SUS Healthcare Guide for Foreigners in Brazil
Direct Answer
SUS (Sistema Unico de Saude) is Brazil’s universal public healthcare system. It provides free medical care to every person on Brazilian territory — citizens, permanent residents, temporary visa holders, and even undocumented foreigners. You do not need insurance. You do not need to pay. Registration requires only a visit to your nearest UBS with a CPF and ID document. SUS covers primary care, emergencies, surgeries, medications, dental, mental health, prenatal care, vaccinations, organ transplants, and cancer treatment.
What Is SUS?
The Sistema Unico de Saude (Unified Health System) is the largest public healthcare system in the world. Created by the 1988 Brazilian Constitution (Articles 196-200) and regulated by Law 8,080/1990, SUS guarantees healthcare as a fundamental right of every person and a duty of the State.
Key principles:
- Universality — healthcare for all, no exclusions
- Integrality — full spectrum from prevention to complex surgeries
- Equity — priority to those with greater need
- Decentralization — managed by federal, state, and municipal governments jointly
- Social participation — community oversight through health councils
SUS serves approximately 190 million Brazilians (about 75% of the population relies exclusively on SUS). The system performs over 4 billion medical procedures annually, including the world’s largest public organ transplant program.
Constitutional Right for Foreigners
Article 5 of the Constitution states that all persons — Brazilian or foreign — present in Brazilian territory have equal fundamental rights. The Migration Law (Law 13,445/2017) explicitly guarantees foreigners the right to access public health services. This means:
- Tourists can use emergency services
- Temporary visa holders can register for full SUS access
- Permanent residents have identical rights to Brazilian citizens
- Undocumented immigrants can access emergency care and, in practice, routine care at many UBS units
- Refugees and asylum seekers have full SUS access from day one
Getting Your Cartao SUS (National Health Card)
The Cartao Nacional de Saude (CNS) — commonly called Cartao SUS — is your registration in the healthcare system. It is a card with a 15-digit number that links all your medical records, prescriptions, and appointments.
How to Register
- Visit your nearest UBS (Unidade Basica de Saude — primary health center)
- Bring documents: CPF (see our CPF guide for foreigners), passport or CRNM, proof of address (utility bill, rental contract)
- Fill out the registration form at the reception desk
- Receive your CNS number — usually issued on the spot
You can also register digitally through ConecteSUS or the Meu SUS Digital app (available on iOS and Android). The digital card is valid everywhere.
Important Details
- Registration is free
- The card is valid nationwide — you can use SUS in any state
- No expiration date
- You can register even without a permanent address (for homeless persons or those in shelters, social workers assist with registration)
- Each family member needs their own card, including children
How the SUS System Is Structured
SUS operates on three levels of care, and understanding this structure helps you handle the system efficiently.
Primary Care: UBS (Unidade Basica de Saude)
The UBS is your entry point into SUS and your primary healthcare unit. Brazil has over 43,000 UBS units nationwide.
Services available at UBS:
- General consultations (clinico geral)
- Pediatric care
- Prenatal care and family planning
- Vaccinations (all vaccines from the national calendar)
- Basic dental care
- Chronic disease management (diabetes, hypertension)
- Health education programs
- Basic lab tests and prescriptions
- Mental health screening
- Wound care and minor procedures
How it works:
- You are assigned to a UBS based on your home address
- Each UBS has a Estrategia Saude da Familia (ESF) team: doctor, nurse, nursing technician, and community health agents
- Community health agents (ACS) may visit your home periodically
- Appointments are scheduled at the UBS reception, usually in person, early morning
- Walk-in consultations available for urgent but non-emergency issues
Practical tip for foreigners: Arrive early (6:30-7:00 AM) on the day appointments open. Many UBS units distribute appointment slots first-come-first-served each morning. Some UBS units now offer online scheduling through municipal health apps.
Secondary Care: Specialists and UPA
When your UBS doctor determines you need specialist care, they issue a referral (encaminhamento) through the SISREG system (Sistema de Regulacao).
Specialist services include:
- Cardiology, dermatology, orthopedics, ophthalmology, etc.
- Diagnostic imaging (X-ray, ultrasound, CT scan, MRI)
- Outpatient surgeries
- Physical therapy and rehabilitation
- CEO (Centro de Especialidades Odontologicas) — advanced dental care
UPA (Unidade de Pronto Atendimento — Emergency Care Unit):
UPAs are 24-hour emergency care units for situations that are urgent but not life-threatening:
- Fever, pain, minor injuries
- Mild to moderate asthma attacks
- Cuts requiring stitches
- Suspected fractures
- Allergic reactions
UPAs use the Manchester Triage System with color-coded wristbands:
- Red — immediate (life-threatening)
- Orange — very urgent (10 minutes)
- Yellow — urgent (60 minutes)
- Green — less urgent (120 minutes)
- Blue — not urgent (240 minutes)
As a foreigner, you do NOT need a Cartao SUS to receive emergency care at a UPA. Present any ID document.
