Um benefici\u00e1rio de plano de sa\u00fade acionou a Justi\u00e7a Federal a fim de garantir a cobertura da realiza\u00e7\u00e3o de tratamento cir\u00fargico para epilepsia com a coloca\u00e7\u00e3o de estimulador de nervo vago. O procedimento foi negado pela operadora do plano com a justificativa de que o tratamento \u00e9 ineficaz na maioria dos casos.<\/p>\n\n\n\n
A 6\u00aa Turma do TRF1 entendeu que cabe somente ao m\u00e9dico do paciente estabelecer o tratamento para curar ou amenizar os efeitos da doen\u00e7a, sendo dever do plano a garantia de que o segurado receba o tratamento adequado e necess\u00e1rio para a sa\u00fade do cliente.<\/p>\n\n\n\n
Segundo o relator, desembargador federal Jirair Aram Meguerian, a pr\u00f3pria junta m\u00e9dica a servi\u00e7o do plano de sa\u00fade \u201creconhece que a terapia de implanta\u00e7\u00e3o de est\u00edmulo de nervo vago trar\u00e1 benef\u00edcios para o autor, embora n\u00e3o esteja prevista pela ANS ou pelo plano de sa\u00fade\u201d.<\/p>\n\n\n\n
Nesses termos, o Colegiado decidiu que o requerente tem direito \u00e0 cobertura do tratamento por neuroestimula\u00e7\u00e3o, mesmo que este n\u00e3o conste no rol de procedimentos da Ag\u00eancia Nacional de Sa\u00fade (ANS), sendo incab\u00edvel que o plano negue tratamento \u00e0 doen\u00e7a que n\u00e3o esteja exclu\u00edda do contrato.<\/p>\n\n\n\n
Processo: 0021376-69.2013.4.01.3800<\/p>\n\n\n\n
TRF1 10.11.2020<\/p>\n","protected":false},"excerpt":{"rendered":"
\u201creconhece que a terapia de implanta\u00e7\u00e3o de est\u00edmulo de nervo vago trar\u00e1 benef\u00edcios para o autor, embora n\u00e3o esteja prevista pela ANS ou pelo plano de sa\u00fade\u201d.<\/p>\n","protected":false},"author":1,"featured_media":644,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","jetpack_publicize_message":"","jetpack_is_tweetstorm":false,"jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[11,28],"tags":[407,626,256,627,467],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=1880%2C1253&ssl=1","featured_image_urls":{"full":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=1880%2C1253&ssl=1",1880,1253,false],"thumbnail":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?resize=150%2C150&ssl=1",150,150,true],"medium":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=300%2C200&ssl=1",300,200,true],"medium_large":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=640%2C427&ssl=1",640,427,true],"large":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=640%2C426&ssl=1",640,426,true],"1536x1536":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=1536%2C1024&ssl=1",1536,1024,true],"2048x2048":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=1880%2C1253&ssl=1",1880,1253,true],"covernews-slider-full":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?resize=1077%2C715&ssl=1",1077,715,true],"covernews-slider-center":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?resize=522%2C500&ssl=1",522,500,true],"covernews-featured":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?fit=1024%2C682&ssl=1",1024,682,true],"covernews-medium":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?resize=540%2C285&ssl=1",540,285,true],"covernews-medium-square":["https:\/\/i0.wp.com\/blog.bfsadvocacia.com.br\/wp-content\/uploads\/2020\/11\/pexels-photo-1250655.jpeg?resize=375%2C250&ssl=1",375,250,true]},"author_info":{"display_name":"bfsadvocacia","author_link":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/author\/bfsadvocacia\/"},"category_info":"advogado sp<\/a> atualidades jur\u00eddicas<\/a>","tag_info":"atualidades jur\u00eddicas","comment_count":"0","amp_enabled":true,"_links":{"self":[{"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/posts\/643"}],"collection":[{"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/comments?post=643"}],"version-history":[{"count":1,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/posts\/643\/revisions"}],"predecessor-version":[{"id":645,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/posts\/643\/revisions\/645"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/media\/644"}],"wp:attachment":[{"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/media?parent=643"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/categories?post=643"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.bfsadvocacia.com.br\/index.php\/wp-json\/wp\/v2\/tags?post=643"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}