How does the healthcare system work in Brazil, and which travel insurance, health insurance or expat insurance do you need?

How does the health and healthcare system work in Brazil?

Quality of health care in Brazil

• Brazil has a universal public health care system called Sistema Único de Saúde (SUS).
• There is also very large private sector, which is widely used by residents with higher incomes or additional insurance.
• The SUS offers free health care to all residents, including foreigners living or traveling in Brazil.
• Virtually all major Brazilian cities have good health care facilities.
• In remote areas, care can be more limited, sometimes poorer quality and/or unsanitary.

Public Health System (SUS)

• Anyone living in Brazil, including expatriates, emigrants and refugees, can access the public system. You do need a Brazilian ID number and migrant registration card, which you can use to buy an SUS card.
• The quality of care is uneven in public institutions, mainly due to overcrowding, lack of resources in rural areas and long waiting times for non-emergency treatment.
• In public institutions, it can be difficult to communicate in English. In private institutions, English is more often spoken.
• There is a shortage of general practitioner care in public health facilities, as most general practitioners work for private clinics.
• Many expats find that public health care does not always match their expectations or needs.
• Pharmacies in Brazil are usually found in urban centers or they are attached to a hospital. Medications are kept as affordable as possible (often with no co-payment) so that a large portion of the population has access. Pharmacies are usually open until 10 p.m.; some have 24-hour service.
• There are walk-in public health clinics (UBS, Basic Health Units) where you can go mainly for non-urgent care or when you do not have a family doctor. You do need an SUS card for this.

Private health care

• Many expats, despite the higher costs, choose private health care in Brazil. The quality is better to excellent and the facilities are more modern.
• Partly for this reason, it is important to have a good expat/emigrant insurance policy that provides access to this better standard.
• In addition, there are always things you will have to deal with as an expat or emigrant that are not covered “by default” (think repatriation, care by good English-speaking doctors, wider treatment choices, etc.) An (additional) private coverage can fill in the gaps and offer a wider choice of coverage.

Dentist

• Dentists are called “dentista” and you can find them in both public health facilities and private clinics.
• SUS also offers free dental care, but wait times can be very long and the language barrier is also a thing.
• Private dental care is very good, not too expensive and the wait times are shorter. Many people even come to Brazil just for this service.

Maternity care

• Maternity care is offered through the public healthcare system SUS or through private clinics.
• Prenatal checkups are extensive and include multiple appointments, ultrasounds, blood tests, etc.
• In the public sector, this is free, but waiting times are often long. In private care, you will find more flexibility.
• Most deliveries take place in the hospital; more than 50% via cesarean section.
• After delivery, mothers usually stay in the hospital for several days.
• There is no structural home maternity care. So make sure you arrange for someone to do this for you in advance.

How safe and unsafe is a trip or stay in Brazil?

Safety

• Brazil has very high crime rates compared to many other expat destinations. There are large disparities between rich and poor, so there is a lot of petty crime. There is also a chance of more violent incidents from Brazil's many organized crime groups. 
• Favelas, or slums, are neighborhoods in and around cities where you will find many houses close together. They are found in all major cities and are best avoided as expats because the situation there can be dangerous and unpredictable.
• Car hijackings are also common, so make sure you always put your belongings out of sight and keep the doors locked. 
• Among other things, travel through river areas on the border with Colombia, Peru and Venezuela is not recommended because of heavy crime and criminal groups. 
• You can also be mugged in public transport. So better not wear obviously expensive things. 
• There are frequent protests and demonstrations. The situation here can sometimes get out of hand. Avoid these gatherings if you can and follow the local news for updates. 
• Always take a copy of your passport with you. 

Nature

• Brazil has floods in the rainy seasons that can disrupt infrastructure. 
• In the dry season there are often intense forest fires that are very dangerous and unpredictable. 

Disease

• Several tropical diseases are present including Dengue, Malaria, Chikungunya and the Zika virus. So make sure you protect yourself well against mosquitoes! 
• Drinking water and sanitary conditions in Brazil vary greatly depending on where you stay. In cities, access to safe water is often better regulated than in rural or remote areas.
• In Brazil, among other things, you can get Schistosomiasis, a parasitic infection caused by contact with fresh water contaminated with parasites. It is particularly common in the northeast and in the Amazon. 

Traffic

• Brazil is known for its high rate of traffic accidents, mainly due to aggressive driving, poor road conditions and lack of enforcement of traffic rules. 
• Driving after dark, especially in rural areas, can be very dangerous because of poorly lit roads or other vehicles without lights. 
• There is strict legislation regarding drunk driving (the Lei Seca), but it still occurs. 
• Roads in cities can be quite good, but in rural areas are often significantly less so. 

Which work and travel insurance policies are suitable for short and long stays in Brazil?

• Is the trip to Brazil and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Brazil if you are going to live there for a while?

• It is not mandatory to have your own insurance when moving to Brazil, but it is recommended to be able to use private care. Read more about insurances for abroad on Expatinsurances.org.