If you are a foreigner living or working in Portugal, you will typically be eligible to access subsidized state healthcare. The Portuguese healthcare system incorporates both public and private healthcare services and the standard of healthcare in Portugal is high.
This helpful guide explains the healthcare system in Portugal and how expats can claim Portuguese healthcare benefits while residing in the country.
The COVID-19 pandemic has been a difficult time for everyone. Many expats find themselves separated from family and loved ones in their home countries. As a foreigner, it is also sometimes difficult to find critical information regarding coronavirus infection rates, local measures and restrictions, and now, thankfully, vaccinations.
For general coronavirus health information in Portugal, including vaccination schedules and locations, visit the SNS Coronavirus (COVID-19) website: https://www.sns.gov.pt
For official COVID-19 measures, rules, and restrictions in Portugal, visit the Portuguese government’s Coronavirus (COVID-19) website: https://covid19.min-saude.pt
PORTUGUESE HEALTHCARE OVERVIEW...
The Portuguese healthcare system...
The healthcare system in Portugal consists of three coexisting systems:
The National Health Service (NHS, or Servico Nacional de Saude, SNS)
Special social health insurance schemes (health subsystems) that are occupation-based schemes used in the public sector and in certain professions such as police, military, and banking
Voluntary private health insurance in Portugal
The Portuguese Ministry of Health (Ministério de Saúde) is in charge of managing the SNS. Similarly, it is free and available to all residents, including expats in Portugal. However, charges have been introduced for many services in recent years. The system covers both primary and secondary healthcare services, including:
Portuguese doctors
Having a baby in Portugal
Some dental care in Portugal
Community healthcare
Portuguese hospitals and specialist care
The SNS covers all of mainland Portugal; the regions of Azores and Madeira have their own healthcare systems. A central administration manages this while five regional health administrations (North, Central, Lisbon and Tagus Valley, Alentejo, and Algarve) deliver it.
Portugal has a high standard of healthcare services. In fact, the Portuguese healthcare system was ranked 13th on the 2018 Euro Health Consumer Index. It is better than in previous years, when it ranked 25th in 2012.
Who can access healthcare in Portugal???
Eligibility for the Portuguese healthcare system is based on being a legal resident. This means that healthcare in Portugal for expats is available for those who are legal residents of Portugal. This can include non-working residents under certain conditions, such as unemployed, retired, or dependent family members.
Non-residents and temporary visitors to Portugal will need to purchase private health insurance to cover their stay in Portugal. However, those on short visits from the European Union (EU), European Economic Area (EEA), and Switzerland can access public healthcare in Portugal through their European Health Insurance Card (EHIC).
Nationals from non-EU countries that have reciprocal healthcare agreements with Portugal may also be able to access public healthcare in Portugal for free or at a reduced cost. The countries with agreements currently in place are Andorra, Brazil, Cape Verde, and Morocco. Other non-EU residents will have to purchase private health insurance to get coverage, however.
Healthcare costs in Portugal...
Healthcare in Portugal is funded through general taxation as well as from Portuguese social security contributions paid by working residents. However, those who are not in employment, dependent family members, or retirees don’t have to make contributions.
Portugal currently spends around 9.1% of its GDP on healthcare, making it in fact the 12th biggest spender out of EU/EFTA countries. Around 70% is public expenditure and 30% is private expenditure.
Residents have to pay a small contribution towards certain costs for doctors, specialists, hospital treatment, and prescriptions, unless they are from a vulnerable or low-earning group. They will have to pay out of pocket for most dental care costs.
Health insurance in Portugal...
Health insurance in Portugal is either covered by your employment-based contributions to the Social Security Institute or Instituto da Solidariedade e da Segurança Social (which entitles you to state healthcare in Portugal), through the EHIC if you are visiting from the EU/EEA or Switzerland, or through private health insurance for non-EU visitors.
Some residents (around 20% of the population) also opt for private health insurance to supplement their public health insurance. This might be to cover extra services that the state Portuguese healthcare system does not include or to cover 100% of costs. This also entitles them to treatment from private healthcare providers in Portugal, which can actually be quicker than public healthcare services.
Unemployed and retired residents don’t need to make social security contributions. If you are retired in Portugal, you can complete an S1 form to access public healthcare.
If you are retired and won’t be making social security contributions via paid employment, you can still be entitled to healthcare in Portugal if you complete an S1 form; this shows you made contributions and are entitled to healthcare in another EU country.
Large expat-friendly health insurance companies that provide private coverage packages are numerous as well.
How to register for healthcare in Portugal as an expat???
To register for public healthcare in Portugal, you first need to register with Portuguese Social Security (Seguranca Social) to get your NIF number. Your employer usually does this if you already have a job. Self-employed people, however, need to arrange this on their own.
