The Health Insurance System in Brazil

Understand which medical costs are covered by insurers and patients, how to pay for medical care and what social security benefits are available...

Though covered by the Unified Health System (Sistema Único de Saúde /SUS), many foreign residents opt for a private health insurance (seguro de saúde). Generally expatriate employees are insured through their employer's health insurance.

A number of Brazilian and international companies offer a wide range of health insurance packages including some of the larger Brazilian banks, such as Bradesco and Unibanco. Many Brazilian companies provide health insurance as part of a combined health and life insurance package (seguro vida), so it is advisable to check the policy carefully if only health insurance is required.

The cost varies depending on the coverage provided and the region of residence. It may be possible for some foreign residents to use health insurance coverage from their home countries if their country and insurance policy has participating doctors in Brazil.

There is a difference in Brazil between a Health Plan (plano de saúde) and Health Insurance (seguro de saúde). Although both vary widely in cost and coverage, the general characteristics of each are:

A health plan is:

  • Restricted to a particular geographical region
  • More expensive than Health Insurance
  • Offers 100 per cent cost coverage
  • Offers few or no choices when it comes to choosing a doctor
  • Like the United States Health Management Organizations (HMOs), providers of health plans tend to offer both coverage and care

Health Insurance:

  • Usually covers medical care regardless of where in Brazil the patient
  • Is less expensive than a Health Plan
  • Is usually managed by a company, not a network of hospitals or clinics
  • Offers more choices of doctors
  • Usually does not offer 100 per cent cost coverage

 

The following documents are required to obtain health insurance:

  • Passport
  • Foreigner's identity number (Registro National De Estrangeiro/RNE)
  • Individual Tax Payers Number (Cadastro de Pessoa Física/CPF)

Hospital bills/payments

Private hospitals may ask for a large financial deposit on admission, or before carrying out any surgery and treatment if the patient is uninsured. If the patient is insured, the hospital usually contacts the insurance company who then communicates with, and pays the hospital directly. If the hospital bill is more than the cover allows, the patient is required to pay the outstanding balance before being discharged from the hospital.

Private health insurance policies have varying terms and conditions. For example, some require the policy holder to pay the hospital bill up front and then obtain reimbursement from the insurance company; other insurance companies will pay the bill immediately. Primary care doctors may require immediate cash payment for their services. Private insurance companies usually issue a health card which should be carried at all times.

It is suggested to check policies carefully as many will not cover pre-existing conditions or chronic medical conditions.

Social Security Benefits

The Brazilian Ministry of Social Welfare (Ministério da Previdência Social) is responsible for implementing government policy on social welfare and organizing payment of social security benefits. There are some benefits available to foreigners in Brazil. In order to qualify, applicants must have a valid work permit and have made a certain number of contributions as required by the Ministry.

Benefits available include:

  • Sickness and injury benefit
  • Maternity benefit
  • Invalidity benefit
  • Survivor/death benefit
  • Unemployment benefit