Public vs Private Healthcare in Brasil

Brasil has two healthcare systems running side by side. One is public and free at the point of use: the Sistema Único de Saúde, or SUS. The other is private, paid for out of pocket or through health plans. Most residents use one, the other, or both, depending on the need.

This guide explains how they fit together for a newcomer. It is general information, not medical advice. In an emergency, call 192. See Emergency numbers.

The SUS: universal and free

The Ministry of Health describes the SUS as universal and free. The Ministry of Justice page on public services for migrants states that access does not depend on your migratory status. The Ministry of Health page for travelers says that foreign visitors can also be seen in urgent and emergency care.

In practice, the SUS has three doors that matter to most people:

• UBS, the basic health unit. The neighborhood clinic for primary care: check-ups, vaccines, prescriptions, routine follow-up. You are generally served by the UBS for your address.
• UPA 24h, the emergency care unit. For urgent problems that are not life-threatening at night or on weekends.
• SAMU 192. The mobile emergency service. It sends an ambulance or gives guidance by phone.

Hospitals sit behind these doors and take referrals and emergencies.

The Cartão SUS

The Cartão Nacional de Saúde, usually called the Cartão SUS, is your record in the public system. The Ministry of Health recommends having one. You request it at a UBS, and a foreigner can do so with a passport. Bring proof of address if you have it. Requirements can vary by city; check the official page and ask at your UBS.

Private care

Private care ranges from single clinics to large hospital networks. People use it for a few reasons:

• Shorter waits for specialists and elective procedures.
• Choice of doctor and hospital.
• English-speaking doctors, which are easier to find in private practice in large cities.

You can pay per visit, or join a health plan, called a plano de saúde or convênio. Plans vary widely in coverage, network and waiting periods. Read the contract carefully, especially the waiting periods for pre-existing conditions. Also see Health insurance abroad for how international plans compare.

Choosing where to go

A simple rule of thumb:

• Life-threatening emergency: call 192, or go to the nearest hospital emergency department.
• Urgent but not life-threatening, outside office hours: a UPA 24h, or a private emergency room if you have a plan.
• Routine care, vaccines, a repeat prescription: your UBS, or a private clinic.
• Specialist care: through a referral from the UBS in the SUS, or directly in the private system.

Practical notes

• Find your UBS early. Locate it when you move in, not when you are sick.
• Keep a short medical summary. A one-page list of your conditions, medicines and allergies, with a Portuguese version, saves time in any clinic.
• Learn the key words. Dor (pain), febre (fever), alergia (allergy), remédio (medicine), receita (prescription). See Survival Portuguese.
• Medicines. Pharmacies are covered in Pharmacies and over-the-counter medicine.

Checklist

1. Find the UBS for your address and the nearest UPA 24h.
2. Request your Cartão SUS with your passport.
3. Decide whether you want a private plan, and read the waiting periods.
4. Save 192 and the address of your nearest hospital in your phone.
5. Prepare a short medical summary in English and Portuguese.

Common questions

Will I be charged at a SUS unit? The SUS is free at the point of use, according to the Ministry of Health. Private clinics charge.

Can I use the SUS and a private plan? Yes, the systems coexist. Check the official page for any details that apply to your situation.

Mistakes to avoid

• Waiting until you are sick to find your clinic. The first visit to a UBS is easier when you are well and have time to ask questions.
• Buying a private plan without reading the waiting periods. A plan that does not cover your condition for months is not the plan you thought you bought.
• Going to an emergency department for a routine problem. It is slower for you and for the people who need it. Use the UBS or a clinic.
• Not carrying any medical summary. A short list of conditions, medicines and allergies helps any doctor, in any system.