By Brazil Stock Guide — Twenty-five large operations linked to the Unimed brand remained broadly stable in both membership and financial performance, suggesting that the problems faced by some cooperatives have not, so far, translated into a broader deterioration across the entities analyzed.
The operations had 10.46 million medical-plan members as of July 2026. Compared with June, their combined membership was virtually unchanged, according to Brazil Stock Guide calculations based on individual changes reported by Brazil’s health-plan regulator, ANS.
By contrast, some of the country’s largest national health groups expanded over the same period. Bradesco Saúde, Amil, SulAmérica and Porto Seguro Saúde grew their combined medical membership by close to 1% in July, while the 25 Unimed operations were broadly flat. Hapvida was the exception among the major national groups, with its medical membership falling by about 0.7% in the month.
Different Unimeds, different trends
The comparison points to a slower pace of commercial expansion among the large Unimed operations in July, but not to a meaningful loss of scale. Gains and losses largely offset each other: Seguros Unimed grew 1.66%, while CNU declined 0.82%. Grande Florianópolis posted a sharper 4.74% drop, although its weight in the overall sample is limited.
The financial picture also points to relative stability. The 25 entities together report roughly R$33.15 billion in premium revenue and R$26.40 billion in medical-care expenses, meaning assistance costs were equivalent to about 79.6% of revenue.
Year-on-year comparisons are heavily distorted, however, by Unimed FERJ. The situation in Rio de Janeiro is well known and involves a deep operational restructuring. FERJ reported an 85.9% drop in revenue and a 97% decline in medical-care expenses from the previous period.
Excluding FERJ, the other 24 operations account for approximately R$32.77 billion in revenue and R$26.32 billion in medical-care expenses. Based on the individual changes disclosed by ANS, BSG estimates that revenue rose by about 8%, while medical-care expenses increased at a broadly similar pace.
The ratio of medical-care expenses to revenue among those 24 entities stood at about 80.3%, compared with approximately 80.1% in the previous period. The change is modest and, in this sample, does not point to a broad deterioration in the relationship between revenue and assistance costs.
One system, very different realities
That does not mean all cooperatives are in the same position. Unimed Londrina, for example, reports medical-care expenses equivalent to about 92.8% of revenue. Costs rose 18.3%, compared with an 11.3% increase in revenue.
In São José dos Campos, the ratio is close to 89%. Unimed Goiânia also operates near 90%. Its recent trend, however, is more favorable: revenue rose 9.1%, while medical-care expenses increased only 3.8%.
At CNU, the ratio is close to 72%. Juiz de Fora, meanwhile, is near 69%.
The differences partly reflect the structure of the Unimed system itself. The brand brings together cooperatives and other entities with their own management teams, balance sheets, member bases and regional markets. At the same time, they remain connected through Unimed’s nationwide interchange system and share a common brand identity.
Member demographics also vary significantly. Seniors account for just over 7% of the medical portfolios at CNU and Seguros Unimed, while they represent more than 20% in Londrina, Divinópolis and São José dos Campos. Older member bases tend to generate higher healthcare utilization and medical costs.
Largest operations in the sample
In July, CNU remained the largest operation in the sample, with 1.71 million medical-plan members. It was followed by Unimed-BH, with 1.62 million, and Seguros Unimed, with just over 1 million.
The group’s overall stability is notable after recent episodes of financial and operational stress at some cooperatives, particularly in Rio de Janeiro. Those cases led ANS to discuss more preventive forms of oversight for the Unimed system.
Even so, the latest data support a more balanced reading. The problems already identified at certain entities do not, at this stage, appear to reflect a broader deterioration among the large Unimed operations analyzed. Membership remains stable, while revenue and medical-care expenses continue to move at broadly similar rates.
Unimed do Brasil told Brazil Stock Guide that no spokesperson was available to comment on the findings by the time of publication.
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