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What is the difference between health insurance and health insurance?

Would you know the difference between health insurance and health insurance? Both types of services present great advantages to users, as they seek to guarantee protection when they need it most.

It is clear that, in Brazil, medical care is everyone’s right and a duty of the State. However, the country still faces many difficulties on the way to its development, and access to public health is a determination of the Constitution that we still struggle to make concrete.

Therefore, civil society organized itself to create more efficient alternatives. We are talking, of course, about insurance and Affordable health insurance. What are the differences between them and which is the best option for you and your family?

That’s exactly what we’re going to talk about throughout this article. In addition, you will check the importance of investing in health and care that should accompany us at each stage of life. Good reading!

The importance of investing in health care

Think about it and try to remember when you had your last checkup, or even went to the doctor. Can you list the habits you’ve developed in recent years to maintain a healthy life, such as exercising regularly, investing in a nutritious diet, improving sleep quality or even drinking more water?

The truth is that, even knowing what are the main decisions we need to make to improve our health and achieve a balance between mental, emotional and physical, we often lack the necessary motivation and discipline.

Investing in our health is not a luxury. Health is life, and our physical and mental strength is the greatest input we have to have more satisfaction and quality in our daily lives. Without this strength, we cannot enjoy pleasant moments with our family and friends, make the dream trip or leverage our professional career.

The lack of health care can make us more vulnerable to the emergence of diseases. Of course, no one will be immune to developing some type of illness, but combining daily preventive care with investment in solutions that the market presents, such as health insurance and health insurance, gives us greater peace of mind and support when we need it most.

In addition, when we invest in our health in a preventive way, we are able to:

• reduce medication expenses;

• improve our productivity;

• be more positive;

• show that we value socializing with our families and the well-being of each one;

• improve the general condition of our organism.

Health care at all stages of life

When we talk about strategies to take care of health, many remember the elderly, who may need more attention to treat and prevent diseases. But not quite. Better understand the peculiarities of each stage of life and what attention needs to be paid.

in pregnancy

Care in the formation of any healthy individual begins even when it is planned to have a child and throughout pregnancy. The first few months are often the most critical, when a woman’s body changes for the development of a new life.

A drop in the production of some hormones, an increase in others and the rapid growth of the baby’s main organs are some of the peculiarities of this stage.

When the first three months are completed, the little baby will be only 11 centimeters, but will already be moving hands, feet, head and even little fingers. This whole process also represents a lot of care that the mother will have to take, such as:

• carrying out prenatal exams;

• suspension of the use of some medications (such as antipyretics and analgesics);

• reduction in high impact exercises;

• dietary improvements for the intake of important nutrients such as folic acid and B vitamins.

In the childhood

The birth of the baby requires a lot of attention, after all, the little one will arrive in the world unprotected and needs special care so that its needs are met. It is certain that this will require a very high dose of energy from the parents – and sleepless nights will not be rare. But all the attention will be very much worth it.

As they grow, children become more independent and demand less attention than babies. But other needs arise.

They need care that now includes not only physical aspects, but also related to the development of written and oral language, healthy habits and responsible attitudes.

In adolescence

When they reach adolescence , many concerns arise related to appearance, such as hair, body and skin. In addition, it is necessary to pay attention to issues related to the prevention of sexually transmitted diseases.

Social interaction and the various academic tasks also increase, and attention to all the emotional aspects arising from these relationships needs to be redoubled. It is important to keep an eye on the mental health of these young people, so that they know how to balance their feelings and thoughts and grow up responsibly.

in the adult stage

After completing basic schooling, now adults, the focus is on work and studies. All of this affects our physical and mental health.

The various changes, indecisions and choices at the beginning of this phase can engender anxiety, fatigue and stress. Therefore, it is important to know how to take care of our health in its entirety.

The choices and habits in health care at this stage largely determine the quality of life we ​​will have at the best age.

at the best age

As we get older, we usually tend to slow down in professional activities, especially after retirement.

But it is very important to keep the mind and body active, which contributes to emotional well-being and good relationships. In addition, additional care with the safety of the home will avoid unnecessary hospitalizations due to falls, for example.

Regardless of the stages of life, there are essential care to keep your health up to date , such as:

• practice of physical exercises;

• balanced diet;

• good relationship with friends and family.

In addition, some types of investments provide the necessary support to us and our families in the event of adversity in all these phases, such as health insurance and health insurance. Do you know the difference between them? That’s what we’re going to talk about now!

Difference between health insurance and health insurance

These are important aids for all stages of life mentioned and that have similarities, but have different definitions. Check details below.

What is a health plan?

A health plan is a service provided by a private company that provides a network of medical care, with laboratories, psychologists, nutritionists, among others. Thus, each institution will have its own service network with registered clinics and professionals.

With a health plan, when you need a medical service, it will be necessary to consult the service network and select the laboratory, clinic or professional provided by the company. Other than that, the plan does not cover.

The types of coverage and scope vary greatly from company to company. Larger ones usually have better service and full coverage, which is ideal for those who travel or move frequently. So, the best plan depends a lot on your profile and the needs of your family.

The service can be offered in different modalities. See some:

•  individual : this is the most expensive option, as it is customized for a single individual;

•  family : extends to the contracting party’s direct family members, which includes father, mother, spouse and children;

•  collective : hired by a group of people, usually in class associations, unions, etc.;

•  corporate : aimed at public and private companies wishing to serve their employees. It is debited directly from the employee’s payroll, reducing part of the bureaucracy.

