According to the results of the latest competitive tracking study on the Brazilian Health Insurance and Dental Plans market conducted by RankingsLatAm.com, the sector closed September 2025 with a stable but clearly segmented evolution, showing contrasting dynamics between health plans and dental coverage, as well as a high degree of competitive fragmentation alongside increasing concentration at the top.
At the end of September 2025, the number of beneficiaries of health plans in Brazil reached 52.9 million, unchanged compared to June 2025. This translates into a marginal quarterly growth of 0.1%, confirming a phase of stagnation in overall health plan enrollment. In contrast, dental plans continued to expand at a faster pace. The number of beneficiaries of dental insurance reached 34.8 million as of September 2025, up from 34.4 million beneficiaries a decade earlier, and reflecting a solid quarterly growth rate of 1.1% in the most recent quarter. This divergence reinforces the structural resilience and growth appeal of dental coverage within the broader supplementary health ecosystem.
From a competitive standpoint, the Brazilian market remains highly fragmented in terms of operators. A total of 649 active competitors were operating at the close of the quarter, while the long-term competitive analysis covering the period from 2011 to 2025 includes 1,442 entities. Despite this fragmentation, market leadership is clearly concentrated among a limited group of large players.
In terms of market share measured by volume of services provided, the leading entities are Bradesco Saúde S.A., Sul América Companhia de Seguro Saúde, Amil Assistência Médica Internacional S.A., Hapvida Assistência Médica S.A., and Notre Dame Intermédica Saúde S.A. Together, these five operators account for 37% of the market, while the top ten competitors jointly represent 49% of total volume, underscoring a moderate but meaningful level of concentration in service delivery.
When market share is analyzed by number of health plan clients, the ranking shifts slightly. Hapvida Assistência Médica S.A. leads, followed by Notre Dame Intermédica Saúde S.A., Bradesco Saúde S.A., Amil Assistência Médica Internacional S.A., and Sul América Companhia de Seguro Saúde. In this dimension, the five largest players concentrate 30% of beneficiaries, while the top ten reach a combined share of 41%, indicating a broader dispersion of clients across medium and smaller operators compared to service volume.
Concentration is significantly higher in the dental insurance segment. The leading players by number of dental plan clients are OdontoPrev S/A, Hapvida Assistência Médica S.A., Notre Dame Intermédica Saúde S.A., Amil Assistência Médica Internacional S.A., and Sul América Companhia de Seguro Saúde. These five entities together control 57% of the dental insurance market, and the top ten reach an even more pronounced 71% share, highlighting the dominant position of large-scale specialized and integrated operators in this segment.
Competitive dynamics over the period also reveal which players have been gaining ground. In health insurance, Bradesco Saúde S.A. recorded the strongest increase in market share by number of clients, gaining 0.31 percentage points. It was followed by Unimed Belo Horizonte Cooperativa de Trabalho Médico with a gain of 0.12 points, Amil Assistência Médica Internacional S.A. with 0.08 points, Select Operadora de Plano de Saúde Ltda with 0.05 points, and Hapvida Assistência Médica S.A., also with a 0.05-point increase. These figures suggest incremental but consistent shifts in competitive positioning rather than abrupt changes.
In dental insurance, market share gains were more pronounced. Amil Assistência Médica Internacional S.A. led the ranking with an increase of 0.33 percentage points, closely followed by OdontoPrev S/A with a gain of 0.30 points. Hapvida Assistência Médica S.A. added 0.20 points, while Odontoart Planos Odontológicos Ltda and Plano Odontológico Dentalvidas Ltda each gained 0.06 points. This pattern reinforces the stronger growth momentum observed in the dental segment compared to health plans.
From a financial performance perspective, the sector posted solid results in the third quarter of 2025. Total revenues from services reached BRL 252.8 billion, while healthcare-related expenses amounted to BRL 203.8 billion. Operating expenses totaled BRL 23.1 billion, commercial expenses reached BRL 9.0 billion, and other expenses accounted for BRL 21.3 billion. These costs were partially offset by BRL 13.6 billion in other revenues. As a result, the sector closed the quarter with a positive overall result of BRL 9.2 billion, confirming the sustained profitability of the supplementary health market despite cost pressures.
The structure of demand remains heavily skewed toward corporate contracting. Corporate plans account for 72.7% of health plan beneficiaries and an even higher 74.2% of dental plan beneficiaries. Individual and family plans represent 16.2% of health plan clients and 16.5% of dental plan clients, while collective plans by adhesion account for 11.0% and 9.2%, respectively. Other forms of contracting remain negligible, with virtually zero participation in both segments.
Finally, the distribution of beneficiaries by operator size highlights the dominance of large-scale competitors, particularly in dental insurance. In health plans, operators with more than 500,000 affiliates account for 52.0% of beneficiaries, while those with up to 500,000 affiliates represent 25.8%, and smaller players with fewer than 100,000 affiliates still hold a meaningful 22.2% share. In dental plans, concentration is markedly higher: operators with more than 500,000 affiliates account for 74.0% of beneficiaries, mid-sized players represent 16.8%, and small operators capture just 9.2% of the market.
Overall, the data from RankingsLatAm.com confirm a Brazilian health and dental insurance market characterized by stable health plan enrollment, robust growth in dental coverage, sustained profitability, and increasing strategic relevance of scale, particularly in the dental segment.