This paper presents the results of a study about the private health plans and insurance, called supplementary health, which were regulated in Brazil more than a decade ago in order to solve conflicts in the provision of services. The model of care, the issues resolved, those that remain and the ones that emerged during this period were described and analyzed, using a qualitative methodology. The results show that the supplementary sector made little progress from the model based on the list of diseases and procedures, approved as a reference plan, increasing conflicts regarding the incorporation of technologies and the increase of the demand and costs, due to the aging of the population. Regulatory policies that hurt the bioethical principles contained in the National Health System were consolidated, mainly regarding the assistance to the most vulnerable, pregnant women and the elderly. Regulation is lacking, by the State, in the adequacy of the supplementary area with other public policies, in the sense of perfecting the quality of care and expanding healthcare coverage equitably.
Brazil; Supplemental health; Bioethics; Model of care; Health services; Health maintenance organizations; Delivery of health care