By Brazil Stock Guide – Brazil’s health plan market was nearly flat in April. Data from the National Supplementary Health Agency (ANS), compiled by BTG Pactual, show the sector added just 8,100 net beneficiaries in the month, not enough to reverse the 29,700-member loss accumulated since the beginning of the year.
More than a weak monthly print, the data point to a market increasingly driven by health operators’ ability to win customers from rivals. In an industry with more than 53 million beneficiaries, a net gain of only 8,000 lives suggests almost no organic growth.
Hapvida once again led the sector’s losses. The company ended April with a net reduction of 48,300 beneficiaries, bringing its year-to-date loss to 67,400 lives. The decline marked another month of portfolio contraction and was concentrated mainly in São Paulo, where the health operator lost about 24,000 lives.
The numbers suggest that commercial stabilization has not yet appeared consistently in ANS data. After years of rapid expansion through acquisitions and the integration of NotreDame Intermédica, investors had been waiting for clearer signs of recovery in the customer base. So far, however, the market leader continues to lose ground to competitors.
SulAmérica also posted a significant decline, with a net loss of 29,200 beneficiaries. According to BTG, however, part of that move was influenced by ASO contracts, or Administrative Services Only agreements. Under this model, the health operator manages corporate health plans but does not directly assume the medical risk. Excluding this segment, SulAmérica would have recorded a net gain of roughly 20,000 lives in the month.
At the other end of the table, Amil was April’s main winner. The health operator added 45,100 beneficiaries in the month, bringing its 2026 net additions to 91,100 lives. Growth was mainly driven by São Paulo, which accounted for about 30,000 new members.
The performance suggests that Amil continues to pursue an aggressive commercial strategy after years of restructuring. The company alone added more than five times the net growth of the entire sector in April, highlighting its ability to capture market share in a low-growth environment.
Bradesco Saúde also delivered a robust performance, with 37,700 net additions in April and 82,200 year-to-date. BTG continues to view the company as one of the most attractive exposures in the sector, supported by maturing hospital assets, new growth initiatives and potential valuation upside.
Other health operators also gained ground. Unimed Seguros added 20,200 lives in April and is up 41,400 beneficiaries in 2026. Porto Saúde recorded a net gain of 13,000 lives in April and 44,700 year-to-date. Although smaller in absolute terms, both companies have been growing consistently and above the industry average.
Porto, in particular, stands out as one of the sector’s more interesting stories. With a much smaller base than leaders such as Hapvida, SulAmérica or Bradesco Saúde, the company has posted one of the strongest proportional growth rates in its portfolio, signaling a gradual increase in relevance in the corporate market.
Central Unimed moved in the opposite direction, losing 3,600 beneficiaries in April and 37,200 lives year-to-date.
In the dental segment, OdontoPrev lost about 7,000 beneficiaries in April, although it remains up 214,000 lives in the year. The broader dental plan market ended the month with approximately 36 million beneficiaries, supported by growth from health operators such as Amil, MetLife, SulAmérica and Porto.
BTG maintains its preference for exposure to Rede D’Or, the controlling shareholder of SulAmérica, and Bradesco Saúde, citing consistent execution, improving profitability and multiple growth avenues. In a market that no longer grows as fast as it once did, the ability to gain share has become one of the sector’s key competitive advantages.
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