Individual/family health plans will have a maximum annual contractual adjustment of 5.11%. The index was decided this Friday (29) by the National Supplementary Health Agency (ANS), the government body that regulates the sector.
Individual plans are those contracted by the people themselves and dependents directly with the operatorsunlike corporate and collective ones, which depend on legal entities.
The country has around 7.7 million individual plan customerswhich represents 14.5% of the 52.9 million health plan consumers.
The maximum adjustment of 5.11% is the lowest authorized by the ANS since the year 2000 (5.42%), with the exception of 2021, the year of the covid-19 pandemic. At the time, the adjustment was negative (-8.19%), that is, the plans became cheaper.
The explanation is that the period of isolation caused a reduction in the use of non-emergency health services, lowering plan costs.
See the adjustments from recent years:
2022: 15,5%
2023: 9,63%
2024: 6,91%
2025: 6,06%
2026: 5,11%
Adjustment date
The adjustment applies to plans contracted from January 1, 1999. and the increase can only be applied in the month of the contract anniversary ─ hire date.
The ANS explains that for contracts with anniversaries in May and June, billing may begin in July or, at the latest, in August, going back to the anniversary month.
The calculations for readjusting the plans were made by the Product Standards and Qualification Board and validated by the Ministry of Finance, before being definitively approved by the ANS Collegiate Board. The decision now goes to publication in the Official Gazette of the Union.
Calculation form
The maximum variation of 5.11% is above the accumulated inflation of the last 12 months. The Broad National Consumer Price Index 15 (IPCA-15), a preview of official inflation, shows that until May the increase in the cost of living in one year was 4.64%.
The ANS justifies that health plan inflation is not the same as general inflation. The adjustment calculation takes into account the frequency of use of health services and the variation in the plans’ care expenses. Therefore, greater or lesser use of services and costs of equipment and medical supplies influence the bills.
According to the CEO of ANS, Wadih Damous, “the objective is always to seek balance, ensuring the sustainability of the sector and the payment capacity of beneficiaries”.
The ANS methodology considers two indices: Assistance Expenses Value Index (IVDA) and official inflation (IPCA).
IVDA, which represents operators’ costs, has a weight of 80%, leaving IPCA with a weight of 20%. The IVDA also takes into account operators’ efficiency gains and increases charged to customers who change age groups.
In addition to the annual contractual adjustment, health plans, whether individual or corporate, are also subject to increases based on age variation. This other variation is applied in the customer’s birthday month, at pre-determined ages, for example, 59 years old.
Business and collective plans
Corporate and collective plans have annual adjustments decided through free negotiation between the contracting legal entity and the plan operator or administrator.
A survey released by ANS on the 5th revealed that these plans had an average variation of 9.9% in the first two months of 2026, the lowest increase in five years.
