A Comprehensive Guide to Healthcare in Portugal for Expats

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    Understanding healthcare in Portugal is a critical step for any expat thinking of moving here. Ensuring you can access high-quality healthcare can be reassuring when making such a significant life transition.

    This comprehensive guide will cover common questions you might have as an expat, from eligibility to cost, the range of services, and insurance options available in Portugal.

    You'll also learn about the differences between private and state healthcare, and how they compare with services in countries like the UK and US.

    Overview of the Portuguese healthcare system

    Portugal's healthcare system is divided into two tiers: public and private.

    The organization that takes care of public healthcare in Portugal, Serviço Nacional de Saúde (SNS), was established in 1979 and ensures that all citizens have access to healthcare. The SNS covers mainland Portugal, while the Azores and Madeira have separate systems. In addition, the country boasts a flourishing private healthcare sector, which offers high-quality services preferred by many expats and locals.

    Public Healthcare System in Portugal

    The SNS offers a wide range of services, including consultations, treatments, surgeries, and long-term care. Expats who are residents, regardless of their citizenship, can access these services, although the process may vary. EU citizens can use their European Health Insurance Card (EHIC), while non-EU citizens need to provide proof of residence.

    While public healthcare is generally free, nominal fees called "taxas moderadoras" may apply for certain services, although they are significantly lower compared to other countries, especially for expats who have moved to Portugal from the US.

    However, the public healthcare system in Portugal sometimes faces criticism for long waiting times, especially for non-urgent specialist services and procedures. Additionally, language barriers may pose challenges, especially for non-Portuguese speakers.

    Understanding the 'Utente Number' and Public Health Centers

    The 'Utente Number' is a unique healthcare identifier necessary for accessing public health services in Portugal, or in other words, it is essentially your patient number and is a requirement for all medical appointments.

    To get your utente number (which can only be done after you become a resident), you’ll need to take the following documents to a Centro de Saúde:

    • Passport or another form of identification.

    • Social Security number if you have one.

    • Residency permit or certificate (Certificado de Registo de Cidadão da União).

    • Proof of address, like a utility bill or rental contract.

    • European Health Insurance Card (EHIC) if you're from the EU/EEA.

    Keep these documents handy, as you'll need them throughout your journey of settling in Portugal.

    Public health centers, known as 'centros de saúde,' serve as the primary access points for these services. Centros de saúde provide general practitioners, pediatricians, and nursing services, ensuring you receive most of your primary care through these facilities.

    Private Healthcare System in Portugal

    The private healthcare facilities in Portugal offer a world-class alternative, providing more immediate care, but at a higher cost. These facilities are equipped with state-of-the-art technology, have shorter waiting times, and often employ English-speaking staff, making them attractive options for expats.

    The cost of private healthcare varies depending on the treatment, but it is generally much more affordable than in the US.

    Expats can consider obtaining private health insurance, either from international providers or local Portuguese insurers, to help mitigate these costs.

    Health Insurance Requirements

    Health insurance is a requirement for all individuals in Portugal, whether through the public or private system. If you need a visa to stay in Portugal, you must have private expat health insurance for at least the first four months of your stay.

    Once you have secured residency and started contributing to social security, you become eligible for public health insurance, granting you the same rights as Portuguese citizens, or you can switch to local, private health insurance, rather than expat health insurance.

    Private health insurance is recommended but not compulsory after qualifying for public health insurance.

    What happens if I am not covered by health insurance at all?

    If you are not a resident, or not working in Portugal, you can still receive treatment at a Portuguese hospital or emergency room without health insurance, but should expect to pay all medical costs. You won’t be turned away from medical facilities, but it can get expensive, so ensure you either have expat medical insurance if you are in the process of moving here, or travel insurance if you are on holiday or just visiting for a short time.

    Should I get local private health insurance or use expat health insurance?

