By Brazil Stock Guide – Brazil’s health plan operators — including insurers, group medicine providers and healthcare cooperatives — once again showed strong profit concentration in 2025, with Amil, SulAmérica and Bradesco Saúde leading the sector’s earnings by a wide margin.
Data from the ANS indicate that Amil ended the year as the most profitable player in the country, posting R$ 5.4 billion in net income, followed by SulAmérica with R$ 3.4 billion and Bradesco Saúde with R$ 3.1 billion. Together, the three companies represent a substantial share of total sector profits, underscoring the importance of scale, pricing power and financial income in shaping results.
Top 10 health plan operators by net income in 2025
| Rank | Company | Net Income 2025 |
|---|---|---|
| 1 | Amil Assistência Médica Internacional | R$ 5.4 billion |
| 2 | SulAmérica Companhia de Seguro Saúde | R$ 3.4 billion |
| 3 | Bradesco Saúde | R$ 3.1 billion |
| 4 | Hapvida Assistência Médica | R$ 1.03 billion |
| 5 | NotreDame Intermédica | R$ 823 million |
| 6 | Porto Seguro Saúde | R$ 705 million |
| 7 | Unimed Belo Horizonte | R$ 632 million |
| 8 | Unimed Seguros Saúde | R$ 616 million |
| 9 | Samel Serviços de Atendimento Médico | R$ 548 million |
| 10 | SulAmérica Paraná Clínicas | R$ 479 million |
Top operators drive sector performance
The leading operators benefited not only from scale but also from stronger financial income — a key driver in 2025 amid elevated interest rates — as well as improved control over medical costs.
Amil stood out with a clear lead, combining strong operational performance with financial gains. SulAmérica and Bradesco Saúde maintained resilient margins despite ongoing pressure from healthcare inflation.
A more competitive second tier
Beyond the top three, the ranking becomes more fragmented. Hapvida and NotreDame Intermédica — despite their large beneficiary bases — still reflect integration challenges and elevated medical cost pressures, limiting margin expansion.
Meanwhile, players such as Porto Saúde and Unimed Belo Horizonte delivered more balanced results, combining growth with cost discipline.
Scale helps — but doesn’t guarantee returns
The ranking highlights that size alone does not ensure profitability. Operators with stronger vertical integration or tighter control over care delivery tend to achieve more stable outcomes, while those more exposed to third-party providers face greater volatility.
Overall, profit concentration remains a defining feature of Brazil’s health plan operators. The dominance of a few large players continues to shape industry dynamics — even as broader sector performance improved in 2025.
Read more: Brazil Health Plan Operators Post R$24.4 Billion Profit in 2025 on Strong 4Q25
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