The National Supplementary Health Agency (ANS) announced this Friday (29) that individual and family health plans may have a maximum readjustment of 5,11% in 2025. The percentage is the lowest authorized by the agency since the Covid-19 pandemic period and will apply to approximately 7,7 million consumers across the country.
The new index applies only to individual and family contracts signed from January 1999 onwards or adapted to the Health Plans Law. According to the ANS (National Agency for Supplementary Health), these contracts represent approximately 14,5% of supplementary health care users in Brazil.
Who is subject to the readjustment rule?
The 5,11% cap applies exclusively to plans contracted directly between the consumer and the operator. The rule does not include corporate group plans, offered by companies to employees, nor group plans by membership, contracted by associations and professional organizations.
In these cases, the adjustments are determined through negotiation between operators and contractors, without a limit established by the ANS (National Agency for Supplementary Health). Currently, most health plan beneficiaries are linked to group contracts.
Medical costs continue to rise.
Despite the smaller price adjustment for consumers, the costs of supplementary healthcare continue to put pressure on the sector. Data from the ANS itself shows that healthcare expenses per beneficiary grew by 8,32% in 2025 compared to the previous year.
According to the agency, the increase is influenced by the rise in the price of medical services and equipment, the greater use of health plans, the aging population, and the inclusion of new mandatory procedures in the coverage.
Since 2019, the ANS (National Supplementary Health Agency) has used a methodology that combines official inflation and variations in healthcare expenses to calculate the annual index. According to the agency, the goal is to avoid automatically passing on costs to consumers.
When can the adjustment be charged?
The new percentage will not be charged immediately to all users. The adjustment can only be applied in the month of the contract's anniversary, that is, the month in which the plan was contracted.
For contracts with anniversary dates in May and June, billing may begin in July or August, with the possibility of retroactive application authorized by the agency. Consumers are advised to verify that the percentage applied by the operator respects the limit defined by the ANS (National Supplementary Health Agency).
Industry association criticizes index
The Brazilian Association of Health Plans (Abramge) criticized the readjustment authorized by the regulatory agency. In a statement, the organization asserted that the percentage does not reflect the growth in medical and hospital costs, the incorporation of new technologies, the increasing judicialization of healthcare, and the growing demand for services.
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