Tertiary Care: Hospitals
For complex conditions, SUS provides hospital care including:
- Emergency trauma surgery
- Intensive care (ICU)
- Organ transplants (Brazil has the world’s largest public transplant program)
- Cancer treatment (chemotherapy, radiation, surgery)
- Cardiac surgery
- Neurosurgery
- High-risk pregnancy and neonatal ICU
Major SUS reference hospitals like Hospital das Clinicas (Sao Paulo), Hospital de Clinicas de Porto Alegre, and Hospital Sarah (rehabilitation) are world-class facilities.
SAMU — Emergency Ambulance (Call 192)
SAMU (Servico de Atendimento Movel de Urgencia) is Brazil’s emergency medical service. Call 192 for:
- Heart attacks, strokes
- Severe trauma (car accidents, falls)
- Difficulty breathing
- Loss of consciousness
- Severe burns
- Childbirth emergencies
- Psychiatric emergencies
SAMU operates 24/7 with basic ambulances and advanced units (with doctors). Response time varies by city — typically 10-20 minutes in urban areas. The service is free and available to anyone, no documentation required.
Other emergency numbers foreigners should know:
- 192 — SAMU (medical emergency)
- 193 — Bombeiros (fire department, also responds to medical emergencies)
- 190 — Policia Militar (police emergency)
Medications: Farmacia Popular and SUS Pharmacies
SUS provides medications through two channels:
UBS Pharmacy
After a SUS consultation, your doctor prescribes medications from the RENAME (Relacao Nacional de Medicamentos Essenciais). You collect these medications free at the UBS pharmacy or a designated SUS pharmacy. The essential list covers:
- Antibiotics
- Blood pressure medications
- Diabetes medications (including insulin)
- Asthma inhalers
- Pain medications
- Psychiatric medications
- Antiretrovirals (HIV/AIDS — Brazil provides free treatment to all)
Farmacia Popular
The Farmacia Popular program provides free or heavily subsidized medications at participating private pharmacies nationwide. Present your CPF and prescription to receive:
- Free: medications for hypertension, diabetes, and asthma
- Up to 90% discount: cholesterol medications, osteoporosis, rhinitis, Parkinson’s, glaucoma, and contraceptives
Look for the “Farmacia Popular” sign at pharmacies like Drogasil, Droga Raia, Pague Menos, and others.
Vaccinations
Brazil has one of the world’s most comprehensive public vaccination programs, managed by the PNI (Programa Nacional de Imunizacoes). All vaccines on the national calendar are free at any UBS.
Vaccines available for adults (relevant for arriving foreigners):
- Yellow Fever (required for some regions)
- Hepatitis B
- Tetanus/Diphtheria (dT)
- Measles/Mumps/Rubella (MMR)
- Influenza (annual campaigns)
- COVID-19 (updated boosters)
- HPV (up to age 45 in current guidelines)
Bring your vaccination record from your home country to the UBS. The nurse will review it and administer any missing vaccines. Your vaccinations are recorded on your Cartao SUS and accessible through the ConecteSUS app.
Dental Care: Brasil Sorridente
The Brasil Sorridente (Smiling Brazil) program provides dental care through SUS:
At UBS (basic dental):
- Cleanings and checkups
- Fillings
- Extractions
- Fluoride treatments
- Emergency dental care
At CEO (Centro de Especialidades Odontologicas):
- Root canals
- Periodontal treatment
- Oral surgery
- Dental prosthetics (dentures)
- Diagnosis of oral cancer
Access to CEO requires referral from UBS dentist. Wait times for dental prosthetics can be 3-6 months.
Mental Health: CAPS
Brazil’s mental health care is provided through CAPS (Centro de Atencao Psicossocial) — specialized centers offering:
- Individual and group therapy
- Psychiatric consultations and medication
- Substance abuse treatment (CAPS AD — Alcool e Drogas)
- Child and adolescent mental health (CAPSi)
- Crisis intervention (CAPS III — 24-hour with overnight beds)
- Occupational therapy and social reintegration
CAPS services are free and operate on an open-door policy — you can walk in directly without referral for initial assessment. For foreigners experiencing culture shock, isolation, or adjustment difficulties, CAPS provides professional support in a therapeutic environment.
The CVV (Centro de Valorizacao da Vida) provides 24/7 emotional support and suicide prevention. Call 188 or chat at cvv.org.br.
Prenatal Care and Maternal Health
SUS provides comprehensive prenatal care through the Rede Cegonha (Stork Network) program:
- Minimum 7 prenatal consultations
- All lab tests and ultrasounds
- High-risk pregnancy specialist referral
- Hospital delivery (natural or cesarean)
- Postpartum care and breastfeeding support
- Neonatal screening (teste do pezinho, orelhinha, olhinho)
Foreign women have full rights to prenatal care and delivery through SUS, regardless of visa status. This is constitutionally guaranteed. Hospital delivery in SUS is free — no bill. If your child is born in Brazil, they are automatically Brazilian citizens (jus soli).
