I pay how much for my prescriptions in Brazil?

by Brett Andrews

About Healthcare in Brazil

Brazil considers healthcare a constitutional right, offering universal coverage to everyone within its borders, regardless of legal status. Their public health system, known as Sistema Único de Saúde (SUS), covers comprehensive services in primary, specialty, mental health, and hospitalization. Care can be slow, so about 25% of residents add private health insurance to get around these delays. 

Brazil’s SUS is rare in its accessibility and breadth of coverage. There’s no application process to delay care access. It also covers health services like dentistry, optometry, physical therapy and wheelchairs——healthcare needs often excluded in other universal care systems. Common conditions like diabetes get free medication, while prescription drugs requiring payment see discounts up to 90%.  

Brazil’s public healthcare system doesn’t use deductibles or copays, aside from small fees on some medications. However, service in the public system is often slow and overcrowded, especially in less-populated areas. Emergency medical services also lag behind the US system, largely because it just became a trained specialty in 1996. The country is aggressively working to minimize the shortages.

Private health insurance fills in the gaps left by the public plan, or even replaces it entirely. As with many countries, private coverage pays for private clinics and hospitals, which may offer faster service or more individualized care. About 70% of those who carry private insurance get it through work, though individuals can buy, as well. Private health insurance costs may be tax deductible in Brazil.

Pharmacies can be found throughout Brazil, most often in city centers or attached to hospitals. The government invested heavily in generic drug production to keep medications fairly affordable for the population. Pharmacies are usually open until 10p, with some offering 24-hour access. The UN Refugee Agency offers more information about locating pharmacies and finding medicines for reduced costs.

Finding a Physician

Finding your new general physician (GP) in Brazil requires a few steps. First, apply for your Cadastro de Pessoa Física (CPF), Brazil’s ID number, either online or in person. Next, get your migratory registry card from the Federal Police office in your area. Finally, take these to your local Basic Health Unit (UBS) to get your SUS card and request a GP. These steps are laid out here and here.

SUS allows for patients to see a specialist after discharge from the hospital. Otherwise, you’ll need a referral from your GP or walk-in clinic to see a specialist. Walk-in clinics like UBS are common choices for non-urgent care or if you don’t currently have a GP.

Public Healthcare

Public healthcare is available to all Brazilian residents, including refugees and expats. SUS, the public health system, covers costs for all medical care. Aside from some prescription drugs, there are no out-of-pocket fees for using SUS, the public healthcare system. 

Expats can register for Brazil’s public healthcare after arriving in the country. Follow the steps described in the previous section to get registered in the public system. Since public healthcare is a constitutional right in Brazil, you can’t be denied care for preexisting conditions in the public system.

Brazil’s public health coverage is strongest around larger cities; consider cities like São Paulo, Rio de Janeiro and Curitiba for best results. Healthcare gets slower around smaller cities, though Brazil is working to overcome this.

Private Healthcare

Private health insurance offers many benefits, including shorter wait times, access to private care facilities, and reimbursement for healthcare services. About one-quarter of residents keep private health coverage in Brazil, often given by their employers.

Private health insurance comes with the usual perks these plans have in countries with universal healthcare: private clinics and hospitals, shorter wait times, and offset out-of-pocket costs. These plans tend to fill in coverage gaps from a country’s public system, but Brazil’s SUS covers all areas of care. When shopping for a private plan, confirm that pre-existing conditions are covered in a new policy.

Terms and conditions vary among private health insurers. Some companies require you to pay for care upfront and file for reimbursement. Others pay the costs for private healthcare immediately. Research your options carefully to understand their terms and whether the insurer covers your pre-existing conditions.

Out-of-pocket Options

Paying out of pocket for medical treatment is certainly an option in Brazil, though not recommended. Expats paying out of pocket may use both the public and private health systems. Walk-in clinics may provide a cost-effective solution for out-of-pocket care. Uninsured expats are treated as private-pay patients under Brazil, including for emergency services. We strongly recommend carrying travel insurance during scouting trips and either public or private health insurance during your time in Brazil.

Healthcare Checklist

• Schedule final appointments with your primary care physician and any specialists you see.
• Research your medications for availability in Brazil and find alternatives where needed.
• Stock up on prescription refills until you can get to the pharmacy in Brazil. It’s a dance because you’ll save money by filling your prescriptions in country, but it may take time for you to learn your way around. 
• Print out and keep photographic records of all prescriptions. Bring meds in original packaging with a letter from your doctor detailing your condition, the drug, and its generic name.
• Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work.
• Ask your providers for referrals abroad. You never know!
• People often find physicians by word of mouth. Ask for recommendations from your local pharmacist, neighbors, or expat Facebook group.
• For public healthcare, visit your local Basic Health Unit (UBS) to get your SUS card. Additional steps may apply.
• For private healthcare, apply for private insurance directly or ask your Brazilian employer. Visit your expat Facebook group to get recommendations.
• See your family doctor and get prescriptions and referrals.