{"id":371,"date":"2021-02-28T11:45:01","date_gmt":"2021-02-28T14:45:01","guid":{"rendered":"https:\/\/moraistavares.adv.br\/blog\/?p=371"},"modified":"2021-02-28T14:10:18","modified_gmt":"2021-02-28T17:10:18","slug":"o-que-voce-precisa-saber-a-respeito-de-carencias-em-planos-de-saude","status":"publish","type":"post","link":"https:\/\/moraistavares.adv.br\/blog\/o-que-voce-precisa-saber-a-respeito-de-carencias-em-planos-de-saude\/","title":{"rendered":"O que voc\u00ea precisa saber a respeito de car\u00eancias em planos de sa\u00fade"},"content":{"rendered":"<style>\r\n.docxpressoPlugin {\n\tfont-size: 83.35%;\n}\n\n.h5p_layout {\n    box-sizing: content-box !important;\n}\n\n.h5p_layout *{\n    float: none;\n    text-align: initial;\n\tbox-sizing: border-box;\n}\n\/*to make sure that floating elements are always inside the document bounds*\/\n.h5p_layout:after {\n    content: \" \";\n    display: block;\n    height: 0;\n    clear: both;\n    visibility: hidden;\n}\n\/* a default 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wrap;font-size: 11pt;}\r\n div#h5p_69e08e784ec47 p {keep-with-next: auto;keep-together: auto;widows: 2;orphans: 2;break-before: auto;border: none;text-align: left;writing-mode: lr-tb;margin-bottom: 0.1111in;line-height: 1.07;background-color: transparent;font-size: 11pt;}\r\n div#h5p_69e08e784ec47 p span {font-family: Calibri;font-weight: normal;font-style: normal;text-transform: none;font-variant: normal;letter-spacing: normal;font-size: 11pt;background-color: transparent;text-decoration: none;text-decoration-color: font-color;language: pt;country: BR;hyphenate: true;}\r\n\r\n<\/style>\r\n<div id=\"h5p_69e08e784ec47\"><section id=\"section_0\" class=\"h5p_layout h5p_page h5p_page_PL0\"><div class=\"PL0\"><p class=\"P1\"><span class=\"T2\">O que voc\u00ea precisa saber a respeito de car\u00eancias em planos de sa\u00fade<\/span><\/p><p class=\"P3\">&nbsp;<\/p><p class=\"P4\"><span>Escrito por: Dr. Luciano Tavares<\/span><\/p><p class=\"P5\">&nbsp;<\/p><p class=\"P6\"><span>Car\u00eancia \u00e9 o tempo que voc\u00ea ter\u00e1 que esperar para ser atendido pelo plano de sa\u00fade em um determinado procedimento. Essa informa\u00e7\u00e3o deve estar claramente disposta no seu contrato.<\/span><\/p><p class=\"P7\">&nbsp;<\/p><p class=\"P8\"><span>No caso dos planos de sa\u00fade contratados antes de janeiro de 1999, as regras de car\u00eancia obedecem ao disposto em cada contrato. J\u00e1 para os contratados a partir de<\/span>&#x200b;&#x200b;&nbsp;<span>02\/01\/1999 \u2013 ou para os que foram adaptados, valem as regras abaixo:<\/span><\/p><p class=\"P9\">&nbsp;<\/p><p class=\"P10\"><span class=\"T11\">1 - Casos de urg\u00eancia, acidentes pessoais ou complica\u00e7\u00f5es no processo gestacional, e emerg\u00eancia, risco imediato \u00e0 vida ou les\u00f5es irrepar\u00e1veis<\/span><span class=\"T12\">:&#x200b;&#x200b;&nbsp;<\/span><span class=\"T13\">24 horas<\/span><\/p><p class=\"P14\"><span class=\"T15\">2 - Partos a termo, exclu\u00eddos os partos prematuros<\/span><span class=\"T16\">:&#x200b;&#x200b;&nbsp;<\/span><span class=\"T17\">300 dias<\/span><\/p><p class=\"P18\"><span class=\"T19\">3 - Doen\u00e7as e les\u00f5es preexistentes (quando contratou o plano de sa\u00fade, a pessoa j\u00e1 sabia possuir):<\/span><span class=\"T20\">&#x200b;&#x200b;&nbsp;<\/span><span class=\"T21\">24 meses<\/span><\/p><p class=\"P22\"><span class=\"T23\">4 - Demais situa\u00e7\u00f5es<\/span><span class=\"T24\">:&#x200b;&#x200b;&nbsp;<\/span><span class=\"T25\">180 dias<\/span><\/p><p class=\"P26\">&nbsp;<\/p><p class=\"P27\">&nbsp;<\/p><p class=\"P28\"><span>E se precisar ser atendido para tratar de uma doen\u00e7a que j\u00e1 sabia ter quando contratei o plano de sa\u00fade, o que fazer?