ANS Consumer Guide: Who Qualifies and What You Get
Learn how to access information about your legal rights and medical coverage if you hold private health insurance in Brazil.
The ANS Consumer Guide provides essential information for people to understand their legal rights and what their private health insurance plans are required to cover.
Who it's for
This guide is specifically designed for individuals who hold private health insurance. If you pay for a private plan rather than relying solely on the public system, this resource is for you.
What you get
You get access to comprehensive information regarding your rights as a consumer of health services. Most importantly, it provides details on coverage, helping you understand which medical procedures, treatments, and services your insurance provider is legally obligated to pay for. This includes guidance on the "Rol da ANS," which is the official list of medical procedures that all health insurance companies must cover.
What it costs you
Accessing this information and using the guide is entirely free. There are no fees to review your rights or to learn about the coverage requirements set by the regulator.
The catch to know
A common challenge for policyholders is that insurance companies may sometimes deny coverage for procedures that they are actually legally required to cover. Because these denials can happen, it is important to use the information in this guide to verify your entitlements before and after a claim is made.
How to apply
- Visit the official portal of the Agência Nacional de Saúde Suplementar.
- Search for the consumer information or guide sections.
- Use the resources to check the list of covered procedures against your medical needs.
- Contact the agency if you find your insurance company is not following the rules for coverage.