Once your social security arrangements are in place, you can register at your local Portuguese health center (centros de saude). You will need to take along a few items, such as:
Your social security card
Your passport or national ID card
Portuguese residence permit
Once you have registered for public healthcare in Portugal you will receive your cartao do utente (healthcare card), which should be used to show your eligibility every time you access Portuguese healthcare services.
You can also register to access the SNS online portal. This portal lets you access information and make appointments online.
Private healthcare in Portugal...
Private healthcare in Portugal exists alongside the public SNS provision, although some doctors actually work in both sectors. The costs for private GP services, specialists, and hospitals can be covered by taking out private medical insurance in Portugal.
Similar to elsewhere, private healthcare in Portugal is more expensive, although not as expensive as in some countries. An appointment with a private doctor will cost around €40–50. Waiting lists for private services are typically shorter; there is a wider availability of services and there is also more chance of being seen by English-speaking staff.
Private health insurance for expats is common in Portugal. In fact, it’s growing in popularity among the local Portuguese population, too; between 10–20% of locals use private health services in Portugal. Some services, such as dental and eye care services, have limited coverage through the SNS. As a result, some residents have little option but to seek out private providers.
Unlike the SNS, which is largely free at the point of use, you will normally have to pay for private services upfront and claim a reimbursement from your insurer. Check your policy for exact details and procedures.
Doctors and specialists in Portugal...
Doctors in Portugal are part of primary medical services covered by the Portuguese healthcare system. Most doctors are based at public health centers and once you have registered for public healthcare in Portugal, you will be able to register and make an appointment with a doctor.
Most of the costs for doctors in Portugal will be covered by public health insurance. However, you will usually have to make a small contribution towards consultation costs unless you’re elderly or from a vulnerable group. To ensure costs are covered, you will need to check that your doctor is contracted to offer services though the public healthcare system in Portugal. Some doctors in Portugal only offer private services.
To see a specialist (e.g., cardiologists, psychologists) through the state healthcare system, you will typically need to be referred by a doctor. Patients usually have to pay something towards the costs of seeing a specialist in Portugal.
Depending on what kind of treatment you need and what kind of specialist you end up seeing, you may need to wait, however. Although the quality of care is high, there can sometimes be a long wait to see specialists in Portugal on the SNS.
Women’s healthcare in Portugal...
Health centers, hospitals, and clinics deliver women’s healthcare in Portugal. The national health system covers maternity care, and an expectant mother generally receives care at the public hospital in her area, unless her practitioner requests it. A woman may also choose to receive private care if she has the appropriate insurance.
Prenatal care takes place at the hospital. During the first appointment, the mother-to-be will receive a Pregnancy Booklet (Boletim de Saúde da Grávida) in which her doctor will record ongoing medical information as the pregnancy progresses. Maternity wards in Portuguese hospitals also offer prenatal classes; however, they are not usually subsidized through public health insurance in Portugal. In addition, midwives (doulas) are available to help with the birth delivery.
Gynecologists work in health centers and clinics. You can access them through your GP. They can provide health advice and carry out routine examinations.
Contraception is widely available and used in Portugal. In fact, according to a 2015 UN report, 74.3% of Portuguese women use some form of contraception. Furthermore, you don’t need a prescription for the birth control pill and you can buy condoms from many places including drugstores and supermarkets.
Since 2007, abortion is legal in Portugal in the first 10 weeks of pregnancy. However, you will need to consult your GP first and undergo a three-day period of reflection. Abortion costs are usually covered by insurance.
Children’s healthcare in Portugal...
Portugal has a child and youth healthcare program, which began in 1992. GP’s and pediatricians deliver healthcare to children.
Children have access to free healthcare in Portugal. The social security payments of their parent or guardian cover this. Children have regular health checks from birth, and can also access services including screening and examinations, vaccinations, and nutritional healthcare. Furthermore, they will have a record that charts their progress.
Portugal has a national vaccination program included on the SNS. This includes vaccinations for diseases, such as:
Hepatitis B
Diphtheria, Tetanus, and Pertussis
Polio
Measles, Mumps, and Rubella
Pediatric healthcare in Portugal is overseen by the Society of Portuguese Pediatricians (Sociedade Portuguesa de Pediatria).
Dental care in Portugal...
Free dental care isn’t available on the SNS unless you are classed as being in a vulnerable group unable to pay; this includes children, elderly, or disabled residents. Most dental treatments such as crowns and bridges can be covered by some form of private health insurance in Portugal.
