Healthcare system in Brazil

Public healthcare in Brazil is the world’s largest publicly administered healthcare system. Since its introduction in 1988, it has made great strides in improving the health of the Brazilian population. Open to everyone, including expats and tourists, the system exists to ensure that all who live in Brazil or visit the country have fair and equal access to suitable care. For most expats this is perhaps a surprise. In many countries, an international health insurance policy is recommended. While this isn’t strictly required in Brazil, there are plenty of reasons why it may be more beneficial. For example, there are limits to what is covered by Brazil’s public health service, meaning that some treatments or medications may come at a cost.

Overall, the quality of care offered by the public system in Brazil is good. However, Brazil is a vast country, and the quality of healthcare in rural areas like Pindorama, Pipa, and Jericoacoara will be vastly different to what you may find in Rio or Fortaleza. Furthermore, all public healthcare facilities across the country can get overcrowded quickly. This leads to long waiting times and overstretched facilities unable to keep up with demand.

To register for the public healthcare service in Brazil is easy. There is no waiting list to join, and as long as you hold a CPF taxpayer number and a National Migratory Registry Card, you are eligible to use the system.  Present the CPF and National Migratory Registry Card at a hospital, clinic or municipal health office, and your CNS (National Health Card) will be granted the same day. For expats it is no different.

Private healthcare in Brazil is often the preferred option for expats. With vastly shorter wait times than found in the public sector, less of a language barrier between patients and professionals and a higher quality of care, it provides a valued safety net when living in a new country. Most urban areas of Brazil have at least one private healthcare facility available, and as you approach the more popular cities, this number increases.

The costs of private healthcare in Brazil vary, and it’s been widely reported that the charges for treatment have risen substantially over the past decade. At the time of writing, it was generally accepted that Brazil had one of, if not the most expensive, private healthcare systems in Latin America. A visit to a GP may cost between £25 and £100, whereas a surgical procedure may incur a fee of almost £4,000. A single day in a private hospital could cost £2,000, and in most cases, this does not include the cost of treatment or any tests.

Brazil is a large country, and you’ll find a wealth of private hospitals spread across the nation. Some of the most recognised and respected include Hospital Israelita Albert Einstein (São Paulo), Hospital Alemao Oswaldo Cruz (São Paulo), and the Rede D’or São Luiz network of private hospitals found across the country.

With the high costs within the private healthcare system, private health insurance is recommended for expats who want to receive the best possible treatment without the vast expense. At Expatriate Group, we offer comprehensive international health insurance plans. This means that you remain covered in Brazil and anywhere else you may need to visit.

Health insurance is not mandatory for expats living in Brazil, but it is recommended. Whilst the SUS remains an option for everyone, the long wait times, occasional rationing of medications and variable treatment levels across the country mean the public system may not always be ideal.

Having a private healthcare insurance policy means you avoid potential delays in treatment and have access to the best possible care without the huge expense it may otherwise incur.

When choosing how to insure yourself in Brazil, you have a variety of plans available. You can have local cover, which comes in four variations or an international plan. Local policies are less expensive than international plans, but they do come with some strict caveats. For example, a planos de saúde enables you to receive treatment from doctors and specific medical establishments but only within certain zones of the country. All variants of local plans only allow for coverage within Brazil.

Opting for an international health insurance plan may cost you more, but its coverage is more inclusive. With broader and more flexible coverage, you remain covered when you leave Brazil but also stand to benefit from enhanced care when in the country. You have more freedom in choosing a doctor, and you find that treatment options are more wide-ranging.

In most cases, local and international health insurance policies have specific exclusions included within their terms. These are often for pre-existing conditions, cosmetic surgery and more. Before committing to a policy, it would be wise to check whether exclusions are mentioned in case they apply to you.

The cost of private health insurance for expats in Brazil varies depending on many factors. Your age, current health status, type of cover and your chosen insurer all play a part. For a low-level policy, you might pay £80 per month.  For a more comprehensive plan, it could cost £400 per month. Local plans cost less than international plans, but do not always provide the necessary coverage. If you have relocated for work, your employer may cover the cost or offer a discounted insurance package. Should that not be the case, you can source insurance from a range of companies. It is advisable to get three to five quotes first so you can compare the cost to coverage.

