of people who are linked to an exclusive financial fund for health services. Every month, they deposit a certain amount into a reserve fund.

If necessary, they use the money invested in exams, consultations and surgeries. If you don’t need it, the reserve fund remains and can be used when needed.

Next, you will better understand how the self-management health plan works and why it is interesting to invest in it.

What are the differences between the self-management health plan and the traditional ones?

In a traditional health plan, the monthly fee also includes taxes and the profits of the health operators.

In this way, any money left over is converted to the owners of private institutions and not to the beneficiaries.

In the self-management health plan, the amount not spent during the month remains in the reserve fund and can be used by its users in the future.

As there are no taxes to pay, what would be the health service operator’s profit is converted into a reserve fund for the beneficiaries.

What are the self-management plans available on the market?

As the company itself is responsible for contracting and managing health services for its employees and their families, it is necessary to contract, in this case, only one type of insurance for this purpose.

It is up to her to negotiate with clinics, hospitals and other health services. Therefore, it is a great responsibility to take on a self-management health plan.

In the corporate collective deductible health plan , a private health plan is contracted with a health operator. In this way, a fixed monthly fee is paid by all employees who want to join. However, there are no readjustments or discounts, even if the beneficiary does not use the contracted health services.

Advantages of self-management plans

In addition to not having fixed monthly fees, self-management health plans meet the specific needs of their contractors. In this way, the accredited network is chosen by its beneficiaries, who also monitor, in real time, the quality of service provision.

The alternative is also cost-effective for the company, which pays only for services provided by healthcare professionals and providers.

Another advantage is having full health care, so there are no restrictions on diseases or problems with preventive treatments, as the plan serves everyone.

According to ANS Resolution No. 279 , even employees who have already left the company are entitled to continue with the benefit of the self-management health plan.

Thus, it is essential to do the math before opting for this model, to be sure if the investment will have the intended return.

When in doubt about choosing between the self-management health plan and the corporate collective, contact a broker! He will definitely answer all your questions

alex

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