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The Supreme Federal Court Establishes That the Prohibition of Age-Based Adjustments Applies to All Contracts, Including Those Prior to the Statute of the Elderly, Reinforcing Protection Against Discriminatory Practices in the Supplementary Health Sector.
The Supreme Federal Court (STF) decided that health plans cannot increase the value of premiums for seniors based on age, even in contracts signed before the enactment of the Statute of the Elderly (Law 10.741/2003). The rule expressly prohibits discrimination through differentiated charges based on age and, according to the Court’s understanding, should have universal and immediate application, encompassing all current contracts.
According to the Conjur portal, the judgment was concluded on Wednesday (8), with a majority of the ministers voting to uphold the prohibition. The specific case involved Unimed, which questioned a decision from the Court of Justice of Rio Grande do Sul declaring the increase in premiums for senior beneficiaries abusive. Minister Edson Fachin, the president of the Court, decided to await the conclusion of another similar judgment (ADC 90) before announcing the formal result, to ensure consistency between the decisions on the matter.
Understand the Case and the Impact of the Decision
The action began in 2020, in the virtual plenary, but was transferred to the physical plenary at the request of Minister Gilmar Mendes.
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The original reporter, Minister Rosa Weber (now retired), voted to reject the operators’ appeal, understanding that the Statute of the Elderly has a protective character and prevails over previous contractual clauses.
Rosa Weber’s vote was supported by Ministers Edson Fachin, Alexandre de Moraes, Ricardo Lewandowski, and Celso de Mello, still during the virtual judgment.
Upon the resumption in person, Cármen Lúcia and Gilmar Mendes joined the same understanding.
Thus, a majority of seven votes against two was formed, ensuring that the rule also applies to old contracts.
The divergence was opened by Minister Marco Aurélio Mello (retired), who argued that the rule could not retroact for contracts signed before the 2003 law.
Dias Toffoli agreed with this position, arguing that retroactivity violates the principles of free enterprise and legal certainty.
The Debate on the Retroactivity of the Statute of the Elderly
The central point of the controversy lies in the Declaratory Action of Constitutionality (ADC) 90, filed by the National Confederation of Insurers (CNSeg).
The entity argues that the part of the Statute that prohibits increases due to age should not affect contracts signed before its enactment, which, according to the sector, could compromise legal stability and the actuarial calculations of the operators.
The rapporteur of the ADC, Minister Dias Toffoli, voted in favor of CNSeg’s request, with the support of André Mendonça and Cristiano Zanin.
However, Gilmar Mendes presented a middle-ground vote, allowing the application of the rule to old contracts that have been renewed after 2004, when the Statute came into effect.
The analysis of the ADC was suspended after a request for review by Minister Flávio Dino, who intends to bring the case to the physical plenary.
The Court’s final decision on this action will definitively define the scope of the rule and its practical application in health plan contracts across the country.
Practical Consequences for Consumers and Operators
With the consolidated understanding, the STF reinforces the protective and anti-discriminatory nature of the Statute of the Elderly.
This means that no operator can justify increases solely based on the beneficiary’s age, even if the contract is older than the law.
For consumers, the decision represents greater security and predictability in health plan costs, especially for seniors who, historically, suffered from significant increases after the age of 59.
For the companies in the sector, the decision creates new regulatory and financial challenges, as part of the pricing of these contracts was based on age-related risk.
Consumer defense entities celebrated the decision, noting that it corrects a historical distortion and ensures equal treatment for the most vulnerable beneficiaries.
On the other hand, representatives of the supplementary health sector warn of the risk of increasing the costs of new plans and the impact on the financial sustainability of smaller operators.
The STF established the prohibition of age-based increases in health plans, even in old contracts, reinforcing the protection of the elderly and the social character of the Statute of the Elderly.
Do you believe that this decision will bring more justice and stability to the sector, or do you fear that the costs will be passed on to other users? Share your opinion in the comments we want to hear from those who feel the effects of these changes in the supplementary health system.
Essa decisão serve para planos de saúde empresarial de aposentados que continuaram no mesmo após se desligar da empresa?
Quando eu fiz 59 anos o plano de saúde subiu 109%, quer dizer, me deram um pontapé no traseiro, porque quem no Brasil que recebe 109% de aumento salarial com 59 anos de idade?
O supremo ta mais que certo. Ninguém aguenta pagar um plano de saúde se nao tiver a parte da participação da Enpresa e mesmo assim tem a coparticipação. E sendo que o sus e mantido pelos impostos que a população paga. E tem muito roubo aliás. Se os governantes quiserem mesmo ajudar a população nesse quesito. Poderia fazer uma mensalidade para o sus. Ampliar as estruturas e o atendimento. E fiscalizar com gente séria. Mas no brasil ate dos aposentados tao roubando quem dira de outros setores