Private Health Insurance

12/08/22 Hi, can anyone recommend good private medical insurance in Brazil ...having been insured in Spain, the quotes here are very high in comparison .
-@dt1380

Welcome, dt1380.  Private health insurance plan availability differs by region in Brazil, so your choices will depend on where you live, or plan to live.  The industry is in transition right now, with one of the big national providers currently in disarray.  Existing national providers accepting new subscribers include  Unimed, and SulAmérica.  They are active nationwide, but have better or worse reputations in different places.  Before contracting with one, it's a good idea to find out how extensive their network is and how good their local reputation is where you're going to live or spend a lot of time.  Local web searches and evaluations will be worthwhile.

Some plans only cover certain states.  Hapvida, for example, is very strong in the Northeast and North, has a small presence in the South, and no presence at all in the Southeast.  If you don't plan to spend much time out of their service area, a plan like this could be a good choice.  Some plans are even limited to the principal hospitals of a particular metropolitan area with no services elsewhere.

All private health plans are regulated by ANS, the Agência Nacional de Saúde Suplementar, which defines the treatments and procedures that companies are obliged to cover, the rate structure, and the annual permitted increases.   Pre-existing conditions do not necessarily result in rejection, but there may be a waiting period of up to a year before they are fully covered.  There are two annual price adjustments, one based on age and the other on actual cost of care.

Initial pricing is based on age, and rises annually with the client's age up to age 60; after that, age-based increases stop.  The annual rate adjustment is based on the actual cost of care for the preceding year.  The intent is to reimburse the carrier for actual costs incurred, and will change annually on that basis.  In 2021, this actually resulted in rate reduction for some plans. 

Average monthly rates for a middle-aged adult are currently around R$600.  For someone 60 or older, they're around R$900 - R$1000.  For younger people, they're proportionately lower.

Thanks very much for that information, l will do as you suggest

Best Regards

Hello there,

As a quick note, it is important to mention that private health insurance also depends on what hospitals you plan on using. As I live in São Paulo, we have some of the best hospitals in Brazil here, including: Oswaldo Cruz, Einstein and Hospital Sírio Libanês. If you want these hospitals on your plan, you will pay a fortune, it doesn´t really matter what age you are. There are also other perks like helicopter service if you get hurt in the Amazon jungle or while traveling in parts of ´no man´s land´ Brazil and have a possible stroke, food poisioning, disease, get bit by a deadly scorpion or whatnot.

Your insurance will also increase depending on the type of laboratory you want to use. The best laboratories are more expensive, of course. I am in my early 40s and pay almost 1,500 Brazilian Rios just for myself. So, you need to be prepared for all this financially. If you work for a company as a registered worker, they will give you health insurance, like in the US. If you are freelance, you will pay out of pocket as I do. It sucks, and it is expensive.. but we own our own house which makes things easier as we don´t pay rent. The health insurance is like a rent every month. YOU need health insurance as the public hospitals (despite what Brazilians might tell you) are not trustworthy. Doctors are underpaid in general, overworked, in a bad mood and most just really don´t care about you. They also do not have all the equipment for more serious exams ( as I hit my head once and almost died and they told me in a public hospital in Tatuape, SP the special machine to scan my head wasn´t working and there wasn´t another one for at least 200 kilometers or more) and you run the risk of dying or being misdiagnosed. I could have died that day at 37 years old from bleeding to the brain and they really just didn´t care. I waited 7 hours for them to tell me that f**cking machine wasn´t working, in pain, scared and alone. Everytime I got up to ask them about the machine they told me to sit down and just deal with it. I was bothering them. This is in Tatuape, one of the wealthier areas of SP.

Some people love public hospitals in Brazil. That is their problem. Let them deal with the consequences after hitting their head or having a stroke. Do you want to take that risk?

Devorah.

12/09/22 Devorah is correct that São Paulo is probably more expensive; Rio de Janeiro and perhaps Brasília will be similar. The ballpark numbers I gave above were national averages. Once you consider the next tier of (very livable) cities, like Fortaleza, Belo Horizonte, Salvador, etc., prices start edging down. Most large to medium-sized state capitals will have a reasonable selection of cost vs. level of care. Anywhere you are, it pays to shop around.

The hospitals that Devorah mentions are on a par with the Mayo Clinic, Massachusetts General in Boston, the University of Chicago Hospitals, or Mount Sinai and Sloan Kettering in New York; in fact, a lot of their practitioners and some of their administrators probably trained in one or more of those places, or their European counterparts. If cost keeps those from being your regular care providers in the US, you're probably not going to be able to afford them here, either unless, as she says, you have a boutique health plan provided by your employer. Fortunately there are still many good providers to choose from available through standard plans.

Since the initial question strongly considered cost I didn't address boutique plans, but above even the boutique level, "concierge medicine" is also alive and doing very, very well in Brazil. Hospitals like the one in São Paulo where Bolsonaro goes to be treated for the ongoing effects of the 2018 assassination attempt, the Vila Nova Star, aren't likely to show up in any advertised plans. I can't tell you much about that system, but if you're lucky enough to be the kind of expat who banks at Estilo (by Banco do Brasil), Personalité (by Itaú) or Bradesco Prime (by Bradesco), I'm sure that your Personal Banker can fill you in.

At the opposite end of the spectrum, SUS isn't as bad as its reputation, and it's better outside the biggest cities. It also shouldn't be judged by its current state, because it took a terrible hit during the pandemic and still hasn't received nearly enough money to recover. It's great for basic care, like vaccines. Still, I can't recommend it as your principal caregiver if you can afford better.