Health plan cancellation due to non-payment: what the law actually allows

The cancellation of a health plan is a situation that generates considerable insecurity and can cause serious harm to people undergoing treatment or who have dependents undergoing medical treatment. However, the cancellation of a health plan by the operator, even in the case of non-payment, cannot occur automatically or arbitrarily, as Brazilian legislation and jurisprudence establish clear rules that limit the actions of operators.

Since 2001 [1] , the law stipulates that the operator can only terminate the contract due to non-payment after giving prior notice to the beneficiary. This requirement aims to ensure that the consumer is effectively informed about the delay and has the opportunity to regularize the situation before losing healthcare coverage. Currently, notification regarding non-payment is regulated by ANS Normative Resolution No. 593, of December 19, 2023 [2] .

The health insurance company must send the notification within fifty days of the first non-payment, granting the beneficiary a minimum period of ten days to settle the debt. Simply sending a generic email or a message without proof of receipt is insufficient; the company must demonstrate unequivocal notification to the consumer.

The regulation also stipulates that the non-payment of a single monthly installment does not justify the cancellation of the health plan; non-payment of at least two monthly installments, consecutive or not, within a twelve-month period is necessary for the company to consider termination.

Another relevant point of the ANS (National Supplementary Health Agency) regulation is the prohibition of suspending or canceling the plan during the hospitalization of the beneficiary or their dependents. Even if the beneficiary is indeed in arrears, the company must wait for medical discharge to issue any notification. This protection aims to avoid extreme situations where the patient is left without assistance precisely at the moment of greatest vulnerability.

Indeed, there are rulings that extend this legal provision to cases where there is no hospitalization, but in which the beneficiary or their dependent undergoes medical treatment without which their life would be at risk [3] . In these cases, the focus shifts from just breach of contract to protecting the dignity and physical integrity of the beneficiary.

Case law has also been advancing towards curbing contradictory behavior by operators, especially in cases where the operator continues to receive monthly payments after the delay, generating in the consumer the legitimate expectation that the contract would remain valid [4].In these cases, even if there has been formal notification, subsequent cancellation tends to be considered abusive, as it violates the good faith that should exist in the relationship between the parties.

Regarding compensation for moral damages, there is no presumption of its existence; that is, compensation is not automatically applied in every case of improper cancellation of a health plan. However, the courts have understood that when the termination of the plan results in the interruption of treatment, the refusal of relevant coverage, or significant suffering to the beneficiary, there is presumed moral damage. The amounts set as compensation vary according to the severity of the case, but are usually modest.

Given this scenario, it is of utmost importance that consumers do not passively accept the cancellation of their health plan, especially when there is a breach of legal requirements or abusive termination. Thus, whenever termination occurs due to non-payment, it is advisable to verify whether there was adequate notification, whether the legal deadline was respected, whether there was ongoing treatment, and whether the operator continued to collect or receive monthly payments.

In situations involving cancellations that appear unfair or irregular, specialized legal guidance is crucial to restoring rights and preventing or repairing losses resulting from the termination of a health plan.

[1] Provisional Measure No. 2,177-44, of 2001, which amended Article 13 of Law No. 9,656/98;

[2] https://www.gov.br/ans/pt-br/arquivos/acesso-a-informacao/participacao-da-sociedade/consultas-publicas/cp88/RN_593_original.pdf , accessed on 16/01/2026.

[3] AREsp No. 2,777,450/SP, rapporteur Minister Moura Ribeiro, Third Panel, judged on 19/5/2025, DJEN of 22/5/2025;

[4]   STJ: REsp No. 2.217.087/GO, rapporteur Minister Daniela Teixeira, Third Panel, judged on 12/8/2025, DJEN of 15/8/2025; and TJSP : Civil Appeal 1051911-98.2018.8.26.0100; Rapporteur: José Joaquim dos Santos; Judging Body: 2nd Chamber of Private Law; Central Civil Court – 37th Civil Court; Date of Judgment: 19/03/2019; Date of Registration: 20/03/2019;