Saiba como fazer o teste diagnóstico de covid-19 pelo plano de saúde Featured

07 Jul 2020
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O exame laboratorial para detecção do novo coronavírus foi incluído pela Agência Nacional de Saúde Suplementar (ANS) no rol de procedimentos obrigatórios de cobertura pelos planos de saúde em março, logo no início da pandemia. Na semana passada, a agência incluiu também o teste sorológico, que identifica os anticorpos do vírus.

Segundo a Resolução Normativa da ANS, o teste deve ser feito quando houver indicação médica e a cobertura vale para clientes de planos de saúde com segmentação ambulatorial, hospitalar ou referência. A orientação da agência reguladora é que o paciente consulte a operadora do plano antes de procurar uma unidade de saúde, para ser orientado sobre onde realizar o exame ou tratamento da doença.

O exame diagnóstico previsto pela ANS é o do tipo pesquisa por RT – PCR, com diretriz de utilização, e deve ser feito em pacientes considerados quadro suspeito ou provável da doença, de acordo com a indicação médica.

Lembrando que os procedimentos para o tratamento de covid-19 também são obrigatórios, como consultas, internações, terapias e exames complementares, de acordo com a cobertura do plano do beneficiário. Internação, por exemplo, não é obrigatória na segmentação ambulatorial.

Anticorpos

Já o teste sorológico para o novo coronavírus, do tipo pesquisa de anticorpos IgA, IgG ou IgM, que detectam a presença de anticorpos produzidos pelo organismo após exposição ao vírus, deve ser feito nos casos em que o paciente apresenta ou tenha manifestado um dos dois quadros clínicos relacionados à covid-19.

O primeiro é a síndrome gripal, com quadro respiratório agudo, sensação febril ou febre, acompanhada de tosse, dor de garganta, coriza ou dificuldade respiratória. O segundo é a Síndrome Respiratória Aguda Grave (SRAG), que gera desconforto respiratório ou dificuldade para respirar, pressão persistente no tórax ou saturação de oxigênio menor do que 95% em ar ambiente, podendo ter também coloração azulada dos lábios ou rosto.

Segundo a ANS, o exame é feito com amostras de sangue, soro ou plasma. “Como a produção de anticorpos no organismo só ocorre depois de um período mínimo após a exposição ao vírus, esse tipo de teste é indicado a partir do oitavo dia de início dos sintomas”, alerta a agência.

Este exame foi incluído de forma extraordinária no Rol de Procedimentos da ANS para cumprir uma decisão judicial.

A ANS orientada que as operadoras disponibilizem em seus portais na internet as informações sobre o atendimento e a realização do exame, além de oferecer canais de atendimento específicos para esclarecer seus usuários sobre a doença.

Desde o início da pandemia, a ANS recebeu 6.347 demandas ou reclamações relacionadas à covid-19. Desse total, 44,16% foram referentes a tratamento ou exame, 37,21% sobre outros tipos de assistência afetadas pela pandemia e 18,62% sobre temas não assistenciais. A agência orienta os clientes a procurarem primeiro a operadora para resolver qualquer dificuldade.

Operadoras

Segundo a diretora executiva da Federação Nacional de Saúde Suplementar (FenaSaúde), Vera Valente, o setor tem atendido imediatamente as resoluções normativas editadas pela ANS. Porém, as empresas discordam da exigência dos exames de anticorpos.

“As operadoras de planos e seguro de saúde associadas à FenaSaúde consideram que a cobertura dos testes sorológicos IgA, IgG e IgM não é a melhor alternativa para os pacientes com suspeita de covid, tampouco para o sistema de saúde suplementar. Tais testes não têm a mesma precisão do exame RT-PCR, considerado padrão-ouro e já coberto pelas operadoras desde março”.

Vera destaca que o monitoramento da qualidade dos dispositivos diagnósticos publicado pela Agência Nacional de Vigilância Sanitária indica que dos 85 testes rápidos já liberados pelo órgão regulador, 44,7% não possuem desempenho de acordo com o alegado pelo fornecedor. “Além disso, conforme mostrou a revista científica BMJ, em aproximadamente 34% dos casos os testes rápidos dão falso negativo”, afirma a diretora.

FONTE: AGÊNCIA BRASIL

 
 
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