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ANS is carrying out inspections at Unimed Ferj headquarters due to the increasing number of complaints from health plan users.

ANS is carrying out inspections at Unimed Ferj headquarters due to the increasing number of complaints from health plan users.

Due to the increasing number of complaints from Unimed Ferj users, representatives of the National Agency for Complementary Health (ANS) were present at the company’s headquarters on Monday morning (8). The main complaints of users relate to difficulties in obtaining payment vouchers, accessing their health plan card and receiving reimbursement, since the exodus of beneficiaries previously served by Unimed-Rio, in April of this year.

  • did you see that?Unimed Ferj will modify individual and family health plans by 20%
  • know moreUnimed-Rio users transferred to Unimed Ferj are having difficulty obtaining a monthly payment voucher

Unimed Ferj currently has 480,434 beneficiaries in its medical and dental care plans exclusively.

“This type of action is of an educational nature and seeks to resolve problems before more serious measures are required on the part of the regulatory body. For ANS, the most important thing for the consumer is to have an effective communication channel with the operator and to be guaranteed assistance, within the deadlines set by the agency, and with quality,” said Elián Medeiros, Director of Inspection (DIFIS).

  • Look stillThe operator declines in the event of an elderly person with cancer and reduces the health plan from R$11,000 to R$2,700.

According to ANS, Unimed Ferj executives have committed to changing processes and improving communication with their customers.

What beneficiaries say

Beneficiaries say that monthly payment invoices are not sent, and that when they try to contact the company, they face hours of waiting at the Customer Service Center (SAC), often without success or with dropped calls.

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On social media, reports are also increasing, with users talking about difficulty accessing the Unimed Ferj website, long waits on the phone, and no return of service via WhatsApp.

Immigration

The decision to transfer users from Unimed-Rio to Unimed Ferj was taken at the beginning of March in a meeting promoted by ANS with the Federal Public Ministry (MPF), the State Public Ministry (MPRJ), the Rio State Public Defender’s Office (DPERJ), Unimed do Brasil, Central Nacional Unimed, as well as Unimed Rio and Unimed Ferj.

The operator has been under the financial and technical direction of the National News Agency since 2015. According to the agency, Unimed-Rio will continue its activities as a health services provider, ceasing to act as a health plan operator.

During the meeting, it was agreed that Unimed Ferj would maintain the Unimed-Rio network, while contracting all operational services from Unimed-Rio to support the transition phase of the portfolio transfer throughout 2024.

Furthermore, Unimed Ferj will lease the hospital and emergency services from Unimed-Rio, assuming autonomy in management, structural dimensions and assistance direction for all rented equipment, in addition to being responsible for Unimed-Rio’s assistance debts for laboratories and clinics.

According to the regulatory agency, the transfer of the portfolio cannot cause any harm to the beneficiaries’ assistance, including changes in prices, products, network and shortages. The doctors (about four thousand members) must also continue under the same current conditions as Unimed Rio.