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Private Health Insurance coverage in Brasil

Hello everyone of you expats.
I am a Greek_American  (Dimitrios ) married to a Brasilian woman (MariaCecilia) and both are retiring in 3 months. We have family in USA and Brasil. I am a retired High School teacher and my wife has retired from the retail sales business world.
I would like your input on how to get a private health insurance in Brasil.
Me and my wife  have been looking on getting health coverage while we move for retirement in Sao Paulo or south Minas area in the next two to three months. We have Globo TV at home here in US and we are very aware of the health care situation in Brasil.
Need info from personal experience on how to proceed. We are both of us 60 years old, ok in our current health.
We know that we can use the SUS in Brasil at any moment but we prefer to have a little better coverage and service when we deal with doctors and service in a hospital setting. At the same time we know about the private health care companies and how they treat you when you are retired and over 59 years old.

My question is: Is there any health care company in Brasil  (SAO PAULO area) that will not ask for an arm and a leg in monthly/yearly  fees for us to get a coverage? or We have only one choice to get health coverage through an international health care company?
Thank you so much for any information that is offered! Obrigado!

Have you both looked at your current plans that maybe available through your employers in retirement ?  I carried my Bluecross/Blueshield from my retirement plan and I am also aware of Health care here in Brazil, living in the Northeast of Brazil I am happy I am in good health. My program runs about $600.00 USD per month and as far as I know there's one Hospital here that accepts my plan. If I need severe care I will return to the US. Research and see if you can continue with your pension programs for it may be easier to work with a US source for medical care and maybe cheaper than seeking a new source.

I hope you are seating down because I have bad news when it comes to continuing with health coverage  as a retired teacher.
I was employed by Clark County school district in Las Vegas Nevada. Yes they offer health insurance but it is costing for retirees ( I am not joking) $2000 a month! Yes, so now you know why we have shortage of teachers especially in US! Maybe Nevada is a special case compare other states in US. I am not sure.
So my answer is not possible to carry over my insurance. Thank you though for your answer.
Dimitrios

Hi,

What do you mean by "we are very aware of the healthcare situation in Brasil"? I thought that is was lacking, but since I have moved here I find the healthcare system good. As long as you have insurance coverage, it's in the door and out the door in minimal time. I find it more convenient and faster than my American plan. Well, it was the VA plan so that could be part of the reason I find the healthcare here to be good.

We have used it several times for our children and even ER visits with being admitted. For x-rays it was done within minutes of doctor sending us for them. I found that the medical staff is very accommodating and will do anything to make your stay better.

Now, if you don't have insurance coverage that's another story.

We are younger (40) and have two children. The best insurance we found was Unimed which we have a really good plan and depending on the exchange rate it's about $350 USD a month.

I could of used my VA benefits, but its pay your own bill and submit to get reimbursement. I do not trust the VA and even when I was active duty I got 3 medical bills sent to collection because they didn't want to pay them.

I would venture to say that it depends on where you live for what healthcare is available. We live in a large city that has it all for any healthcare needs. If you live out in the middle of no where then you can expect to have minimal options.

Good luck!

No, we have a good idea about the SUS situation in Brasil. What i was looking about is local or even international companies offering a decent price for two 60 year old persons intending to live in Brasil.
Glad to see that you are having a good price on your insurance coverage for your family. It is of course based on age more than anything else. Enjoy it as long as it lasts and plan for the future. Who knows what it will be when you reach my age. :(
Thanks for sharing your information!

Private healthcare is getting more and more expensive here in Brazil. I get my cover through my employer but my wife doesnt as she is in the public service. So she has to pay for an individual plan; she is 42 years old and she pays R$ 620 per month. Not an insignificant sum, obviously. And it increases each year in line with her age. So, if you are 60 years old, you should expect to pay a fair bit more. Furthermore, it is becoming more difficult to obtain an individual plan; you have to go through an agency and a lot of  healthcare companies don't want to cover individuals. They prefer company plans.

So, as you get older, you really need to consider the cost of good healthcare and the fact that you will need it more. Is it a good idea to retire to Brazil?  Personally, I wouldn't. I would come here on extended vacations but continue living in the US or Canada. The quality of life is better and it's less stressful.   

The public health system in Brazil is terrible; you can wait for 3 days or even die in the corridor in the hospital. This is no exaggeration; it happens. Just by looking at a public hospital you can see there is zero investment and nobody gives a damn.  You really need at least some basic private insurance.

Thank you for your input. We are aware more and more every new day of what you just described. We were not sure though about the cost of private insurance in Brasil. Yesterday we did get quotes from Amil, Unimed and One Health for three specific cities/areas around Sao Paulo and we were shocked. At the same time you can see from my previous posting is crazy here ( in US) too based again where you intent to live.

I guess the message is out and loud wherever you live, "hurry up and die now!" by all private insurance companies!

Hi there,

Having lived in Belo Horizonte and Rio, and being American I definitely recommend that you get coverage before arriving. Yes, I'm answering as an insurance agent as well to be completely upfront. My recommendation is that you purchase an expat health plan from a reputable international company before you go so that you are applying from your home country and would still qualify, then renew it annually.

If you have questions, I can certainly assist.