Brazil has a wide range of hospitals varying in size and quality. Whilst public hospitals can sometimes be found to lack suitable facilities and be overcrowded, the private hospitals are considerably different. 60% of the hospitals found in Brazil are private, and among them, six featured within Newsweek’s “Best Hospitals in the World 2024”. That is not to say all the public hospitals are of poor quality. Twenty-five hospitals across the two sectors are now JCI-accredited, and many hospitals throughout the country work alongside other international medical institutes to share knowledge and enhance care.

English is not a native language of Brazil, so there can often be a language barrier, especially when you use the public system. Luckily, many private hospitals throughout the country have well-trained, multilingual staff or interpreters, making a visit or stay much easier for English-speaking expats. It would be advisable to check what services are available in advance, so you don’t get caught out.

Throughout Brazil there is a wide range of excellent hospitals across some of the major cities. With more than 6,000 hospitals in the country, it can be easy to find inadequate care. Some of the best include Hospital Israelita Albert Einstein and Hospital Sirio-Libanes in São Paolo, Hospital Itamed in Paraná and Hospital Mae de Deus. All exhibit high levels of care, dedicated staff and excellent treatment facilities.

Many public hospitals across Brazil offer essential medical care such as treatment for common illnesses, emergency care and surgery. However, the disparity of care made available can vary between regions. It is not uncommon for some remote areas to offer a basic appointment before recommending that you visit a larger city-based hospital for treatment. Larger hospitals provide more specialised treatment. Hospital das Clinicas in São Paolo, for example, is a public hospital providing cardiology, oncology and neurosurgery treatment among many others.

Private hospitals in Brazil offer a full range of treatments, with some specialising in specific areas of medicine. Hospital de Coracao, for example, is renowned for its heart treatments.

The process for hospital admission in Brazil varies between the private and public sectors. In emergencies, hospitals will accept walk-ins, but patients are triaged and then treated in order of urgency. For non-emergencies, you will first need to be seen at a UBS (Basic Health Unit), where the doctor will then refer you to a hospital.

Within the private sector, patients can book consultations with on-site specialists and then be admitted should hospitalisation be required. In the case of emergencies, walk-ins are accepted, but similar to the public sector, patients are triaged before admission.

With SUS, you’ll pay nothing for treatment in a public Brazilian hospital unless you are attending for cosmetic or elective procedures. In some cases, dental care may also come at a cost, but this depends on the treatment required. In addition, certain high-cost medications are exempt from SUS coverage, meaning you will have to pay.

Private hospitals will charge regardless of the treatment required, and presently, their costs rank among the highest in Latin America. A consultation may cost £25-£100, and a surgery could cost £4,000 or more. Additional costs can then be added for overnight stays, room types and any extra support you may require.

Public hospitals in Brazil range from excellent to poor. They can offer fantastic facilities, especially in major cities, but can be found lacking essentials in rural areas. With a large percentage of the population relying on the public system, hospitals and clinics soon become crowded, leaving patients waiting a long time to be seen.

In contrast, private facilities are much larger, better equipped and provide a more personalised service in pleasant and comfortable surroundings.

Health insurance will be accepted in the majority of private Brazilian hospitals. The way treatment is paid for may vary per facility. Some may request payment upfront, with you claiming afterwards. Others may allow you to make a claim pre-treatment.

Most private hospitals in Argentina accept local health insurance (prepagas) and some international insurance plans. However, international coverage may be limited, so expats often choose local insurance for better access and coverage within the country’s healthcare system.

Before moving to Brazil, you should ensure your routine vaccinations are up to date. This would include MMR, diphtheria, polio and tetanus. There are no mandatory vaccines required for entry to Brazil, but yellow fever, rabies and typhoid vaccinations are recommended.

As global health can change quickly, speak to your GP before you leave to discover whether any other specific vaccinations are necessary.

With no specific vaccination requirements for entry into Brazil, you are, for the most part, safe. However, there are risks of Schistosomiasis, a parasitic infection that can be caught when bathing in freshwater rivers or streams. Zika virus and Dengue fever are also concerns, so you must protect yourself from mosquito bites.

For some people, altitude sickness and heat-related illnesses are also possible in Brazil. These can be prevented by gradual movement through altitude and using appropriate sun protection.

At the time of writing, Brazil was experiencing an Oropouche virus outbreak. There is currently no vaccine to prevent it, so it is important to follow standard bite avoidance measures when in areas where the virus is present.