If you qualify for either free or subsidized treatment, you will need to bring your cartão de utente (healthcare card) when visiting your dentist to ensure you do not pay the full amount for the consultation. Read more about the requirements for visiting the dentist in Portugal.
Hospitals in Portugal...
People that register at a local health center can access hospital services at a discount, and sometimes even free. You should bring your healthcare card with you.
Unless you have to go to hospital for emergency treatment, you will need a referral from a Portuguese doctor for treatment. Public hospitals in Portugal provide services including:
Emergency treatment
Outpatient treatment
Nursing
Post-operative care
Maternity care
Psychiatric care
Care for those with terminal illnesses
As with doctors’ services, standard public health insurance may not cover some hospital costs, so you will need to check before receiving treatment. There are both public and private hospitals, and you can find a long list of them in Portugal.
Health centers and health clinics in Portugal...
There are numerous health centers (centros de saude) all over Portugal, where you typically start any process for seeking treatment. Health centers are where most doctors in Portugal are based; in fact, this is where you have to first register for public healthcare in Portugal. Most health centers in Portugal are open from 8am to 8pm and various health professionals run these. As well as Doctor or GP services, you can find maternity and childcare services, basic non-life threatening emergency care, and sometimes dental services.
In addition, you can visit the SNS website for information on where to find your local health centre in Portugal.
Pharmacies in Portugal...
You can find pharmacies (farmácia) in Portugal in town centers and shopping malls. General opening hours for pharmacies in Portugal are from 9am to 7pm on weekdays (with a lunch break between 1pm and 3pm) and 9am to 1pm on Saturdays.
There are duty pharmacies (farmacio de servico) which stay open out-of-hours for emergency situations. In any pharmacy, you can find a list of pharmacies providing 24/7 services. However, you can also find a list on the SNS website, along with details of community pharmacies.
Public health insurance in Portugal generally covers some of the costs towards prescription drugs, however, you usually need to contribute a payment. In Portugal, medical costs have grades and these have subsidies, as follows:
90% – Grade A
69% – Grade B
37% – Grade C
15% – Grade D
Mental healthcare in Portugal...
Mental healthcare in Portugal is provided through mental health teams working in health centers and hospitals. Recent studies have shown that around 30% of Portuguese residents have experienced some form of mental health problem. In fact, the country has higher than EU average levels of depression and substance abuse.
Despite this, Portugal’s mental healthcare provision is not as developed as in several other countries. There are 12.4 psychiatrists per 100,000 inhabitants, which is below the EU average. Community-based mental healthcare is also underdeveloped.
You can access mental health services through the SNS. However, your GP should be your first point of contact. Depending on your situation and service availability in your region, your GP can:
Prescribe medication
Refer you for counseling
Depending on your condition, refer you to a specialist
For more serious conditions, refer you to a psychiatric unit or emergency unit
Refer you to a community-based program
Only some mental health services are available through the NHS. Therefore, to access a wider range of treatments, you will need to purchase private health insurance. You can find psychiatrists and psychologists in both public and private sectors in Portugal.
Other forms of healthcare in Portugal...
Although alternative and complementary medicine is generally not available through the SNS, it is common in Portugal. In fact, according to one study based on Lisbon patients, 76% have used some form of alternative therapy.
Licensed professionals in Portugal can practice alternative and complementary treatments. You will have to pay out of pocket for these unless you have a private insurance policy that covers it. Practitioners have integrated acupuncture to some degree into regular medical practices; you may be able to access this through your GP.
Licensed treatments in Portugal include:
Chiropractic
Osteopathy
Naturopathy
Herbal medicine
Massage
Emergencies in Portugal...
Emergency treatment in Portugal is available to everyone regardless of residence status or insurance. Once your condition has stabilized, however, you need to show proof of your Portuguese residence status or health insurance to have the costs covered.
The main emergency number in Portugal is 112, which connects you to ambulance, police, and fire services.
Useful medical words and phrases:
Call an ambulance: Chame uma ambulancia
I would like to see a doctor: Gostaria de ver um médico
I feel ill: Estou doente
I’d like to make an appointment: Gostaria de marcar uma consulta
Health centre: Centro de Saúde
Hospital: Hospital
Doctor: Médico
Medicine: Medicina
Pharmacy: Farmácia
Maternity: Maternidade
Emergency: Emergência
Useful Resources:
www.sns.gov.pt – Website for the Servico Nacional de Saude (SNS), the Portuguese national health service.
https://servicos.min-saude.pt/utente/ - SNS online health portal.
www.portaldocidadao.pt – Portal do Cidadao, “Citizens”portal website with details on healthcare.
www.seg-social.pt – Portuguese Social Security website (Seguranca Social).
www.apf.pt – Portuguese Family Planning Association website.
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