Blog/ Hospital management
ANS 2025 price adjustment: the main updates
See the 6.06% cap set for individual and family contracts in the 2025/2026 cycle. This article explains the difference for the group segment and market projections in light of changes in healthcare expenses
- By
- Rivio, Editorial team
- Published
- Reading time
- 2 minutes
ANS (Brazil’s National Supplementary Health Agency) has officially set the annual adjustment cap for regulated individual and family health plans at 6.06% for the period from May 2025 to April 2026. This percentage is the maximum that payers may apply to the monthly premiums of these contracts and must be respected in renewals that take place from each contract’s anniversary month onward.
This index takes into account the change in healthcare expenses, including the costs of procedures and how often plan members use services, together with economic indicators such as the IPCA (Brazil’s official consumer price index) — a methodology ANS has applied since 2019.
Comparison with previous periods
The evolution of the adjustments authorized in the most recent cycles shows a trend toward moderation, despite inflation and rising healthcare costs. For reference:
-
2025/2026: cap of 6.06%.
-
2024/2025: cap of 6.91%.
-
2023/2024: a higher index (close to 9.63% on adjusted industry bases).
These numbers signal a gradual reduction in regulatory limits after peak adjustments in previous years, driven by both changes in healthcare costs and macroeconomic factors.
Group plans: no regulatory cap
Unlike individual and family plans, group plans (employer-sponsored or affinity‑based) do not have an adjustment cap set by ANS. In this segment, the percentages applied are defined through negotiation between the payer and the contracting party, and are merely reported to the regulator.
According to data consolidated through August 2025, the average adjustment applied to group medical-hospital contracts was about 11.15%, with higher variations in smaller contracts (up to 30 covered lives).
Market outlook for 2026
Recently published market analyses suggest that adjustments for individual plans in 2026 may exceed the current ANS cap. Some projections point to increases of approximately 7.5%, driven by the pace of healthcare costs observed in 2025.
These projections, however, reflect market estimates and do not change the official regulatory limit, which can only be adjusted by a formal ANS decision in the coming review cycles.
Conclusion
For consumers with individual and family plans, the 6.06% adjustment authorized by ANS for the period from May 2025 to April 2026 is the official parameter that must appear in contracts and payment slips. Any increase above this limit can be challenged administratively or in court.
In group plans, the dynamics are different: the absence of a regulatory cap means greater variability in adjustments, which can result in rates significantly higher than those applied to individual plans.