    There are benefits to both. Expat health insurance usually offers benefits such as repatriation or evacuation and direct payment for treatment in any country if you plan on traveling outside of Portugal at all. Local Portuguese private health insurance can work out a little cheaper.

    With both kinds of insurance, the cost will vary depending on the level of coverage you choose and most schemes will come with a deductible before your insurance kicks in.

    Be sure to compare these aspects when choosing your plan.


    Portuguese local private health insurance providers

    Please note: While some providers’ websites are not in English, they will certainly be able to help in English if you call / email them for a quote.

    - Médis

    - Multicare

    - AdvanceCare

    - Tranquilidade

    - Allianz Local


    Expat health insurance often provides wider coverage, including international medical evacuation and repatriation, which may not be included in local private health insurance.

    If you are getting insurance for your visa application, you have to be careful to get specific expat health insurance. Regular travel insurance doesn’t qualify.


    Expat health insurance providers

    - Safetywing. The best policy we’ve found for expats applying for a visa is Safetywing Nomad Insurance.

    - Cigna

    - Allianz Expat

    - AXA


    Specialized Healthcare Services

    Aside from general healthcare, there are numerous specialized services, such as opticians and dentists.

    Regular eye check-ups in Portugal can be done at opticians, typically found in shopping centers and town centers. Costs can be lower than in the US, with the quality of service comparable.

    Dental care, while not extensively covered by the SNS, is readily available privately with high standards and private health insurance policies with options specific to dental care are also available.

    Regular check-ups, cleanings, and standard procedures in Portugal can often be more affordable than in the US and comparable to the UK.

    Portuguese Pharmacies

    Under state health insurance in Portugal, you’ll be expected to pay a portion of the cost of your medicine. How much you have to pay depends on how common the medicine is, whether it’s for a serious illness, and if you belong to a vulnerable group. Again, these costs are considerably lower than in many countries, particularly the US.

    Portuguese pharmacies (farmácias) are easy to identify as they have a green cross outside the building. They are usually open from Monday to Friday (closing for an hour during lunchtime) and on Saturday mornings. In larger towns, some pharmacies are available on Sundays.

    For urgent medical issues, there are always 24-hour service pharmacies (farmácias de serviço) in each area, so it is worth researching this on your scouting trip.

    Older adults, disabled people, and those with low incomes may qualify for financial help with pharmaceutical costs through social security. People living with chronic illnesses can access their usual medications for free through the SNS by applying online.

    Getting an EHIC (European Health Insurance Card)

    When you become resident in Portugal, even as a non-EU citizen, you are entitled to an EHIC card, which is a great idea if you plan on doing any other traveling in Europe.

    Having an EHIC allows you to get medical treatment on the same basis as residents of the country you’re visiting. You typically pay upfront and then can reclaim some or all of the costs. What you pay for, how much you pay, and what is reimbursable varies depending on the country’s healthcare policy. Each family member needs their own European health card.

    The EHIC, which is free of charge, is not an alternative to travel insurance. In general, the EHIC does not cover private healthcare or being flown home after injury or illness. In some cases, though, insurers may require you to have an EHIC before they will offer you cover.

    To receive the card, you must legally reside in Portugal (or elsewhere in the EU) and pay or be by covered by social security, however, you cannot use your EHIC for treatment in Denmark, Iceland, Liechtenstein, Norway, and Switzerland.

    When you become a Portuguese resident, you can get your card here.

    GHIC (Global Health Insurance Card)

    The Global Health Insurance Card, on the other hand, is the new equivalent of the EHIC for British citizens after Brexit.

    The GHIC is a free card that gives you the right to access state-provided healthcare during a temporary stay in the European Union (EU). It covers you if you're on holiday, a business trip, studying abroad for less than a year, or on a short-term stay in an EU country.

    If you are a British citizen moving to Portugal, you will still need to follow the Expat Health Insurance guidelines for your visa application and neither a GHIC or regular travel insurance will be valid.