<\/span><\/p><p class=\"P29\">&nbsp;<\/p><p class=\"P30\"><span class=\"T31\">Para as doen\u00e7as e les\u00f5es preexistentes,&#x200b;&#x200b;&nbsp;<\/span><span class=\"T32\">aquelas que o consumidor j\u00e1 sabia possuir e que informou no formul\u00e1rio da declara\u00e7\u00e3o de sa\u00fade ao contratar o plano<\/span><span class=\"T33\">, ele ter\u00e1 cobertura parcial tempor\u00e1ria at\u00e9 cumprir dois anos de car\u00eancia.&#x200b;&#x200b;&nbsp;<\/span><\/p><p class=\"P34\">&nbsp;<\/p><p class=\"P35\"><span>Isso significa que, durante esse per\u00edodo, ele poder\u00e1 ser atendido para tratar dessas doen\u00e7as, respeitadas as demais car\u00eancias, exceto em caso de procedimentos de alta complexidade, leitos de alta tecnologia - CTI e UTI - e cirurgias decorrentes das doen\u00e7as preexistentes. Para esses \u00faltimos casos, ser\u00e1 preciso aguardar os dois anos.<\/span>&#x200b;&#x200b;&nbsp;<\/p><p class=\"P36\">&nbsp;<\/p><p class=\"P37\"><span>Entretanto,<\/span>&#x200b;&#x200b;&nbsp;<span>se<\/span>&#x200b;&#x200b;&nbsp;<span>o consumidor<\/span>&#x200b;&#x200b;&nbsp;<span>preferir ser atendido mesmo nesses casos, sem ter que aguardar esse per\u00edodo de tempo: basta escolher pagar um valor adicional.<\/span><\/p><p class=\"P38\">&nbsp;<\/p><p class=\"P39\">&nbsp;<\/p><p class=\"P40\">&nbsp;<\/p><p class=\"P41\"><span>E como fica o atendimento no caso de urg\u00eancia e emerg\u00eancia?<\/span><\/p><p class=\"P42\">&nbsp;<\/p><p class=\"P43\"><span>No caso de urg\u00eancia e emerg\u00eancia \u00e9<\/span>&#x200b;&#x200b;&nbsp;<span>obrigat\u00f3rio o atendimento<\/span>&#x200b;&#x200b;&nbsp;<span>a partir de 24 horas da<\/span><\/p><p class=\"P44\"><span>vig\u00eancia do contrato, devendo ser observadas as<\/span>&#x200b;&#x200b;&nbsp;<span>regras de cobertura para cada tipo de plano<\/span>&#x200b;&#x200b;&nbsp;<span>contratado.<\/span><\/p><p class=\"P45\">&nbsp;<\/p><p class=\"P46\"><span class=\"T47\">A&#x200b;&#x200b;&nbsp;<\/span><span class=\"T48\">urg\u00eancia<\/span><span class=\"T49\">&#x200b;&#x200b;&nbsp;s<\/span><span class=\"T50\">\u00e3o os casos resultantes de acidentes pessoais<\/span><span class=\"T51\">&#x200b;&#x200b;&nbsp;<\/span><span class=\"T52\">ou de complica\u00e7\u00f5es no processo gestacional<\/span><span class=\"T53\">&#x200b;&#x200b;&nbsp;(como&#x200b;&#x200b;&nbsp;<\/span><span class=\"T54\">prenhez tub\u00e1ria, ecl\u00e2mpsia, parto prematuro,<\/span><\/p><p class=\"P55\"><span>diabetes e abortamento);<\/span><\/p><p class=\"P56\">&nbsp;<\/p><p class=\"P57\"><span>A emerg\u00eancia<\/span>&#x200b;&#x200b;&nbsp;<span>s\u00e3o os casos que implicam risco imediato de<\/span>&#x200b;&#x200b;&nbsp;<span>vida ou de les\u00f5es irrepar\u00e1veis para o paciente,<\/span>&#x200b;&#x200b;&nbsp;<span>caracterizados pelo m\u00e9dico assistente.