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One of the first questions from anyone with Brazilian private health insurance (a health plan) is whether it covers the treatment. The short answer: having a health plan usually makes the path considerably easier — even when coverage is neither automatic nor total. And at no stage do you walk alone: our team handles the paperwork with you, from A to Z.
I want an evaluationUnderstand the Coverage
The patient-specific titanium plate falls into the category the healthcare sector calls OPME — orthosis, prosthesis, and special material linked to a surgical procedure. Brazil's health plan legislation and the rules of the ANS (Brazil's National Supplementary Health Agency) provide that, when there is a medical indication justified by the surgeon, this type of material enters the insurer's coverage review. Note that this applies to Brazilian private health insurance (health plans), not to insurance systems in other countries.
In practice, this puts those who have a Brazilian health plan in a much more comfortable position than those who have to pay for the entire treatment out of pocket: there is a formal path for requesting coverage, with legal grounds to support the request.
Those who have a health plan have an extra path to reduce the cost of treatment. Those who don't go straight to the private (out-of-pocket) route.
The hospital facilities, anesthesia, and part of the team involved in the procedure are usually within the standard coverage of Brazilian health plans that include oral and maxillofacial surgery.
The mandatory review of OPME linked to the surgical procedure gives the patient a formal basis to request coverage — and, if necessary, to contest a denial.
The certified surgeon prepares the report and the technical justification, and leads the request with the insurer — the patient does not have to negotiate alone.
Even when coverage is not 100% of the plate's cost, what falls outside the plan tends to be a smaller fraction than the full out-of-pocket treatment.
Important: every insurer, every plan, and every case is analyzed individually. It is not possible to guarantee in advance what percentage of coverage will apply, or that approval will be automatic — the process can take days and depends on the documentation submitted by the surgeon. Even so, for those who have a Brazilian health plan, this is usually the most advantageous starting point.
One of the biggest fears of anyone starting this kind of treatment is having to deal with the paperwork alone — understanding the plan's forms, chasing down exams, tracking deadlines. At Cubo Biomedical, that does not fall on you. We have a team prepared to give the patient full assistance, side by side with the surgeon, from the first contact to the final rehabilitation.
We take care of organizing the documentation and follow up on the authorization request with the insurer, always alongside the surgeon in charge.
We help organize the CT scan and the other exams needed for planning, so you don't have to chase them down on your own.
Our team follows the progress of the case with the surgeon at every stage, from planning to surgery.
We know this is a delicate moment. We are available to answer questions and offer support at every stage, so you never feel alone in the process.
From the health plan paperwork to the clinical and emotional follow-up — we structure your case from A to Z, so that your only concern is recovering.
The treatment can also be done privately, directly with a certified surgeon. The difference is that, without a plan, there is no coverage request stage — the path goes straight to the private cost estimate for the case. Even so, our team's support from start to finish remains the same.
Frequently Asked Questions
The plate is classified as OPME linked to the surgical procedure. With a justified medical indication, Brazilian health plans must as a rule analyze coverage — but this does not guarantee automatic approval or full coverage, since each insurer evaluates individually. Even so, having a plan usually makes the path considerably easier.
The certified surgeon prepares the medical report with the technical justification and requests the authorization form from the insurer. That document opens the review process.
Denials can be contested, including through administrative appeals with the insurer or with the ANS (Brazil's National Supplementary Health Agency). It is worth talking to the surgeon and, if necessary, seeking specialized legal advice.
Yes. The treatment can also be done privately, directly with the certified surgeon, without depending on an insurer's approval.
No. We have a team prepared to assist the patient with all the paperwork, together with the surgeon: documents, the request to the health plan, support with exams, clinical follow-up, and emotional support — from start to finish.
Fill out the referral form and our team will connect you with a certified surgeon near you, who will evaluate your case and the documentation for your health plan.