Health plan adjustments could reach 6.06% this year, ANS approves

The National Supplementary Health Agency (ANS) approved this Monday (23) the adjustment of up to 6.06% in the monthly payments of individual and family health plans in Brazil. The new rate is valid for the period from May 2025 to April 2026 and may be applied by operators on the anniversary date of each contract, that is, in the month in which the service is contracted.

The percentage was below the increase authorized in the previous cycle, which was 6.91%, and represents the lowest rate since 2021, when there was a negative adjustment of -8.19% due to the reduction in assistance expenses during the Covid-19 pandemic.

The increase, however, will not affect corporate or membership group plans, which represent around 83.5% of the market.

According to the ANS, Brazil had 52.3 million beneficiaries of health insurance plans by April 2025, of which only 8.6 million, or 16.5%, were linked to individual or family contracts. The other modalities, which include corporate, membership and unidentified contracts, totaled 43.7 million users.

Although the Broad National Consumer Price Index (IPCA), which measures the country's official inflation, accumulated an increase of 4.83% in 2024 and 5.32% in the 12 months up to May 2025, the ANS avoids making direct comparisons with the readjustment of plans.

According to the agency, the calculation of the percentage takes into account not only the price variation calculated by the IPCA, but also the frequency of use of health services by beneficiaries.

“Therefore, the percentage calculated by ANS considers aspects such as changes in the prices of health products and services, as well as changes in the frequency of use of health services,” the agency explained in a note.

According to the agency, per capita healthcare expenses in regulated individual plans grew by 9.35% in 2024 compared to 2023. This variation in healthcare costs, it says, reflects the increase in the prices of healthcare services and supplies, “as well as an increase in the pattern of consumption of healthcare services associated with incorporations into the list of supplementary healthcare procedures”.