Portuguese 
English 
Spanish 
4 min of reading 
0 comments 
Health Plans Lead Complaints in 2025: ANS and Procon Impose Fines of R$ 200 Million. Denials of Coverage and Abusive Rate Increases Are at the Top of the List.
The year 2025 has consolidated an alarming trend: the growth of complaints against health plan operators in Brazil. Data from the National Health Agency (ANS) and records from state Procons show that the sector, which already served over 51 million Brazilians, is facing an unprecedented wave of dissatisfaction.
Denials of coverage, abusive rate increases, and difficulty in scheduling appointments are among the main reasons for complaints. The problem is so severe that, in the first half of 2025 alone, fines imposed against the five largest operators exceeded R$ 200 million, according to a survey released by the specialized press.
Who Leads the Complaints Ranking
Although the numbers vary between states, some operators frequently appear at the top of the list. Among the most cited are:
-
From sertanejo star to international investor: Ana Castela invests millions in a mansion in the USA, creates a themed accommodation in Orlando, and shows that the “boiadeira” also wants to grow away from the stage.
-
The 10 most stunning motorhomes in the world: a $3 million trailer with a rooftop nightclub and garage for a Ferrari, “palaces on wheels” with Italian marble, private cinema, and five-star hotel luxury for billionaires.
-
Trump wanted to spend $400 million on the White House, but the courts prohibited the million-dollar construction.
-
How the Egyptians erected giant structures like pyramids, temples, and obelisks without modern technology, cranes, or engines still amazes the world and reveals the power of engineering based on ramps, levers, ropes, and colossal organization.
- Amil
- Hapvida NotreDame Intermédica
- Bradesco Saúde
- Unimed (different subsidiaries spread across the country)
- SulAmérica
These names together concentrate the majority of the market and also the largest share of complaints registered in 2025.
The Main Reasons for Consumer Complaints
According to reports from ANS and Procons, the issues that most affect consumers are:
- Denial of Coverage: patients report refusals for exams, surgeries, and hospitalizations, even when the procedure is medically indicated and should be guaranteed by ANS’s list of procedures.
- Abusive Increase in Premiums: increases above inflation in collective plans by adhesion and corporate plans have led thousands of customers to court.
- Reduced Network of Providers: hospitals and clinics stop accepting plans, forcing beneficiaries to seek care far from home.
- Delayed Service: long wait times to schedule appointments with specialists or to undergo basic exams.
- Unilateral Cancellation: users report contract cancellations without prior notice.
Million-Dollar Fines Imposed by ANS
In an effort to curb abuses, ANS intensified inspections in 2025. The five most complained-about operators have already accumulated over R$ 200 million in fines. The penalties range from noncompliance with the list of procedures to failures in communication with the consumer.
The majority of sanctions are related to unjustified denials of coverage, a practice considered illegal and that, in many cases, is only reversed after the patient takes legal action.
The Impact on Brazilians’ Wallets
The increase in complaints is not just a regulatory problem, but also a financial drama for millions of families. In 2025, health plans received an authorized rate adjustment from ANS of 6.91% for individual plans — an index that already weighs on budgets.
In collective plans, which have no cap on adjustments, the situation was even more severe: in some contracts, increases exceeded 20%.
With increasingly expensive premiums and lower quality services, user dissatisfaction is growing, as they see their rights being violated even while paying high prices for coverage.
The ‘Judicialization’ of Health
Another direct reflection of the crisis in the sector is the increase in judicialization. Courts across the country recorded a growth in lawsuits against health plans in 2025, especially for cases involving oncological treatments, high-cost medications, and complex surgeries.
The National Justice Council (CNJ) estimates that over 500,000 lawsuits related to supplementary health are currently ongoing, overburdening the judiciary and showing that the legal route has been the only option for many beneficiaries.
The Position of Operators
For their part, companies claim they are facing increasing cost pressure. The incorporation of new medical technologies, the rising cost of medications, and the aging population are cited as factors driving up service costs.
Despite this, experts assert that part of the rate increases and denials is the result of a market strategy to reduce costs at the expense of the consumer.
What to Expect in 2026
The outlook for the next year is uncertain. The federal government is studying new adjustment rules for collective plans, which currently represent over 80% of the market and concentrate the largest complaints. Additionally, there is pressure from consumer advocacy entities to increase ANS oversight and make penalties stricter.
For users, the recommendation is clear: monitor rate adjustment indices, know the list of mandatory coverages, and file complaints with Procon and ANS whenever there is a denial of service.
The health plan market moves over R$ 250 billion a year in Brazil and is considered one of the most profitable sectors in services. However, the increasing number of complaints shows that the current model is under pressure.
If nothing is done, 2026 could consolidate a crisis of trust between users and operators, turning the dream of quick access to health services into a financial nightmare for millions of Brazilians.
Seja o primeiro a reagir!