<\/span><\/p><p class=\"P58\">&nbsp;<\/p><p class=\"P59\">&nbsp;<\/p><p class=\"P60\">&nbsp;<\/p><p class=\"P61\"><span>Publica\u00e7\u00e3o em atendimento ao disposto no Provimento 94\/2000 CFOAB.<\/span><\/p><p class=\"P62\">&nbsp;<\/p><p class=\"P63\">&nbsp;<\/p><p class=\"P64\">&nbsp;<\/p><p class=\"P65\"><span>#carencia<\/span>&#x200b;&#x200b;&nbsp;<span>#planosdesaude #saude #unimed #qualidadedevida #pediatria #clinicamedica #sa\u00fade #planodesaude<\/span>&#x200b;&#x200b;&nbsp;<span>#carenciaplanosdesaude<\/span>&#x200b;&#x200b;&nbsp;<span>#urgencia #emergencia #urgenciaemergencia #prontosocorro<\/span><\/p><p class=\"P66\">&nbsp;<\/p><p class=\"P67\">&nbsp;<\/p><p class=\"P68\"><span class=\"T69\">Dr. Luciano Tavares<\/span><span class=\"T70\">&#x200b;&#x200b;&nbsp;\u00e9 advogado,&#x200b;&#x200b;&nbsp;<\/span><span class=\"T71\">s\u00f3cio do escrit\u00f3rio Morais &amp; Tavares Advogados Associados<\/span><span class=\"T72\">&#x200b;&#x200b;&nbsp;e especialista em Direito M\u00e9dico e da Sa\u00fade, e Direito P\u00fablico.<\/span><span class=\"T73\">&#x200b;&#x200b;&nbsp;Atuante em assessoria e consultoria jur\u00eddica na prote\u00e7\u00e3o de interesses de segurados de planos de sa\u00fade e usu\u00e1rio do SUS.<\/span><\/p><p class=\"P74\">&nbsp;<\/p><p class=\"P75\">&nbsp;<\/p><p class=\"P76\">&nbsp;<\/p><p class=\"P77\">&nbsp;<\/p><p class=\"P78\">&nbsp;<\/p><p class=\"P79\">&nbsp;<\/p><p class=\"P80\">&nbsp;<\/p><p class=\"P81\">&nbsp;<\/p><p class=\"P82\">&nbsp;<\/p><p class=\"P83\">&nbsp;<\/p><\/div><\/section><script>(function( $ ) {\n    \/\/footnotes\n    $('.defaultNote').children(\":first\").css('cursor', 'pointer');\n    $('.defaultNote').children(\":first\").click(function(){\n        var gotoID = '#' + $(this).parent().attr('id');\n        $('html, body').animate(\n            {\n              scrollTop: $('a[href=\"' + gotoID + '\"]').offset().top - 60,\n            },\n            250,\n            'linear'\n          )\n    });\n}(jQuery));\n\n\n<\/script><script>\r\nvar numFormat = \",.\";\r\n(function( $ ) {\n    \"use strict\";\n    \/\/do some cleaning on load\n    var sortCells = $('td[data-sorting], th[data-sorting]');\n    sortCells.each(function(){\n        var first = $(this).text().trim().charAt(0);\n        if (first == '@'){\n            var oldHTML = $(this).html();\n            var newHTML = oldHTML.replace('@', '');\n            $(this).html(newHTML);\n        } \n    });\n    function sortingTable(node, pos, ordBy){\n        var rows = node.children('tbody').children('tr').get();\n\n        rows.sort(function(a, b) {\n\n        var X = $(a).children('td').eq(pos).text().toUpperCase();\n        var Y = $(b).children('td').eq(pos).text().toUpperCase();\n        \n        if (numFormat != '.,'){\n            \/\/we are dealing with a different locale and we need to do some \n            \/\/transformation in numbers\n            X = convert2number(X);\n            Y = convert2number(Y);\n        } else {\n            X = X.replace(\/,\/g, '').replace(\/ \/g, '');\n            Y = Y.replace(\/,\/g, '').replace(\/ \/g, '');\n        }\n        var currencies = ['$', '\u00a5', '\u00a3', '\u20ac'];\n        var arrayLength = currencies.length;\n        var XX = X;\n        var YY = Y;\n        for (var i = 0; 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