This note presents the characteristics of public health insurance systems and analyzes their characteristics in relation to Universal Health Coverage in Mozambique. Compulsory public insurance systems represent an improvement in access and financial protection in contexts where there was no public health coverage. However, they present challenges in terms of inequities in the financing and use of services, coverage of groups outside the formal economy, high administrative economy, high administrative costs to manage reimbursements for each medical act and constant in the labor market. Current international evidence recommends prioritizing general taxation and not making health care conditional on the payment of a particular tax or fee.