Healthcare in Brazil: the SUS is there for everyone, and the plano de saúde has waiting periods from 24 hours to 300 days

No, the Netherlands does not keep paying for your care in Brazil. Brazil is not on NederlandWereldwijd's list of treaty countries nor on that of the CAK; the social security treaty that both countries signed in Brasília in 2002 "enters into force on a date yet to be determined" and after more than twenty years still has not. So no S1, no treaty contribution, and your basic insurance ends on the day of your deregistration. What takes its place costs two things: nothing, for the public system the constitution promises to everyone, and a monthly premium for the plano de saúde with which you bypass the waiting lists. The pitfall is the order: the visa requires the policy before you even leave, and the policy itself makes you wait up to 180 days for everything that is not an emergency.

	SUS	Plano de saúde
For whom	everyone in Brazil, migrants too, whatever their status	whoever takes out a policy
Cost	none	premium per insurer, rising with age
Waiting period	none in law, but waiting lists	at most 24 hours emergencies, 180 days other, 300 days childbirth
Pre-existing conditions	covered	exclusion possible up to 24 months after the start
For the visa	does not count	a policy valid in Brazil is a condition

May I use the SUS as a foreigner?

Yes, and that is written in three places. Article 196 of the constitution calls health "a right of all and a duty of the state", with "universal and equal access" to care. Article 2 of the law on the Sistema Único de Saúde repeats it as a fundamental right. And article 4 of the migration law of 2017 gives the migrant "access to the public services of health and social assistance, without discrimination by nationality and migratory status". So you do not have to wait for your residence card to knock on the door of the neighbourhood post, the unidade básica de saúde; bring your passport and your CPF and have yourself registered at the post of your neighbourhood.

What the SUS is not, is fast or comfortable. For a specialist or a planned procedure the waiting lists are long and the differences between city and countryside large. That is why whoever can afford it takes a plano de saúde alongside: the SUS as a safety net and for emergencies, the plano for speed and for the private clinics.

What does the law regulate for the plano de saúde?

The planos privados de assistência à saúde fall under Lei 9.656 of 1998 and under the supervision of the ANS, the Agência Nacional de Saúde Suplementar. Article 12 caps the carência, the waiting period after taking out the policy: at most 24 hours for urgencies and emergencies, at most 180 days for all other care, and at most 300 days for a full-term birth. The ANS adds that these are maximums: an insurer may go shorter, never longer.

Article 11 is about what you already had. An insurer may not exclude a pre-existing condition for longer than 24 months after the start of the contract, and must prove itself that you knew about it. Whoever leaves with a chronic condition therefore counts on two years in which that condition leans on the SUS, and asks the insurer in writing what exactly is excluded.

The 180 days only start with the Brazilian policy. A travel insurance or international policy you take out for the visa does not count as waiting period served with a Brazilian insurer. Whoever switches after arrival starts counting again. Count the first six months double: the visa's policy for cover, the plano for the future.

Which policy does the visa require?

Resolução Normativa 40/2019 for retirees lists among the documents for the consulate "health insurance valid in the national territory", and the other routes ask the same. The consulate in Amsterdam wants to see that policy at the application. That can be an international insurance that covers Brazil; it has to say so, not just "worldwide" if you are not sure. Such a policy has, by Dutch standards, high entry limits on age and excludes what exists; ask the acceptance question months before you cancel the Dutch one.

The order that prevents a gap

First the policy for the visa, before the application at the consulate. Then let the Dutch basic insurance end on the day of deregistration, not earlier. In the first weeks in Brazil the registration at the neighbourhood post of the SUS and the choice of a plano de saúde, with the waiting periods in hand. And cancel the international policy only once the 180 days of the plano are over. Medicines you use daily you bring for the first months; the SUS supplies on prescription, but not every Dutch brand.

What is not here: what a plano de saúde costs. That differs per insurer, per age and per city, and the ANS publishes the insurers but not the premiums; ask for three quotes, with the carência and the exclusions on paper.

In Vertrekklaar this is phase 1 of 5 of the journey, step 1.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Brazil or go straight to step 1.2 in the open plan.