Brazil's Insurance Act raises health cover costs for resident nomads

Brazil's new Insurance Act took full effect on December 11, 2025, and it changes how resident foreigners must arrange health cover. The law pushes expats and long-term nomads toward locally licensed insurance, which industry rules suggest will cost more than the international policies many have relied on.

What changed

Law No. 15,040/2024 is Brazil's first comprehensive statute governing private insurance contracts. It applies to any policy where the insured is resident or domiciled in Brazil. Overseas insurers can no longer directly underwrite Brazilian risks without a SUSEP-authorized local entity, and foreign licenses do not carry over.

The cost pressure stems from the reinsurance rules. According to Insurance Europe, SUSEP is set to require collateral in Brazilian government bonds from foreign reinsurers, or impose a 10% CIDE tax on companies that use them. Brazilian carriers pricing international-style medical plans absorb that spread and pass it on at renewal. A separate measure, Complementary Law No. 213/2025, in force since January 15, 2025, brought insurance cooperatives and mutual protection groups under regulatory supervision, closing some of the cheaper informal channels expats had used.

What it means for residents

For a foreigner holding a CRNM residence permit, the practical route is now a SUSEP-regulated insurer or an ANS-regulated health plan (plano de saúde). According to the source, mid-tier private plans in São Paulo and Rio typically run R$800 to R$2,500 a month, roughly $145 to $455 depending on age and network. International expat policies for the same age brackets are often quoted at $100 to $180 a month.

Switching from an unlicensed foreign plan to a compliant local one could add $600 to $3,300 a year, before any reinsurance-driven increases arrive at renewal. International policies are not banned, but they can no longer be sold as Brazilian domestic insurance. Many will be restructured as supplemental overlays sitting on top of a local base plan, meaning two premiums instead of one. The practical advice: price the local plan first, then treat international cover as a top-up.

What it means for short-stay nomads

If you are on the VITEM XIV digital nomad visa and have not converted to residency, little changes for now. CNIG Resolution 45/2022 still governs the visa and requires health insurance valid in Brazil for the full stay. It does not mandate a Brazilian-issued plan, and consulates continue to accept international policies covering treatment and repatriation, with informal minimums around $30,000 for medical emergencies.

Because short VITEM XIV stays fall outside the residency trigger, nomads keep the cheaper international option, at least until they convert to a CRNM. Anyone considering a longer stay or a shift to residency should factor the higher local insurance costs into their budget before committing.

Originally reported by Stamped Nomad.