Before you start

CPF, for the Cartão Nacional de Saúde
Proof of address, which determines your Unidade de Saúde
Employer plan enrolment where offered
Vaccination record

Step-by-step

1
Take the yellow fever vaccination at least ten days before you arrive
Yellow fever is endemic in the Amazon region and Manaus's municipal health service recommends vaccination with at least ten days' lead time. It is free at Brazilian health units too, but the protection is not immediate, so doing it before departure is strictly better. Do not schedule it in the same month as a live measles-mumps-rubella dose; the recommended interval between live vaccines is 30 days.
In personWho: YouAt least 10 days before arrivalFree at a Brazilian health unit
2
Register at the health unit covering your address
Take CPF and proof of address to the Unidade de Saúde da Família for your catchment. The Cartão Nacional de Saúde is free and links you to a family health team, to vaccination and to the free medicines list.
In personWho: YouFree
3
Learn where malaria risk actually is
Risk in Amazonas is year-round but not uniform: it is materially higher on the periphery of the city, at the balneários and in the interior than in the built-up centre. SEMSA's standing advice is to avoid riverside bathing spots from dusk to dawn and to use repellent. If you will spend time in the forest or on the rivers, talk to a travel-medicine doctor about prophylaxis before you go, not after.
In personWho: You
4
Know that FMT-HVD is the place for a tropical fever
The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado is the state reference hospital for malaria, arboviruses and venomous bites. If you present with a fever after time on the rivers or in the forest, say where you have been — the exposure history is what directs the test, and this is the institution that runs those tests routinely.
In personWho: You
5
Treat mosquito control as household maintenance
Aedes aegypti breeds in small volumes of clean standing water around buildings and carries dengue, chikungunya and Zika. Screens, dry plant saucers and balconies, and repellent are the practical measures, and they are worth doing every month of the year in an equatorial climate rather than seasonally.
In personWho: You
6
Check the tier of your private plan against a specific hospital
A plano de saúde is a standard benefit at the industrial-pole employers. Manaus's private hospital market is smaller than a southern capital's, so which hospitals a tier admits you to matters more, and so does whether the plan covers medical transfer to São Paulo for anything complex. Ask about that transfer clause explicitly.
Via employerWho: YouCommonly BRL 400–1,300 per month for an adult individually

Documents you’ll need

CPF
Proof of Manaus address
Passport or CRNM
Vaccination record, including yellow fever
Private plan card and policy, where applicable

Things most newcomers don’t know

Nobody will check your yellow fever vaccination, and that is exactly the problem.

Yellow fever is endemic in the Amazon region and the vaccine takes ten days to protect, but Brazil does not require proof of vaccination for entry as a tourist. So the enforcement that would have made you do it does not exist, and people arrive unvaccinated because no counter asked. The dose is free at any Brazilian health unit and it is the single highest-value piece of preparation for living here.

Source: Ministério da Saúde and SEMSA Manaus — Saúde do Viajante

Manaus has a dedicated tropical-medicine hospital, and knowing its name is worth something.

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado is the Amazonas reference centre for malaria, arbovirus and venomous-animal cases, with the laboratory capacity that goes with it. A fever after time on the rivers is a different clinical problem from a fever in São Paulo, and FMT-HVD is where that problem is routine rather than exotic. Say where you have been; the exposure history is the diagnosis.

Source: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado / Governo do Amazonas

Malaria risk is about where you go, not about living in Manaus.

Amazonas carries year-round malaria transmission, but the risk is concentrated in peri-urban areas, at the balneários and in the interior rather than in the dense centre. That distinction is what decides whether prophylaxis is even a sensible question for you. Someone whose life is an office in Adrianópolis and a flat in Vieiralves is in a different position from someone doing fieldwork upriver, and the advice should be different too.

Source: Ministério da Saúde and SEMSA Manaus malaria guidance

Ask whether your private plan pays to fly you to São Paulo.

Manaus's private hospital network is smaller than a southern capital's, and for complex surgery or specialised oncology the practical answer is often a transfer to São Paulo. Whether the plan covers that transfer, and under what conditions, is a clause worth reading before you need it — it is the single biggest practical difference between a plan here and the same-priced plan in the south-east.

Source: ANS — regras de rede assistencial; confirm the specific policy wording

Common mistakes to avoid

Skipping the yellow fever vaccination because nothing at the border asked for it.
Taking yellow fever and MMR in the same fortnight rather than 30 days apart.
Not registering for a Cartão SUS because you have private cover.
Assuming malaria risk is uniform across the city rather than concentrated at the edges and the balneários.
Buying a private plan without reading whether it funds a medical transfer out of the state.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.