FAQs on the Public Health System in Brazil

health insurance scrabble tiles placed on a planner

By Thaina Guimaraes, Senior Manager, Client Solutions and Joara Saraiva, Local Representative, Client Solutions.

Navigating employee benefits in Brazil can be challenging, especially when it comes to health insurance.

According to the Organization for Economic Co-operation and Development (OECD), the Brazilian healthcare system is a “duplicate and supplementary model.” In addition to enjoying Brazil’s universal healthcare system, known as Sistema Único de Saúde (SUS), people can also buy private plans. This enables quicker access to certain services, facilities or professionals.

As part of this model, it is a common practice for employers in Brazil to provide private health insurance to employees. Private insurance plans in Brazil vary, with options including monthly premiums, copayments and different levels of coverage.

Understanding the intricacies of providing private healthcare plans is crucial for employers to make informed decisions. In this blog post, we address several frequently asked questions (FAQs) about private health insurance in Brazil.

What benefits are covered by the public health system? Are all employees automatically entitled?

Brazil’s public health system, Sistema Único de Saúde (SUS) covers a range of services, including medical care, dental care, vision care, inpatient care and approved surgeries. This system aims to provide all Brazilian citizens access to essential health services.

In theory, all employees and citizens are entitled to these benefits without any direct costs. However, the system usually only covers the basics, leading many employers to offer private health insurance.

Patients in the public health system frequently face long wait times to book medical appointments and schedule routine exams. There is also a national queue for surgeries, with emergency cases depending on hospital availability. Smaller towns often lack the necessary health supplies to provide essential care, further complicating access to timely and adequate treatment.

How common is it for employers to provide private health insurance plans to employees?

Most employers in Brazil offer private health insurance in the current landscape. Senior employees are more likely to expect this benefit from employers.

Can employers be selective in providing private health insurance only to certain groups of employees?

This topic is widely debated and there are case laws that have been decided both ways. Generally, employers can offer health insurance to specific groups. However, employees in the same group must receive the same type and level of coverage. For example, all managers earning a similar salary must receive the same plan.

What are customary levels of benefits provided to employees participating in private plans?

Private health insurance plans in Brazil typically vary based on the employee’s role and level within the company. Non-managerial positions commonly receive at least an intermediate-level plan. This may cover client support roles, administrative positions and analysts. These plans offer a standard range of medical services and coverage.

Employers in Brazil usually provide more extensive plans for senior roles or highly paid specialists. This may include managers, executives, directors and CEOs. These plans often include more comprehensive coverage, access to top-tier hospitals and additional benefits.

This tiered approach ensures that the level of health insurance aligns with the employee’s position and responsibilities within the company. It also allows companies to remain competitive in the talent marketplace.

What does private health insurance typically cover?

Private health insurance typically covers a wide range of medical services. This includes:

  • General medical appointments
  • Routine exams
  • Preventive care
  • Hospitalization
  • Physical therapy
  • Psychological therapy
  • Psychiatrist care
  • OBGYN care
  • Oncology treatment
  • Cardiology treatment
  • ENT treatment
  • Vision care
  • Pediatric care
  • Orthopedic treatment
  • Diagnostic services
  • Laboratory exams
  • Various imaging exams (such as ultrasound, X-ray, MRI, CT scan, among others)
  • Emergency care services

Is there a waiting period for employees to start using the plan?

The waiting period varies between employers and is negotiated during the contract phase with the health insurance supplier. It’s common for companies to negotiate favorable plan conditions, sometimes with no waiting period.

How does the EOR hiring model support private health insurance?

An Employer of Record (EOR) solution can be a pivotal tool for simplifying the administration of private health insurance plans in Brazil. By adopting the EOR hiring model, international companies not only manage benefits efficiently but also enhance overall HR management.

Here’s how an EOR solution supports international companies in Brazil:

  • Support with Private Health Insurance: An EOR partner can seamlessly administer private health insurance plans, giving employees comprehensive healthcare coverage. This includes managing both statutory and supplemental benefits, providing a seamless experience for employees and promoting their well-being.
  • Comprehensive HR Management: With an EOR solution, businesses can delegate compliance management, payroll processing and benefits administration tasks to experienced teams. This allows international companies to focus on core business activities while enjoying accurate and timely HR management.
  • Safeguarding Compliance: An EOR partner handles all compliance-related tasks to make sure operations align with Brazilian labor laws and regulations. This proactive approach minimizes risks of non-compliance and potential penalties, providing peace of mind to international companies in Brazil.
  • Local Expertise and Competitive Benefits: EOR partners offer valuable insights into the Brazilian labor market, including an understanding of local customs, regulations and industry practices. Through this expertise, international companies can design competitive benefits packages that meet the needs and expectations of the Brazilian workforce.

Overall, the EOR hiring model allows international companies to remain compliant, streamline HR management and engage top talent in Brazil.

Learn more about regulations and hiring in Brazil here: Hire in Brazil | GoGlobal

Contact us today to discover how the GoGlobal Global Benefits Team can help you design benefits that fuel business expansion and hiring in Brazil.