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SEUS DIREITOS | 20.MAIO.2016<\/p>\n
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Home care: quando o plano de sa\u00fade deve oferecer?<\/p>\n
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O servi\u00e7o de aten\u00e7\u00e3o domiciliar, popularmente conhecido como home care, \u00e9 considerado como continuidade do tratamento hospitalar e procura garantir o bem-estar e seguran\u00e7a do paciente em sua pr\u00f3pria casa. Ele deve ser solicitado pelo m\u00e9dico e indicado como \u00fanica forma poss\u00edvel ou mais adequada de cuidados para as condi\u00e7\u00f5es do benefici\u00e1rio.<\/p>\n
Esse tipo de servi\u00e7o n\u00e3o tem cobertura obrigat\u00f3ria por lei. Ele n\u00e3o est\u00e1 incluso Rol de Procedimentos e Eventos em Sa\u00fade da Ag\u00eancia Nacional de Sa\u00fade Suplementar (ANS), que determina a cobertura m\u00ednima a ser oferecida pelos planos de sa\u00fade de cobertura ambulatorial, hospitalar com ou sem obstetr\u00edcia e odontol\u00f3gicos, e tamb\u00e9m n\u00e3o consta na Lei dos Planos de Sa\u00fade n\u00ba9.656\/1998. Por\u00e9m, se o servi\u00e7o for oferecido pelo plano contratado, a operadora deve fornecer mat\u00e9rias, medicamentos, equipamentos e o atendimento profissional de acordo com as especifica\u00e7\u00f5es do plano.<\/p>\n
Al\u00e9m disso, quando presente no contrato, o servi\u00e7o de home care \u00e9 garantido pelo C\u00f3digo de Defesa do Consumidor (CDC), j\u00e1 que, ao negar o fornecimento de um procedimento, a operadora do plano est\u00e1 descumprindo as cl\u00e1usulas contratuais. Se o paciente tiver a solicita\u00e7\u00e3o de atendimento domiciliar negada pelo plano ou n\u00e3o for atendido de forma satisfat\u00f3ria, pode processar a empresa e denunci\u00e1-la \u00e0 ANS, que poder\u00e1 at\u00e9 mesmo multar a operadora pelo n\u00e3o cumprimento dos servi\u00e7os de sa\u00fade ofertados.<\/p>\n
Mesmo que n\u00e3o inclusa no Rol, o home care est\u00e1 sujeito \u00e0 RDC n.\u00ba 11\/2006 da Anvisa, que disp\u00f5e sobre o \u201cRegulamento T\u00e9cnico de Funcionamento de Servi\u00e7os que Prestam Aten\u00e7\u00e3o Domiciliar\u201d. E, se o plano de sa\u00fade n\u00e3o incluir o servi\u00e7o no contrato, mas houver indica\u00e7\u00e3o m\u00e9dica expressa para interna\u00e7\u00e3o domiciliar, a operadora dever\u00e1 continuar cobrindo a interna\u00e7\u00e3o hospitalar, pois a vida do paciente pode correr riscos pela negativa de custeio da operadora.<\/p>\n
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Apesar de n\u00e3o ser obrigat\u00f3rio, o servi\u00e7o de aten\u00e7\u00e3o domiciliar, quando dispon\u00edvel, deve atender \u00e0s normas da ANS.<\/p>\n","protected":false},"author":1,"featured_media":307,"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":[28],"_links":{"self":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/302"}],"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=302"}],"version-history":[{"count":4,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/302\/revisions"}],"predecessor-version":[{"id":412,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/302\/revisions\/412"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media\/307"}],"wp:attachment":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media?parent=302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/categories?post=302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/tags?post=302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}