A court in Brazil’s Federal District has ordered Bradesco Saúde to cover insulin pumps for a patient with type 1 diabetes, reflecting a growing judiciary push to mandate health plan coverage for essential medical devices when prescribed by doctors.
A court in Brazil’s Federal District has ordered Bradesco Saúde to cover an insulin pump and related supplies for a patient with type 1 diabetes, in a ruling that reflects a broader judicial trend towards forcing health plans to fund the device when doctors say it is medically necessary. The Federal District and Territories court said the insurer must also reimburse costs the beneficiary had already paid after coverage was refused.
According to the case, the patient was prescribed continuous insulin infusion after conventional treatment failed to keep blood sugar under satisfactory control. Medical reports and an expert assessment supported the need for the technology, but the health plan still declined to provide the equipment and consumables, leaving the patient to pay out of pocket.
The decision was overturned on appeal after the patient and the Federal District public prosecutor’s office challenged an earlier ruling that had found no contractual or legal duty to cover the treatment. In its reasoning, the court pointed to recent case law from Brazil’s Superior Court of Justice, which in March set criteria for mandatory coverage of insulin pumps, including a medical prescription, proof that no suitable alternative is available on the National Health Agency’s list and registration with the health watchdog Anvisa. The high court also said that law changes passed in 2022 apply immediately to existing health insurance contracts.
The ruling adds to a growing body of decisions from the Superior Court of Justice. In December 2024, its Fourth Panel said insulin infusion systems are medical devices that health plans must cover, even if they are not listed among standard procedures. In November 2024, another panel reached a similar conclusion for patients with type 1 diabetes when the need is properly documented. A public hearing in August 2025 also showed that the issue remains contested, with public bodies and private groups arguing over both medical benefits and costs. The Federal District court’s latest decision was unanimous.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
