Portuguese health care options

Healthcare is a big concern for many people who move to Portugal. The country has a well developed national healthcare system, Serviço Nacional de Saúde (SNS), that is funded by taxes and can be used by all legal residents. They can seek care at little or no costs at the SNS network of health centers(Centro de Saude) in towns and villages all over the country or at public hospitals which are located in the larger towns and cities.

There is also a growing network of private facilities and providers, such as Hospital da Luz, CUF and HPA, available throughout Portugal to those who pay for medical insurance.

These public and private healthcare networks rank well overall. The World Health Organization gave Portugal a number 12 ranking in its 2019 World Health Report.

How does the public system work?

Americans and residents of countries outside the European Union who want to move to Portugal must obtain a D7 visa. In order to get the visa, they must show proof of travel insurance which covers medical costs. (Since January 2021, because of Brexit, people from the United Kingdom must also have a D7 visa to move to Portugal.)

In effect this means that residents of these countries must have private health coverage when they arrive in the country in expectation of a permanent stay.

D7 visa holders can apply to be covered by SNS once they have been granted a residency permit by the immigration and borders service, Serviço de Estrangeiros e Fronteiras (SEF).

Once a person has their residency permit, they can register to be covered by the SNS at their local health center to get the health system’s user number, or número de utente. They will have to show documentation such as passport, tax number (Número de Identificaçao Fiscal or NIF) number and residency permit.

After registering, in theory, you are assigned to a local primary care doctor and will be able to make appointments in person, by phone or online. There is a small fee for consultations and tests, usually less than 20 euros, services are free for those aged 65 years and older. In practice, the Covid 19 pandemic has put a severe strain on the system and many local health centers no longer have a doctor. So people have to travel further for routine appointments and care. Many hospitals are also experiencing staff shortages which have forced them to temporarily close certain departments or services during recent months.

Private healthcare options

Numerous private health insurance options are available in Portugal through companies like Fidelidade, Allianz, Cigna and Medis. Plans cover most or all of the cost of routine check-ups and consultations with private specialists and hospital charges.

Coverage for pre-existing conditions is not typically available through these plans. However, the Association of Foreign Property Owners in Portugal (AFPOP) also offers its members special insurance rates through Medal Seguros. Under certain circumstances those plans will cover pre-existing conditions.

One thing to be aware of is that the cost of different plans increases with the age. In addition, there are very limited options for people over age 65. For those people, private insurance is available from MGEN, Medis (Vintage Plan) through Millennium bank, or Allianz-Medal, through membership in AFPOP.

For more detail on healthcare in Portugal and interviews with people who have moved here, read my article “Portuguese Health Care: Public and Private” on page 83 in the current issue of Portugal Living magazine.

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