Moving to Brazil with kids or having kids in Brazil can lead to a basic question: how do I deal with their health care? Learn in this article what your options are and what vaccines are mandatory for your kids.
General overview of the Brazilian health care system
Roughly speaking, there are two main types of health care options in Brazil: public and private. We tend to think that the public health system is the bad quality one and that the private is the one offering the best services. This isn’t necessarily true as there are private hospitals offering terribly bad services and the most prestigious hospitals in Brazil in terms of service and scientific research are held by public universities, such as Hospital das Clínicas, in São Paulo city.
Public health care
Any Brazilian citizen has got rights to public health care (at least in theory). This system is known as SUS, short for "Sistema Único de Saúde". Anyone who walks into a public hospital in Brazil has the right to receive a treatment. The only requirement is to present an ID card (mostly RG or driver’s license) and if the hospital is held by the municipality, you may be required to present a proof of residence (mostly requested in cases that are not an emergency).
What happens in many cases is that hospitals are in precarious conditions, mostly overcrowded and there is a general lack of doctors. Sometimes the service can take so long that it is not uncommon to hear that a patient ended up dying while waiting for the doctor or for the ambulance to arrive.
Although precarious in many cases, the public health system is always an option in case of emergency and at least until you can afford a private health insurance. SUS covers most mandatory vaccines, supports pregnant women and guarantees child-birth, provides free medication for some diseases like diabetes and high blood pressure.
Private health care
According to IBGE, in 2010 26,3% of the Brazilian population has private health care. Also, the great majority of those who have access to private health care (82,5% to be more specific) had a monthly income of at least five minimum salaries.
Private health care in Brazil varies a lot according to the health care provider. Just to give an idea, a health care plan for an elderly ranges from BRL 250 to BRL 850,00, so it really is necessary to do a lot of research before choosing your health care plan.
Health care has been pointed out as the most important benefit a company could offer its employees. As the service is rather expensive to the reality of most Brazilians, to many families the only way to have access to it is through a corporate health insurance that entitles the insurance holder to include his/her family members.
How to add my child to my health insurance?
Having a health insurance only for your child is not very common in Brazil. Most Brazilians would rather having a health insurance that would cover the whole family and then have the children included as dependents.
For your children to be considered as your dependents, they must be under 21 years old. This age varies according to the health insurance provider (some of them accept as dependents children up to 24 years old), but 21 is the most commonly practiced.
Some family health insurance plans classify as family members those who live in the same house. In most cases – especially for corporate plans –, family members are considered to be spouse and children under 21. In some cases it is also possible to include the parents of the the insurance holder.
If your family health insurance plan is private (in the sense that it is not paid by the company you work for), you pay for a full value for all family members. Just to give an idea, basic health insurance plan for a family in which the parents’ age range between 29 and 33 years old and there are two kids from zero to 18 years old would pay a monthly amount of BRL 700,00.
If you have a corporate health insurance, things are a little bit different. Corporate health insurance is not the same as having a family health insurance, but in most cases it is possible to add your family members who would qualify for a family plan into your corporate plan by a much more accessible price. And another advantage of the corporate health insurance is that this modality is exempted from the grace period that can be of nine months for simple surgeries.
If you rather pay for your child’s health care individually, prices range from BRL 41,80 to BRL 141,22 per month.
Important: If your health insurance offers obstetric services, your newborn child can be included in your plan without the grace period as long as the inclusion happens within 30 days from birth or adoption. Also, to get your child included on your health insurance plan, it is necessary to issue their CPF.
When establishing your life in Brazil, you will be required to take all mandatory vaccines. In Brazil, they are divided in three age groups: children, teenagers and adults and elderly. Down below is a list of all mandatory vaccines for children:
- BCG – ID: against severe tuberculosis (single dose);
- First dose of the vaccine against hepatitis B.
- Second dose of the vaccine against hepatitis B.
- First dose of the Tetravalent vaccine (DTP + Hib): prevents from Diphtheria, tetanus, pertussis, meningitis and other infections caused by Haemophilus influenza type B;
- First dose of VOP, the oral vaccine against Poliomyelitis;
- First dose of VORH (oral vaccine against human rotavirus): prevents from diarrhea caused by human rotavirus;
- Second dose of the Tetravalent vaccine (DTP + Hib).
- Second dose of VOP, the oral vaccine against Poliomyelitis;
- Second dose of VORH (oral vaccine against human rotavirus): prevents from diarrhea caused by human rotavirus.
- Third dose of the Tetravalent vaccine (DTP + Hib);
- Third dose of VOP, the oral vaccine against Poliomyelitis;
- Third those of the vaccine against hepatitis B.
- Vaccine against Yellow Fever (single dose).
- SRC (MMR – triple viral): prevents measles, mumps and rubella (single dose).
- Reinforcement of VOP, the oral vaccine against Poliomyelitis;
- First reinforcement of DTP (triple bacterial): prevents diphtheria, tetanus and pertussis.
From four to six years old
- Second reinforcement of DTP (triple bacterial);
- Reinforcement of SRC (MMR – triple viral).
At ten years old
- Reinforcement of the vaccine against Yellow Fever.
The vaccination card is where all the vaccines your child has taken will be registered. Some companies require their female employees to present this card if they have children who are under five years old. This is because there are some benefits for mothers with little kids, such as Salário Família, an initiative of the federal government in which the mother who earns less than BRL 915,05 receives an amount that goes from BRL 22,00 to BRL 32,00 per child under 14 years old.
The vaccination card is often requested along with a school certificate, proving that the child is going to school. It also entitles mothers to receive some other benefits granted by companies, helps the employer estimating how many times the female employee will have to be absent due to her kid’s health and is also used to the calculation of the income tax.
There are other vaccines that even though are not mandatory, may be recommended by your pediatrician. If you have a health insurance, then it will probably cover these vaccines, but if you rely on SUS, you will have to pay for it out of your pocket.
These vaccines cost from BRL 60,00 (Influenza, for example) to BRL 260,00 (pneumonia).