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- Anexo. Legislações Específicas Sobre Os Planos de Saúde
Resolução do Conselho de Saúde Suplementar - CONSU nº 06 de 3 de novembro de 1998
Autor | Josiane Araújo Gomes |
Ocupação do Autor | Mestra em Direito Público pela Universidade Federal de Uberlândia (UFU). Especialista em Direito das Famílias pela Universidade Federal de Uberlândia (UFU). Servidora do Tribunal de Justiça do Estado de Minas Gerais (TJMG) |
Páginas | 336-337 |
Page 336
Dispõe sobre critérios e parâmetros de variação das faixas etárias dos consumidores para efeito de cobrança diferenciada, bem como de limite máximo de variação de valores entre as faixas etárias definidas para planos e seguros de assistência à saúde.
O Presidente do Conselho de Saúde Suplementar - CONSU, instituído pela Lei nº 9.656 de 03 de junho de 1998, no uso de suas atribuições legais e regimentais, de acordo com a competência normativa que lhe foi conferida para dispor sobre a regulamentação do regime de contratação e prestação de serviços de saúde suplementar, e, considerando o disposto no art. 15 da referida Lei,
RESOLVE:
Art. 1º Para efeito do disposto no artigo 15 de Lei 9.656/98, as variações das contraprestações pecuniárias em razão da idade do usuário e de seus dependentes, obrigatoriamente, deverão ser estabelecidas nos contratos de planos ou seguros privados a assistência à saúde, observando-se as 07 (sete) faixas etárias discriminadas abaixo: (Redação dada pela Resolução CONSU nº 15, de 1999).
I - 0 (zero) a 17 (dezessete) anos de idade;
II - 18 (dezoito) a 29 (vinte e nove) anos de idade:
III - 30 (trinta) a 39 (trinta e nove) anos de idade;
IV - 40 (quarenta) a 49 (quarenta e nove) anos de idade;
V - 50 (cinqüenta) a 59 (cinqüenta e nove) anos de idade;
VI - 60 (sessenta) a 69 (sessenta e nove) anos de idade;
VII- 70 (setenta) anos de idade ou mais.
Art. 2º - As operadoras de planos e seguros privados de assistência à saúde poderão adotar por critérios próprios os valores e fatores de acréscimos das contraprestações entre as faixas etárias, desde que o valor fixado para a última faixa etária, não seja superior a seis vezes o valor da primeira faixa etária, obedecidos os parâmetros definidos no Art. 1º desta Resolução. (Redação dada pela Resolução CONSU nº 15, de 1999).
§ 1º A variação de valor na contraprestação pecuniária não poderá atingir o usuário com mais de 60 (sessenta) anos de idade, que participa de um plano ou seguro há mais de 10 (dez) anos, conforme estabelecido na Lei nº 9.656/98. (Redação dada pela Resolução CONSU nº 15, de 1999).
§ 2º A contagem do prazo estabelecido no parágrafo anterior deverá considerar cumulativamente os períodos de dois ou mais planos ou seguros, quando sucessivos e ininterruptos, numa mesma operadora, independentemente de eventual alteração em sua denominação social, controle empresarial, ou na sua administração, desde que caracterizada a sucessão. (Redação dada pela...
Para continuar a ler
PEÇA SUA AVALIAÇÃO- Contratos de Planos de Saúde
- Anexo. Legislações específicas sobre os Planos de Saúde
- Lei nº 9.656, de 3 de junho de 1998
- Resolução do Conselho de Saúde Suplementar - CONSU nº 06 de 3 de novembro de 1998
- Resolução do Conselho de Saúde Suplementar - CONSU nº 13 de 3 de novembro de 1998
- Resolução de Diretoria Colegiada - RDC nº 39, de 27 de outubro de 2000
- Resolução Normativa - RN nº 19, de 11 de dezembro de 2002
- Resolução Normativa - RN nº 63 de, 22 de dezembro de 2003
- Resolução Normativa - RN nº 124, de 30 de março de 2006
- Resolução Normativa - RN nº 162, de 17 de outubro de 2007
- Resolução Normativa - RN nº 171, de 29 de abril de 2008
- Resolução Normativa - RN nº 172, de 8 de julho de 2008
- Resolução Normativa - RN nº 186, de 14 de janeiro de 2009
- Resolução Normativa - RN nº 195, de 14 de julho de 2009
- Resolução Normativa - RN nº 196, de 14 de julho de 2009
- Resolução Normativa - RN nº 363, de 11 de dezembro de 2014
- Resolução Normativa - RN nº 387, de 28 de outubro de 2015
- Referências
- Índice Alfab ético Remissivo
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