Health insurance in Portugal
Do you need health insurance in Portugal? Find out if you can register for state health insurance in Portugal to receive free or discounted healthcare.
If you live and work in Portugal and contribute to social security in Portugal, you will typically be entitled to subsidised state healthcare in Portugal using a Portugal health insurance card, although many expats also take out supplementary private health insurance in Portugal or even expat insurance.
Health insurance in Portugal can be a complex system although reportedly provides access to a good healthcare system, ranked as the world's 12th best by the World Health Organisation (WHO). The system has improved considerably in recent years, although some services still lag behind other parts of Europe.
This guide explains who can access state healthcare in Portugal, how to take out health insurance in Portugal and when to consider private health insurance in Portugal.
This guide to health insurance in Portugal covers:
- Who needs Portugal health insurance?
- Portugal's health insurance system and how to apply
- Private health insurance in Portugal
- Portugal's health insurance costs and reimbursements
- What is covered under health insurance in Portugal?
- Other health insurances in Portugal
Short-term visitors can access healthcare in Portugal, although will typically have to pay unless they are covered by travel insurance or medical insurance (a typical visa requirement). You will need to register with a doctor before any first appointment although many foreigners head to emergency health clinics or hospitals in Portugal, or any private clinic.
Travellers from the European Union (EU), European Economic Area (EEA – EU plus Iceland, Liechtenstein and Norway) or Switzerland who are visiting Portugal can be covered by their European Health Insurance Card (EHIC Portugal), which allows access to subsidised healthcare on the same conditions as local residents.
All international citizens who become official residents or employees in Portugal, however, whether from the EU or outside of Europe, typically gain the same healthcare rights as Portuguese nationals and will be covered by health insurance in Portugal – although not all types of treatment are available for free, with many requiring a patient contribution.
Portugal's health insurance system is open to those who pay social security (seguranca social), their dependent family members and retired people. For those aged over 65, subsidised prescriptions and contributions towards additional healthcare such as dental and optical treatment are provided.
EU citizens who retire early and move to Portugal may qualify for free or subsidised healthcare for up to two years of residence, provided they obtain form S1. Alternatively, early retirees can pay voluntary social security contributions or get private health insurance in Portugal. Once EU citizens reach the legal retirement age, they will be typically covered for free or subsidised healthcare under another insurance (with a S1 form).
Portugal has its own national healthcare system, the Servico Nacional de Saude (SNS), which is operated by the Ministry of Health and works relatively similarly to the United Kingdom’s NHS. The SNS refers to numerous initiatives and healthcare centres, involving a number of complicated and sometimes contradictory schemes. State healthcare is considered to provide a relatively good, albiet not uniformly consistent, standard of care, although it is oversubscribed and waiting times can be long.
The system is advantageous in that almost anyone paying social security – and their dependent family members – can be covered by health insurance in Portugal but recently the government had to introduce fees for certain services, with only basic treatments for free and some treatments now carrying hefty fees. Unlike in the UK where residents pay a set medical fee regardless of cost, Portugal's health insurance typically covers a percentage, meaning personal costs are subject to the cost of medicine or treatment. For those with ongoing health issues or expensive medicine, in some cases private health insurance in Portugal may provide more coverage.
Registering for health insurance in Portugal
If you are working in Portugal, your employer should automatically enrol you and arrange payments into the social security system in Portugal, after which you can get health insurance in Portugal. Self-employed people, however, will need to register with the Social Security Institute (Instituto da Solidariedade e da Segurança Social) themselves before apply for health insurance in Portugal.
Once you’re registered, you then need to visit your local health centre (centros de saude), where you’ll be assigned to a doctor (read more about registration at a health centre, or see the SNS's site in Portuguese). When registering at the health centre, you’ll need to take your social security card and passport and residence permit. You’ll then be given a temporary registration certificate, before being sent a healthcare card (cartão do utente), which you should carry at all times and allows you to receive discounted healthcare.
If you haven't yet received your residence permit, you can get a certificate from your local Junta de Freguesia confirming more than 90 days of residence in Portugal. You can show this, along with other necessary paperwork such as your ID, tax number and proof of address, to your local health centre to get your healthcare number (numero utente).
Portugal's health insurance system covers most medical treatments except for dental care.
If you don’t qualify for the state healthcare system, you will need to consider private health insurance in Portugal if you want to be covered. With the state healthcare service relatively cash-strapped and sometimes with long waiting lists, private health insurance in Portugal is gradually growing in popularity. Some people also opt for supplementary private insurances, such as dental insurance or vision insurance.
As in many other countries, private healthcare typically offers shorter waiting times, better facilities, wider choice and more opportunity to be seen by a specialist who speaks your language. Although in major cities and resort towns there are plenty of English-speaking doctors, this isn’t always the case if you live in a more rural or remote areas.
Private health insurance in Portugal is widely available from both well-known international private insurers and local private insurance companies. You can use comparison websites to search the range of health insurance companies in Portugal, although quotes vary wildly depending on the level of coverage and most providers can't give you an accurate policy quote until you fill out a health questionnaire or undergo a health check.
Before signing up for private health insurance in Portugal, you should check your policy to note any clauses giving insurers the right to cancel or increase your insurance charges once you reach a certain age, for example, 70 years old; to change a policy or take out new insurance at the age of 65 or 70 can be considerably difficult or expensive. Additionally, many Portuguese private insurers only offer policies for people aged under 55, so if you’re older you may need to get cover from an international insurer.
