Has your health insurance refused your treatment? Now what?

Faced with countless denials of treatment by health plans on the grounds that the treatment recommended by the doctor is off label (the indication for use of the drug for that patient is outside the indications approved for that drug by Anvisa), the Superior Court of Justice has ruled in favor of the insured.

The STJ has held, and recently reiterated its position for the disease Lupus erythematosus, that even if the drug prescribed by the doctor was not initially indicated for the disease (since the antineoplastic drug is registered with Anvisa and its application is carried out by a qualified professional), the refusal to pay for it by the health insurance company is undue.

If you are or know someone who is in this situation, I recommend that you go to a professional specializing in medical law as soon as possible and demand that your treatment be covered.