“I have private health insurance, can I use the SUS?” It is a common question, often carrying a bit of guilt: would it be “jumping the queue” ahead of those without insurance? The legal answer is clear and lifts that weight: yes, you can, and using the SUS takes nothing away from anyone. This guide explains why and how, and it applies whether you are Brazilian or a foreign resident with private insurance.
The SUS belongs to everyone, including those with insurance
The SUS is universal: access is a right of anyone in Brazil, regardless of having insurance, a job or income. Having private insurance excludes no one from the public system. In practice, everyone already uses the SUS in some way, through vaccination, health surveillance, the SAMU ambulance, blood banks, or an emergency far from home.
When it makes sense to use the SUS even with insurance
- What insurance does not cover: public-calendar vaccines, certain specific programs, high-cost medication supplied by the State;
- Centers of excellence that are references within the SUS: some of the country’s best transplant, oncology and complex-disease centers are public;
- Emergency: in the moment of urgency, what matters is the nearest door, as explained in emergency care in Brazil: where to go.
The bill that is not yours: reimbursement to the SUS
Here is the point that undoes the guilt. When an insured patient uses the SUS for care the insurer should have covered, the insurer is required to reimburse the public system, this is the “ressarcimento ao SUS”. In other words: the cost goes back to whoever received your premium, not to other users. You did not “jump” anyone’s queue; it is the insurer that ends up owing the SUS.
Using the SUS while having insurance is a right, not a workaround. This guide is part of our practical series on how to use the SUS.
About the author
Ramon Martins Andrade (OAB/RJ 188.374) is a lawyer graduated from UFRJ in 2011, holding master’s degrees from the Université Sorbonne Nouvelle and from the Brazilian Naval War College (EGN). He is currently a researcher in Human Rights and Health at ENSP/Fiocruz, where the concept of sanitary return emerged from his research in study groups on the Brazilian diaspora and access to healthcare.
This content is for informational and educational purposes only. It does not constitute legal advice, advertising of results, or any guarantee of outcome, under Rule (Provimento) 205/2021 of the Brazilian Bar Association (OAB).