There are also different types of plans, according to their coverage margin, divided into two large groups: reference and segmented.

REFERENCE PLANS

They are the most expensive, as they are more complete, guaranteeing ample coverage for treatments, exams, surgeries and even transplants.

SEGMENTED PLANS

According to the plan segment:

•  outpatient : very basic plan, with coverage for consultations and simpler procedures — restrictions depend on the contract of each operator;

•  hospital : in addition to basic coverage, it also guarantees hospitalization without time limits;

•  hospital with obstetrics : compared to the previous one, prenatal care, childbirth and care for the newborn are added;

•  dental plan : restricted to dental procedures performed in an office, such as periodontics, radiological exams, endodontics and simpler oral surgeries, in addition to emergencies and urgencies.

And health insurance?

In this case, the institution does not provide a service network. It is, in fact, an insurance contract that reimburses the user for medical expenses related to consultations, laboratory tests, various treatments, surgeries, etc.

Thus, the insured is free to choose the professional or medical institution that he wants. This reimbursement will follow the guidelines of the contracted plan.

Its operation is similar to traditional insurance . The client pays the premium (monthly fee), which varies according to the potential risk of future treatment costs.

What do health insurance and health insurance have in common?

Many people confuse health insurance and health insurance, even using the two expressions synonymously. The truth is that this confusion is justified insofar as plans and insurance have many attributes in common, despite not being the same thing!

To give you an idea, even the National Health Agency (ANS) , in some cases, establishes the same rules for these two activities. But before we talk about the differences between them, let’s mention the similarities.

We can say that the two institutes have the same objective: to provide medical and hospital assistance in a time of need, without the patient having to rely on the public network — which, in many regions of the country, offers a service below the expected quality standards. .

In terms of lack , there is also a similarity. Each contract will define the insurance and health plan periods. This is the period in which the services cannot be accessed by the user, even paying the monthly fees or the premium. So, whatever the choice, there’s nowhere to run.

Both in the case of insurance and in the case of the health plan, the service usually covers from simple consultations with general practitioners and specialist doctors to hospitalizations, surgeries and exams. But what then would be the difference between the two? That’s what we’re going to analyze from now on!

What is the difference between insurance and health insurance?

The health plan is already an old acquaintance of Brazilians, while insurance is still gaining strength.

Despite the similarities shown, that is, the concern with providing medical and hospital assistance, the scope of the contract for the two services is quite different, in addition to the monthly price, which is usually lower in health insurance. See below for details.

HEALTH PLAN

The health plan offers consumers a package of health-related services to be provided in certain situations. All specified in an adhesion contract signed by the consumer.

As we mentioned, the scope of assistance offered by a health plan is limited in advance to a set of professionals and establishments that are affiliated to the operator. It is usually made up of a variety of doctors from different specialties and also a few hospitals, clinics and laboratories.

The names of affiliated professionals and establishments are made available to the consumer through periodicals (the so-called plan booklet) and also, of course, on the operator’s website.

It’s always good to keep an eye on what’s new, as, naturally, there is a turnover of professionals — one of the disadvantages, details of which will be provided later.

If the service or treatment demanded by the patient is within the coverage of the contract, he does not need to pay anything extra for it. That is: in addition to the monthly payment of the plan. If the treatment is excluded from coverage, as a rule, the user must bear the costs in full.

HEALTH INSURANCE

The big difference between the plan for health insurance is the scope of the contract. In health insurance, the consumer is not limited to the network of professionals, clinics, hospitals and laboratories imposed by the operator.

Consumers can choose where to take their laboratory tests, which doctors to consult and which hospitals or clinics they want to attend. Now, anyone who thinks that the consumer pays a fortune in exchange for all this freedom of choice is wrong.

The amount of the premium paid in health insurance depends on each contract, but, in general, it is usually cheaper than a health plan. This is because the insurance system works a little differently.

The patient chooses the professional or service he wants, pays for it and is then reimbursed by the insurance company. The amount reimbursed, however, is not 100% of the cost borne by the insured. Of course, the higher the percentage assumed by the insurer, the more expensive the premium paid by the insured will be.

Which is better: health insurance or health insurance?

The great truth is that each health care model has advantages and disadvantages, so it all depends on the needs and peculiarities of each one.

The important thing is not to be discovered, since everyone is subject to the risk of being affected by a disease suddenly, even following the tips that we gave at the beginning of this article regarding a healthy life at different stages of life. But check out the advantages of insurance and health plan and find out which option best fits your profile.

ADVANTAGES OF THE HEALTH PLAN

The health plan has some advantages, which we have listed below.

Security and tranquility

Nothing better than ensuring quality service when you need it most. Health plans provide extensive coverage. When you need the service, just consult the website or the company guide and look for the professional or hospital closest to you.

portability

If you move to a region not covered by your plan, you can request portability from another operator. That way, you won’t have to go through the grace period again.

The same is true if you wanted to switch to a company that provides broader or more advantageous coverage. To do this, according to ANS, it is necessary to present the current plan portfolio and the last 3 paid slips and to have at least 2 years of participation in the plan.

Zero cost in service

The health plan is a little more expensive, but while with health insurance you will have to shell out the costs to be reimbursed in part later, the health plan doesn’t require you to have a penny in your pocket at the time of service.

ADVANTAGES OF HEALTH INSURANCE

In addition to the advantage of having greater peace of mind and security when you need medical services, health insurance also offers other advantages.