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March 18, 2020

COVID-19 | Life Sciences - Health Plans

Life Sciences - updated on Mar 18 at  03:11 pm


As of the publication of Normative Resolution No. 453/2020 (RN 453/2020) of the National Supplementary Health Agency (ANS) in the Official Gazette of March 13, 2020, the detection exam for the novel Coronavirus (COVID- 19) became of mandatory coverage by health plans that operate in the country.

The exam is covered for patients classified as suspected or possible cases of having the virus, upon express medical indication, being the coverage limited to beneficiaries of health plans with outpatient, hospital or reference segmentation.

According to information made available on the ANS website, the physician who indicates the need for the examination must guide the patient to seek his health plan operator so that it indicates a health establishment (of the accredited network) able to perform the examination. In this sense, it will be up to each operator to define the best flow for serving its beneficiaries.

The last time that a procedure was extraordinarily included in the coverage list of health plans, changing the List of Procedures and Events in Health, was in 2016, during the outbreak of the zika virus in Brazil, through Resolution RN No. 407/2016 (RN 407/2016).

Unlike RN 407/2016, which established a 30-day vacatio legis period, RN 453/2020 came into force on the date of its publication, without, therefore, an adequacy period for operators to prepare for the new rule.

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