{"id":1428,"date":"2017-01-19T08:00:29","date_gmt":"2017-01-19T10:00:29","guid":{"rendered":"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/?p=1428"},"modified":"2017-01-18T17:15:38","modified_gmt":"2017-01-18T19:15:38","slug":"o-que-voce-precisa-saber-doencas-ou-lesoes-preexistentes-dlps","status":"publish","type":"post","link":"https:\/\/segurosinteligentes.com.br\/oldrh\/o-que-voce-precisa-saber-doencas-ou-lesoes-preexistentes-dlps\/","title":{"rendered":"O que voc\u00ea precisa saber: Doen\u00e7as ou Les\u00f5es Preexistentes (DLP\u2019s)"},"content":{"rendered":"

[et_pb_section admin_label=”section” transparent_background=”on” background_color=”#ffffff” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” padding_mobile=”on” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” custom_padding=”0px||50px|”][et_pb_row admin_label=”row” make_fullwidth=”off” use_custom_width=”on” width_unit=”off” use_custom_gutter=”off” padding_mobile=”on” allow_player_pause=”off” parallax=”off” parallax_method=”off” make_equal=”off” parallax_1=”off” parallax_method_1=”off” parallax_2=”off” parallax_method_2=”off” column_padding_mobile=”on” custom_padding=”50px|35px|50px|35px” background_color=”#ffffff”][et_pb_column type=”2_3″][et_pb_text admin_label=”tag e data” background_layout=”light” text_orientation=”left” text_font=”|on|||” text_font_size=”16″ text_text_color=”#9ec31e” text_line_height=”1.5em” use_border_color=”off” border_color=”#ffffff” border_style=”solid” custom_margin=”||0px|”]<\/p>\n

SEUS DIREITOS | 19.JANEIRO.2017<\/p>\n

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O que voc\u00ea precisa saber: Doen\u00e7as ou Les\u00f5es Preexistentes (DLP\u2019s)<\/p>\n

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Ao contratar ou aderir a um plano de sa\u00fade voc\u00ea j\u00e1 deve ter se deparado com a seguinte pergunta na ficha de cadastro: \u201cVoc\u00ea tem alguma doen\u00e7a ou les\u00e3o preexistente? \u201d e junto dela uma lista de problemas de sa\u00fade que devem ser assinalados em caso positivo. <\/p>\n

Segundo a Ag\u00eancia Nacional de Sa\u00fade Suplementar (ANS), as Doen\u00e7as e Les\u00f5es Preexistentes (DLP\u2019s) s\u00e3o problemas de sa\u00fade que benefici\u00e1rio ou seu representante legal tem conhecimento da sua exist\u00eancia no momento da contrata\u00e7\u00e3o ou ades\u00e3o ao plano privado de assist\u00eancia \u00e0 sa\u00fade, de acordo com o art. 11 da Lei 9656\/98. As operadoras de sa\u00fade n\u00e3o podem recusar a inclus\u00e3o de um cliente portador de DLP\u2019s, mas essas doen\u00e7as podem gerar restri\u00e7\u00f5es \u00e0 cobertura de servi\u00e7os oferecidos pelo plano de sa\u00fade, as Car\u00eancias e Coberturas Parciais Tempor\u00e1rias (CPT\u2019s), que n\u00e3o podem ultrapassar 24 meses, prazo m\u00e1ximo definido pela ANS.<\/p>\n

Segundo o tipo de plano, as CPT\u2019s aplic\u00e1veis \u00e0s DLP\u2019s seguem as seguintes regras:<\/p>\n

Contratos Individuais ou Familiares:<\/strong> pode haver cobran\u00e7a de car\u00eancia e CPT\u2019s;
\nContratos coletivos por ades\u00e3o:<\/strong> pode haver car\u00eancia e CPT\u2019s, com exce\u00e7\u00e3o das ades\u00f5es ocorridas no anivers\u00e1rio do contrato firmado entre contratante\/estipulante e operadora, quando ent\u00e3o n\u00e3o existem.
\nContratos coletivos empresariais com mais de 30 benefici\u00e1rios:<\/strong> n\u00e3o pode haver car\u00eancia nem CPT\u2019s desde que a inclus\u00e3o do benefici\u00e1rio titular ocorra em at\u00e9 30 dias da data do v\u00ednculo com a empresa e que inclus\u00e3o dos dependentes ocorra dentro dos limites contratualmente indicado. No \u00faltimo caso, usualmente as operadoras t\u00eam aplicado o prazo de 30 dias do in\u00edcio da condi\u00e7\u00e3o de dependente (casamento, nascimento, ado\u00e7\u00e3o, in\u00edcio de uni\u00e3o est\u00e1vel).
\nContratos coletivos empresariais com menos de 30 benefici\u00e1rios:<\/strong> pode haver car\u00eancia e CPT\u2019s, mesmo que a inclus\u00e3o do benefici\u00e1rio titular ocorra em at\u00e9 30 dias da data do v\u00ednculo com a empresa, ou que inclus\u00e3o dos dependentes ocorra dentro dos prazos contratualmente negociados.<\/p>\n

Mas fique tranquilo, isso n\u00e3o quer dizer que voc\u00ea n\u00e3o poder\u00e1 utilizar o plano para tratar uma doen\u00e7a que j\u00e1 existia antes da contrata\u00e7\u00e3o. Nesse caso, basta negociar com a operadora o pagamento do chamado Agravo, um acr\u00e9scimo \u00e0 mensalidade do benefici\u00e1rio que garante o tratamento para essas doen\u00e7as no per\u00edodo de car\u00eancia.<\/p>\n

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PORTAL RH IT\u2019SSEG \u00e9 uma publica\u00e7\u00e3o da It\u2019sSeg Seguros Inteligentes. N\u00e3o \u00e9 permitida a reprodu\u00e7\u00e3o do conte\u00fado, mesmo que parcial, para uso comercial de qualquer natureza.<\/p>\n

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PORTAL RH IT\u2019SSEG \u00e9 uma publica\u00e7\u00e3o da It\u2019sSeg Seguros Inteligentes. N\u00e3o \u00e9 permitida a reprodu\u00e7\u00e3o do conte\u00fado, mesmo que parcial, para uso comercial de qualquer natureza.<\/p>\n

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Entenda o que s\u00e3o as DLP’s e quais s\u00e3o as restri\u00e7\u00f5es permitidas por lei de acordo com o plano contratado. <\/p>\n","protected":false},"author":1,"featured_media":1439,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_links_to":"","_links_to_target":""},"categories":[13],"tags":[12],"_links":{"self":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/1428"}],"collection":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/comments?post=1428"}],"version-history":[{"count":4,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/1428\/revisions"}],"predecessor-version":[{"id":10585,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/1428\/revisions\/10585"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media\/1439"}],"wp:attachment":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media?parent=1428"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/categories?post=1428"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/tags?post=1428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}