MedSênior and Leve Saúde plan minority stake sales

MedSênior, which already has Singapore’s sovereign fund Temasek as a shareholder since 2022, is considering a secondary offering in which the founding family would reduce its stake but retain control. Leve Saúde, on the other hand, is negotiating a capital raise of between R$300 million and R$500 million to expand its network of clinics and hospitals, Valor has learned.

Most health insurers in Brazil avoid the over-60 population, citing high medical costs, which has led to a shortage of plans for this age group. Currently, 7.7 million Brazilians over 60 have health coverage—15% of the total market—but they account for one-third of all medical expenses, according to consulting firm Arquitetos da Saúde, using data from the national health regulator ANS.

Yet Prevent Senior, MedSênior, and Leve Saúde—Brazil’s three leading senior-focused insurers—are defying that trend. Their loss ratios (medical costs relative to revenue) are well below the industry average, which closed 2023 at 83.8%.

In 2024, MedSênior posted a loss ratio of 56.7%—the lowest in the sector. Leve Saúde was close behind at 56.78%. Prevent Senior, after peaking during the pandemic, ended 2023 with a ratio of 83.1%, which fell to 74.7% in March—closer to historical levels.

Prevent Senior came under fire during the pandemic over allegations ranging from promoting unproven COVID-19 treatments to negligent care. Some cases were dismissed due to lack of evidence, while one investigation by São Paulo’s public prosecutor is still ongoing. No convictions have been issued. “Prevent Senior has always denied any wrongdoing,” the company said.

Over the past two years, a wave of unilateral cancellations by other insurers has driven many new clients to Prevent Senior, disrupting the balance between supply and demand.

Rapid growth

Between 2018 and 2024, MedSênior’s revenue jumped from R$193.8 million to R$2.1 billion. Net income reached R$297 million last year—more than twice that of Prevent Senior, despite the latter generating around R$7 billion in revenue. Leve Saúde, founded in 2020, grew from R$2.3 million in revenue to R$383 million by 2024. The company is still posting losses, due to its smaller scale (81,000 clients) and limited operating history.

Founders Maely Coelho (MedSênior) and Ulisses Silva (Leve Saúde) argue that serving older adults can be profitable. They entered this underdeveloped segment in response to Brazil’s aging population, which is expected to increasingly demand healthcare services. In 2023, 15.6% of Brazilians were aged 65 or older. By 2070, that figure is projected to rise to 37.8%, according to the Brazilian Institute of Geography and Statistics (IBGE).

Together, the three specialized insurers have about 850,000 members, including a small share of younger dependents. Their market share is still limited, considering the 7.7 million Brazilians over 60 with health plans.

Roughly half of those older members have employer-sponsored coverage, often retained after retirement from companies that allow former employees to keep their benefits. However, more employers are eliminating this option—even for retirees willing to pay out of pocket—creating an opening for insurers offering individual plans. These are scarce for all age groups and particularly rare for older adults.

Model focused on prevention

Prevent Senior, MedSênior, and Leve Saúde operate on a prevention-oriented model that emphasizes routine exams and chronic disease management—costs that are far lower than hospital stays or surgeries. In addition, services are offered through proprietary clinics and hospitals designed specifically for elderly care, which is more cost-efficient than outsourced provider networks.

Prevent Senior pioneered this model and remains the market leader, with nearly 600,000 clients—three times more than MedSênior. Its network includes 13 hospitals, 4 emergency care units, and 29 clinics, mostly in São Paulo. This year, the company plans to open two more hospitals, two new urgent care centers, and a clinic.

“Having an operation fully focused on this demographic makes a difference. These companies have deep expertise—their entire infrastructure and data systems are tailored for this audience. Industry data shows people over 60 account for 15% of the member base but 34% of medical costs. Yet these specialized players perform far better,” said Luiz Feitoza, a partner at Arquitetos da Saúde.

Most insurers struggle to maintain a dedicated division for older clients. Not surprisingly, sources say Prevent Senior received acquisition and merger offers from large insurers shortly before the pandemic.

Around the same time, investors were eyeing MedSênior, which ended up selling a 15% stake to Temasek in 2022. The capital raised—undisclosed—went to shareholders. This time, the new offering would again be secondary, and Temasek’s stake would not be diluted, people familiar with the matter said.

The Singaporean sovereign fund did not invest directly into the operation but opened doors for MedSênior’s expansion into new markets.

“We don’t need capital—we generate cash. But we’re a small operator from Espírito Santo, and it’s hard to break into São Paulo, for example. Once we say our partner is Temasek, everything changes. It gives us credibility. Temasek did a thorough due diligence process, which proves everything is in order,” Mr. Coelho said. “They’re a dream partner. They don’t interfere, they know we understand healthcare. They sit on the board and have helped us a lot with introductions,” he added.

MedSênior is now present in São Paulo, Rio de Janeiro, Minas Gerais, the Federal District (Brasília), Paraná, Rio Grande do Sul, and, more recently, Recife.

Founded during the COVID-19 pandemic in 2020, Leve Saúde is also growing rapidly. Sources said its capital raise—between R$300 million and R$500 million—will fund hospital acquisitions in its core market of Rio de Janeiro and expansion to other regions of Brazil. The company currently operates 11 clinics, which serve as patients’ first point of care.

Leve also has clients in small and mid-sized business plans (PME), a segment MedSênior has only recently entered. One of Leve’s strategies is to attract clients from other Rio-based insurers such as Assim Saúde, which is reportedly in talks to be sold, and Golden Cross, which will be shut down by the ANS in mid-May and must transfer its clients to other providers.