ANS establishes deadlines for health insurance medical appointments

Health insurance users frequently report difficulties scheduling medical appointments, often facing wait times of two to three months. However, the National Supplementary Health Agency (ANS) establishes specific maximum deadlines for guaranteed care once contractual grace periods are met.

According to ANS regulations, basic consultations in areas such as pediatrics, general medicine, surgery, gynecology, and obstetrics must be provided within seven business days. Other specialties, including cardiology, neurology, endocrinology, and dermatology, have a maximum deadline of 14 business days. Consultations with psychologists, nutritionists, physiotherapists, and other allied health professionals must occur within ten business days.

Diagnostic services also have regulated timelines: clinical analysis laboratory exams must be provided within three business days, while other diagnostic and outpatient therapy services must be available within ten business days. High-complexity procedures and elective hospitalizations have a maximum window of 21 business days. In cases of urgency and emergency, service must be immediate. These regulations require providers to offer a qualified professional within the network, though they do not guarantee a specific doctor chosen by the patient.