In popular expat areas, it’s possible to get advice from English-speaking insurance specialists who compare private health insurance products on your behalf. If you already have private insurance in another country, or even expat insurance or international insurance, you can also look into extending your existing private health insurance to include coverage for Portugal.
Expat health insurance
Expat health insurance typically offers more flexibility to access healthcare in a number of countries, and benefits such as repatriation or evacution, coverage for non-urgent issues abroad and direct payment for your treatment in any country. You can read about the differences between local and international health insurance and how to choose the best expat health insurance
Portugal's health insurance scheme allows for residents to access healthcare services for free or at discounted costs. State healthcare is well subsidised but you will need to pay higher fees for some treatments and services, unless you fit into one of the following groups: low-income earners, students, children, patients with diabetes, people over 65 and pregnant women. The cost in total is thus your mandatory social security payments and the reduced cost of any treatment and medicines.
If you take out private health insurance in Portugal instead, it can cost anything from a several hundred euros per year to a few thousand, depending on your personal circumstances. Most schemes will also come with an excess fee, which you’ll have to pay before making a claim with your insurance. In addition to individual policies, it is also possible to get private healthcare packages to cover your whole family.
The cost of private health insurance varies depending on the level of coverage you choose and for where (in Portugal, Europe or worldwide), although families can usually get competitive rates. Many private insurance policies don't cover outpatient costs, for example, family doctor visits or certain medicines, although you can increase your coverage to incorporate such factors. Most private insurance in Portugal will, however, typically cover the full costs of specialist or hospital treatments. Typically the higher the cost of private insurance, the more features and choice of doctors and hospitals will be available.
Health insurance at the doctor
Once you’ve registered at your local health centre, you should be able to book an appointment over the phone, in person, or online to see your assigned doctor. When visiting the doctor, Portugal's health insurance scheme will cover most costs but you may need to make a payment towards the costs of the consultation, depending on your health insurance in Portugal (for example, low-income earners and pensioners pay less or nothing).
What is covered at hospitals?
Portugal boasts around 200 hospitals, around half of which are private. Unless you’re admitted in an emergency, you’ll need to be referred by your doctor to visit a specialist in a hospital (for example, if you need an X-ray or other treatments), otherwise it may not be covered by your health insurance in Portugal. How soon you get an appointment and where you will be treated can often depend on whether you’re covered by private health insurance in Portugal or are using the state system, which has long waiting times for some services.
Health insurance in an emergency
If you require an ambulance for a medical emergency, you should call 112. If you use an ambulance you’ll often need to make a small contribution towards the service that is not necessarily covered by health insurance in Portugal. Alternatively, if you can make your own way to the hospital, you should be able to visit an around-the-clock emergency department.
Pharmacy costs under Portugal's health insurance
You’ll be able to access many medicines over the counter at your local pharmacy (farmacia de servico), with some requiring prescriptions from your doctor. Under health insurance in Portugal, you’ll typically need to contribute a percentage of the cost of your medicine, with different grades of medicine subsidised by the following percentages: Class A (90 percent), Class B (69 percent), Class C (37 percent) and Class D (15 percent).
Pharmacies are usually open all day from Monday to Friday (although some close at lunch times) and on Saturday mornings; in larger towns, some pharmacies open on Sundays. In any case, there are always 24-hour facilities in each area for urgent medical issues.
Maternity health insurance coverage
Most maternity care is provided by your local hospital. Medical examinations are free under health insurance in Portugal, but pre-natal care classes aren’t usually subsidised. Pregnant women are provided with a Pregnancy Booklet (Boletim de Saude de Gravida), where the progress of the pregnancy is recorded.
If you go on maternity leave, you’re entitled to 100 percent of your salary for the first 120 days, and 80 percent for the following 30 days. Fathers, meanwhile, are entitled to five days paternity leave once the baby has been born.
Sick pay in Portugal
Sick pay is also available to those who pay social security contributions. If you’re absent through illness or injury, you are eligible to receive sick pay for a total of 1,095 days. The amount of sick pay allowed operates on a sliding scale of between 55 percent and 75 percent of your salary, depending on how long you’re off for, although this figure can also vary based on whether you are paid benefits, earn a very low wage or have several dependants.
Dental care isn’t usually free on the SNS unless you’re deemed to be in a vulnerable group (such as the elderly or children), in which case you could be issued with dental vouchers to cover dental costs. Otherwise, some private health insurance companies offer dental insurance, either as a comprehensive health insurance plan or as an optional add-on.
Eye care works slightly differently. If you want to see an optician under the state system, you’ll need to ask your local health centre to book an appointment with a specialist, for which you may need to wait several months unless your problem is deemed urgent. Optical care isn’t covered on the SNS, so you’ll need to pay for glasses and contact lenses yourself or consider vision insurance in Portugal.
Student health insurance
EU, EEA and Swiss students are entitled to the same healthcare benefits as Portuguese citizens using their European Health Insurance Card (EHIC Portugal), which you can present any time you need to use healthcare services.
Students from outside of the EU typically need a student visa to study in Portugal. As part of the application process, non-EU students generally need to take out adequate healthcare insurance to cover them during their stay.
Company health insurance
You may be offered a company health insurance plan. If you change employers it will typically cease and you may lose coverage for certain factors, such as existing illnesses, if you change companies. The conditions will depend on your employer.
- Portugal national services website: healthcare advice
- Portugal's health ministry
- Social security in Portugal
- Healthcare in Portugal: UK NHS guide
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