Health insurance in Portugal

Health insurance in Portugal

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If you're living in Portugal, here is an overview of health and sickness insurance in Portugal.

Sickness protection, guaranteed by the general social security scheme, comprises the following benefits:

  • Health Insurance.
  • Compensatory allowances for holiday pay, Christmas bonus or similar payments.
  • These benefits are intended to offset loss of earnings due to sickness not caused by the job, and are awarded to beneficiaries who meet the respective conditions.


Health insurance is awarded on the following conditions:

  • Temporary incapacity, certified by the competent health services, the beneficiary being responsible for sending the respective certificate to the social security services;
  • Six calendar months, consecutive or separate, with registered earnings, from the date the employee became unfit to work.


It is awarded for a specific period of time:

  • No more than 1,095 days (three years); when this period has expired the beneficiary is covered by invalidity protection, if he/she is eligible for the invalidity pension;
  • Unlimited time when the disease is tuberculosis;
  • It is not paid in the first three days except in cases of tuberculosis, hospitalisation or a disease beginning in the period when maternity benefit is paid that exceeds that period;
  • The amount is calculated by applying a percentage to the beneficiary’s reference pay, which varies according to the duration and nature of the illness.


Compensatory allowances for holiday pay, Christmas bonus or other payments are awarded on the following conditions:

  • Time off work for a disease eligible for benefit;
  • Provision, in an instrument of collective labour regulation or another source of labour law, that such time off prevents the payment of such benefits, either totally or in part.


The following are not entitled to sickness benefits:

  • Workers who are imprisoned (they retain only the benefit being paid on the date of detention);
  • Employees receiving unemployment benefits;
  • Employees who have taken early retirement with total suspension of activity;
  • People receiving invalidity or old age pensions under any social protection scheme, whether in work or not;
  • Employees whose incapacity is due to action by third parties for which they are owed compensation.


A special social protection scheme exists for occupational diseases.

 

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