Omni faz rodada para dobrar seu seguro de medicamentos

Omni, a startup that created a health insurance plan already used by Azul, Light, MetLife, and Spoleto, has just closed a funding round to double its base of lives to 50 million by next year and generate R$ 50 million in revenue. The round, led by ACNext, a venture capital firm founded by former Accenture executives, also saw participation from GreenRock, a fund with ties to the Salomão Zoppi family, and Enseada, the family office of Larragoiti from SulAmerica.

ACNext's CEO, Fernando Domingues, co-founder of Conexa Saúde, a telemedicine startup, disclosed that Omni has raised a total of R$ 30 million across three rounds since its founding in 2024. Domingues launched Omni after leaving Conexa Saúde, selling his stake to a fund last year to focus entirely on Omni. Both businesses emerged from the same observation of a gap in the Brazilian health market compared to the US, where drug insurance, known as PBMs, is a multi-billion dollar market.

However, in Brazil, drug coverage is not a mandatory requirement in health plans, and PBMs operate mainly in the US. Omni's pitch is that facilitating access to medications can prevent disease exacerbation, absences, and hospitalizations, particularly for mental health patients and those needing antibiotics, ultimately reducing costs for employers and insurers.

The model allows employers and insurers to pay a monthly fee per life, defining the amount each employee can spend on medications, ranging from R$ 50 per month to over R$ 1,000. Omni's benefits cover generic medications and allow purchases of any drug available in pharmacies, with higher coverage resulting in higher prices. The startup operates through an app where employees submit medical bills, and if the medication is covered, they receive authorization to pay via Pix.

Afterward, they must submit a tax receipt, which AI tools verify against prescriptions. Omni earns no revenue from drug sales or pharmacy commissions; its income comes from managing operation risk by controlling sinistries and avoiding fraud. With over 70 clients, Omni serves 350,000 lives, and the goal is to double this base within a year.

In the previous month, Omni generated R$ 26 million in annualized recurring revenue (ARR), with an expectation of reaching R$ 30 million by year-end. By the end of 2027, the projection is to reach R$ 50 million in revenue and achieve breakeven for the first time. Omni competes with companies like Funcional, VidaLink, and Epharma, which have been active for years, primarily anticipating the day when drug coverage would become a mandatory requirement in health plans.

Domingues stated that while it is difficult to predict when regulation might change, the company aims to prove through cases that it helps plans avoid fraud and reduce sinistries through higher medication adherence, making it a potential addition to the ANS radar.