Wait Times: The Reality
SUS wait times are the system’s most significant challenge. Be prepared for:
Short waits (same day to 1 week):
- UBS general consultations
- Emergency care (UPA, SAMU)
- Vaccinations
- Prescription pickup
Moderate waits (2 weeks to 2 months):
- Blood tests and basic lab work
- X-rays and ultrasounds
- Dental cleanings
- Mental health initial assessment
Long waits (2 to 12+ months):
- Specialist consultations (orthopedics, ophthalmology, dermatology)
- MRI and CT scans
- Elective surgeries (hernia, gallbladder, knee replacement)
- Dental prosthetics
Strategies to handle wait times:
- Build a relationship with your UBS team — community health agents can advocate for you
- Use the Ouvidoria (ombudsman) — file complaints at ouvidoria.saude.gov.br if wait times exceed reasonable limits
- Check multiple facilities — some UBS units and hospitals have shorter queues
- Use UPA for semi-urgent specialist needs — UPA doctors can order imaging and lab tests with faster turnaround
- Monitor your referral status through your municipality’s health portal
Private Health Insurance (Plano de Saude) vs. SUS
Many foreigners in Brazil maintain private health insurance while relying on SUS as backup. Here is a comparison:
| Feature | SUS | Private Health Plan |
|---|---|---|
| Cost | Free | R$200-R$1,500+/month |
| Coverage | Comprehensive | Varies by plan |
| Wait times | Can be long | Usually short |
| Hospital rooms | Shared wards | Private/semi-private |
| Doctor choice | Assigned by system | Choose your doctor |
| Emergency | Excellent trauma centers | Good but varies |
| Medications | Free (essential list) | Not always covered |
| Transplants | World-class program | Limited |
| Bureaucracy | High | Moderate |
Regulated by ANS (Agencia Nacional de Saude Suplementar — ans.gov.br), private health plans in Brazil must cover a minimum list of procedures. Major operators include Amil, Bradesco Saude, SulAmerica, Unimed, and Notre Dame Intermedica.
As a foreigner, you can purchase private health insurance with a CPF and valid visa. Plans have mandatory 24-hour emergency coverage from day one. Carencia (waiting period) for other procedures ranges from 30 days (consultations) to 300 days (childbirth).
Important: Even with private insurance, SUS remains available. Many Brazilians use both — private for routine care and SUS for complex procedures like organ transplants or cancer treatment where public reference centers excel.
How SUS Connects to Other Government Systems
SUS interacts with several institutions foreigners should understand:
- Receita Federal — your CPF is needed for Cartao SUS registration
- INSS — workplace injuries treated through SUS may generate INSS disability claims
- Banco Central — private health plan payments require a bank account
- CAIXA — social programs like Bolsa Familia include health conditionalities tracked through SUS
- Policia Federal — visa renewal may require proof of health insurance (for some visa categories)
Key Government Portals
- Ministry of Health: gov.br/saude
- ConecteSUS / Meu SUS Digital: conectesus.saude.gov.br
- DataSUS (health data): datasus.saude.gov.br
- ANS (private plans regulator): ans.gov.br
- Farmacia Popular: gov.br/saude/farmacia-popular
- CVV (crisis support): cvv.org.br or call 188
- Health Ombudsman: ouvidorsus.saude.gov.br
Practical Tips for Foreigners Using SUS
- Get your CPF first — it is the universal key to all Brazilian public services
- Register at your local UBS early — do not wait until you are sick
- Download the Meu SUS Digital app — track appointments, prescriptions, vaccination records
- Learn basic Portuguese medical vocabulary — most SUS staff do not speak English; bring a bilingual friend or use a translation app
- Keep your vaccination booklet updated — some vaccines are required for school enrollment and certain jobs
- Use the Ouvidoria if you face discrimination or are denied care — it is illegal to refuse SUS care based on nationality
- For complex conditions, ask your UBS doctor to refer you to a university hospital (hospital escola) — these have more resources and often research programs
- Carry your Cartao SUS number on your phone — you will need it at every appointment
When to Use SUS vs. Private vs. Emergency Room
- Routine checkup, vaccinations, prescription refills → UBS (schedule appointment)
- Fever, pain, minor injury, vomiting → UPA (walk-in 24 hours)
- Life-threatening emergency → Call SAMU 192 or go directly to hospital emergency
- Specialist consultation with short wait → Private health plan
- Organ transplant, burn treatment, complex trauma → SUS reference hospital (often superior to private)
- Dental cleaning and fillings → UBS dental or private dentist
- Mental health crisis → CAPS or call CVV 188
How ZS Advogados Can Help
Navigating Brazilian public institutions as a foreigner involves more than healthcare. Our team assists with:
- Immigration and visa services — ensuring your legal status gives you full access to public services
- Consumer protection — disputes with private health insurance companies (ANS complaints, coverage denials)
- Civil litigation — medical malpractice claims against SUS or private providers
- Family law — foreign births in Brazil, custody involving healthcare decisions
If you have been denied SUS care, faced discrimination at a health facility, or need help with private insurance disputes, contact our team for a consultation.
This guide is for informational purposes and does not constitute legal or medical advice. Healthcare policies and procedures may vary by municipality. Last updated May 2026.