When we lived there we had UniMed and Allianz coverage. Yes, I do still recommend an expat plan. Better coverage and service for less money usually.

Hi, thanks for your posting/reply.
Do you represent currently a company here in US? If you then are you willing to give a quote? If yes send me an email please. i would be interested to see prices.
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Finding a decent and reasonable local individual plan today is much more difficult  - some would say impossible - than say three or four years ago, and with the lack of competition, much more expensive, as you are discovering. 

Why the scarcity? 

The plans have major protections for policy holders versus group plans, which the insurance companies naturally favor.   For that reason group plan premiums are priced significantly lower than individual plans, at least initially.

Short of fraud, you cannot get kicked off an individual plan for any reason, but that is not the case with a group plan.   They can kick you off at will. 

Also,  premium increases for individual plans, as hefty as they are - this year's increase is again over 14% - are controlled by the health plan regulator, ANS.  Group plan increases are known to be significantly higher than that, and are at the sole discretion of the plan provider, based on usage..... 

For both types of plans, there are age bands of five years apiece where additional premium increases occur.   Unlike in the US, then, you can actually budget for these increases at contract signing.  However, most folks are caught unawares at the highest age band - age 59 - when increases of 70% to over 100% are common.  Check the contract before you sign. 

After age 59, for individual plans, the only increase allowed is the regulator-sanctioned annual premium increase for medical inflation.  However, for group plans, the sky is still the limit.

Keep in mind though that most local plans still do not have any type of co-pay or deductible, but that is changing with new plans.   If you consider these out-of-pocket expenses as embedded with the premium, especially for older plans, then the premiums are not as outrageous - even extremely reasonable. 

Many folks, desperate to find local coverage, form "companies" for the sole purpose of attaining "group"  health insurance.  While initially much less expensive, see the caveats above. 

Finally,  there are no lifetime limits on usage for local plans, unlike international health plans.  A recent thread indicated that international providers commonly set a 1 -2 milion dollar lifetime dollar  limit.  That may be OK for travelers, but that clearly does not qualify as "insurance" for residents.

If you go for a local plan, and are a resident, then you might consider a rider that covers you for  international trips.  That is what I do.

Good points Marcos!

Who is your favored carrier in the local market? Who would you recommend most for individuals getting national coverage vs an expat plan?

Amil is owned by UnitedHealthcare (UHC) and they of course are strongest in Rio/Sao Paulo areas.

Eager to hear who you think would be the best national carriers right now.

Thanks!
Andrew

Andrew:  around three or for years ago I would have recommended Amil hands down.   However, that was obviously in a completely different market environment from today.

Even after their takeover by United Health, when they predictably got a bit more bureaucratic.  Not that I have any major complaints now, here in Rio, with their excellent network, a fully functional website, and if you consider the lack of deductibles/copays, a reasonable premium. 

Problem is, the individual plan I have, and those similar, are not commercialized any longer.  Still,  I know folks, both locals and expats, who have gone the "company" route to obtain a similar "group" plan,  at an initally very interesting discount from individual plans,  but see my post above for certain cautions.

At one point, I considered migrating over to Unimed Rio, as they were a bit more cost-effective, but I am glad I didn't, given their subsequent precarious financial situation, and I would not have been able to switch back.  Note that given their "Co-op" structure, every local Unimed is in a different financial situation.  A year or so back, a Sao Paulo Unimed went belly up, but I understand all planholders were duly accommodated by other plans, mostly other Unimed's. 

Another local option in Rio, with a much more limited network, but with a solid cost-benefit relationship, would be Assim. 

If I were starting this process from scratch, and were looking for a local plan, I would do the following.  I would first research which hospitals or clinics I would definitely want access to, and see which local plans, group or individual, accommodated those places.  After that, I would check  their overall network of medical professionals in terms of proximity to where I lived.  After running cost simulations on the respective plan websites, I would then contact the local plans.  After that initial research I would contact a local insurance broker, just to see if there was something I missed or if they had access to some promotion. 

You could also do something similar with an international plan -  seeing which of your "must have" or preferred local health facilities they support.   The major downside, at least for me, seems to be  their liftetime coverage maximums, but do let me know if that is not your understanding.   

Are you planning to move back here?  Given your background I and I am sure others would be interested in hearing how you end up going about this, and your reasoning in determining whether a local vs international plan was ultimately better for you.  Cheers and do keep us posted.

Hi there Marcos,

Thanks for your insight into Amil since UnitedHealthcare purchased them. I have not kept up with them. I've heard the marketing for Assim Saude but not sure how good it is yet.

Yes, we are planning on moving back but maintaining an address in the US. In doing so, at this point my top choice is the WEA Select plan from the PA Group. I do represent them, along with Cigna, Aetna, etc for group and individual plans.

Over the years I have seen our clients extremely satisfied with the WEA Select plan, and the network for Brazil is outstanding and the cost is significantly less than any other option out there.

It's a constantly changing area so I'll keep up to date. Watching and reading the experiences people have on here and other boards does help too.

One area that many overlook in relocating is life insurance, and I do feel it's a crucial plan to keep in it in place, or get started (it's not too late).

Thanks for your comments and do keep it going.
Reach out anytime.

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