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Sancionada lei que proíbe plano de saúde de limitar tratamentos médicos

2 de junho de 2020 Nayanna Ximenes

Sancionada pelo governador Reinaldo Azambuja e publicada nesta terça-feira (2.5), a Lei 5.516/2020 proíbe a limitação pelos planos de saúde dos tratamentos prescritos pelos profissionais de saúde.

Somente o médico que acompanha o caso poderá estabelecer qual o tratamento adequado para alcançar a cura ou amenizar os efeitos da doença.

“Não cabe à operadora do plano de saúde negar cobertura a exame destinado a completar o diagnóstico e precisar a evolução de doença cujo tratamento tem cobertura prevista”, justifica o autor da proposta, deputado João Henrique.

Segundo ele, empresas que oferecem planos privados de assistência à saúde podem estabelecer quais patologias estão excluídas da cobertura pelo seguro e inserir tal previsão no contrato, mas não cabe a elas eleger os tipos de exames ou de tratamentos que lhes sejam mais convenientes.

A lei publicada no Diário Oficial do Estado não vale para intervenção sem cobertura contratual entre segurado e plano privado e nem para casos restringidos por lei ou norma da Agência Nacional de Saúde Suplementar.

Quem descumprir estará sujeito às penalidades previstas no Código de Defesa do Consumidor.

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