    How to Get a GHIC: Step-by-Step Guide

    Getting a GHIC is a straightforward process that can be completed online. Here are the steps you need to follow:

    1. Visit the official GHIC website. It's important to use the official site to avoid unnecessary charges, as the card is issued free of charge.

    2. Fill in the online application form. You'll need to provide some personal information, including your full name, date of birth, and National Insurance or NHS number (England, Wales, and Isle of Man), CHI number (Scotland), or Health and Care number (Northern Ireland).

    3. Submit your application. Once you've filled in all the necessary information, you can submit your application.

    4. Wait for your card to arrive. Your GHIC should arrive within 10 days.

    Remember, the GHIC is not an alternative to travel insurance. It does not cover any private healthcare or costs such as a return flight to your home country or lost/stolen property. It's advisable to have both a GHIC and a private travel insurance policy that covers your specific needs, including healthcare, when traveling to EU countries.

    What to do if you need medical care in Portgual

    In case of emergency situations or urgent healthcare needs in Portugal, follow these guidelines:

    1. For medical assistance, head to your nearest Centro de Saude (health center).

    2. For emergencies, go directly to the emergency room at the nearest hospital.

    3. If you require immediate assistance, dial the European Emergency Number: 112. This number connects you to the ambulance, police, and fire services.

    Additionally, you can reach out to the SNS (public health services) information hotline at 808242424. The hotline operates 24/7 and provides free information in English.

    FAQs

    Is medical care free in Portugal?

    Medical care in Portugal is generally not entirely free, but the country provides a public healthcare system and as a result costs are very low, and much lower than countries like the US. This public health system (called the SNS) covers most basic medical needs and treatments, including annual check-ups and some specialist consultations.

    Is healthcare expensive in Portugal?

    Healthcare in Portugal is not expensive compared to other European or North American countries. Public healthcare is almost free or provided at a reduced rate for registered residents who cannot afford private healthcare costs.

    Do I need health insurance in Portugal?

    Having health insurance in Portugal is not legally required, but the government strongly encourages having adequate coverage, either by means of public health insurance (which you get automatically as a resident by paying social security) or by having private health insurance.

    For many expats and travelers, private health insurance plans are a popular choice and the private system tends to provide better care than the public system.

    What types of healthcare services are available in Portugal?

    Healthcare in Portugal is divided into two sectors: public and private. The Portuguese National Health Service (SNS) provides registered residents with free or low-cost medical care. Private healthcare is more expensive but provides access to specialists, higher quality care, shorter wait times, and unavailable treatments through the public system.

    How much does it cost to see a doctor in Portugal?

    The cost of seeing a doctor in Portugal depends on whether you choose public or private healthcare. Doctors in the public system are free to registered residents of Portugal, while those in the private sector will typically charge a fee of around €50-€60 for each consultation. The fee is usually based on the type and complexity of the service provided.

    Is Portugal good for healthcare?

    Yes, Portugal is an excellent option for healthcare. Numerous public and private hospitals nationwide offer various quality services at competitive prices. The Portuguese National Health Service (SNS) provides free or low-cost services to its registered residents, while private healthcare options provide access to specialists and treatments unavailable under the NHS.

    Do doctors speak English in Portugal?

    Yes, many doctors in Portugal speak English. Private clinics are more likely to have staff who can communicate with foreigners in their native language.

    Conclusion

    The Portuguese healthcare system, both public and private, offers quality services that cater to the diverse needs of its residents, including expats, adults or children.

    While the public healthcare system provides comprehensive, low-cost care, the private sector offers greater quality, convenience, and speed, and whichever choice you make, when you arrive in Portugal, it's essential to familiarize yourself with how to make appointments, the nearest emergency services, and understanding prescriptions.


    Wanna know more about Portugal and the Portuguese life? Thinking of moving to Portugal? Questions on visas? Healthcare? Expat life? Where you should live? Download our “Portugal Beckons - Book”, read by over 700 expats.


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