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Health Insurance in Portugal

8 de November, 2022

Health Insurance in Portugal

Health insurance facilitates access to private health services in Portugal by offering cheaper rates for medical care.
Reading: 8 min

Health insurance in Portugal facilitates access to private healthcare services in the country, allowing the user to pay much lower rates for medical care.

We have prepared this article to explain to you whether health insurance is mandatory in the country, how it works, average prices, and how to get yours. Check it out!

Is health insurance mandatory in Portugal?

No.

In Portugal it is not mandatory for citizens to have health insurance. A good part of the population (about 30%) has health insurance for care in the private sector, but this is optional.

Portugal’s public health system works well (despite having some flaws, of course). But because it is so efficient, about 70% of the Portuguese rely solely on the services provided by the National Health Service (SNS).

In other countries it is different

In other European countries, where there is no universal public health care, citizens are obliged to take out health insurance. This is the case in countries such as Holland, Germany and Switzerland.

Therefore, in these countries all residents (nationals and immigrants) are required to have insurance that guarantees the necessary health care and procedures.

How does the healthcare system work in Portugal?

In Portugal there are public and private health care services. The public ones are available to all citizens and the private ones can be accessed by those with private health insurance or even by private individuals in general.

Public health

Public health in Portugal is the responsibility of the SNS, which offers a network that includes medical and dental services, psychological care, exams, and surgical procedures, distributed among hospitals and health centers.

Portuguese public health services are organized around the concept of primary care, which takes place in health centers. In the centers, patients are initially seen by a family doctor.

Doctor's appointment
The family doctor monitors the wearer’s health and makes referrals to specialists when necessary

This doctor, who is responsible for monitoring the patient, can prescribe treatments, tests, and medications, as well as make referrals to specialists, whenever necessary.

If you have heard that there are not enough family doctors in Portugal, know that in some regions this is true. But even if you don’t have a doctor assigned, you can always make an appointment with the on-call doctor at the health center where you are registered.

The Cost of Public Health in Portugal

Today, citizens no longer have to pay for public health services, as almost all user fees have been abolished by June 2022.

Only services performed in hospital emergency rooms without prior referral by an NHS professional can still be charged. Even then, if the patient who goes to the emergency room requires hospitalization, no fee should be charged for this service.

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Private Health Care

Private health care, on the other hand, can be accessed by any citizen who wants it, as long as they pay for the service individually or through private health insurance.

Besides making appointments with doctors or at examination clinics, users can use the services of private hospitals, such as those of the Lusíadas or CUF networks.

Portuguese with health insurance

According to a survey for the year 2022, more than 5 million Portuguese have private health insurance or a health subsystem (intended for Public Administration workers).

Private insurance membership itself exceeds the 3 million mark, according to data from the Private Hospitalization Association of Portugal.

Also understand how health care works for Brazilian retirees in Portugal.

How does health insurance work in Portugal?

In health insurance in Portugal, patients pay a monthly fee and are entitled to good discounts for consultations, exams, surgeries, and other health care services.

There are many options to choose from, and the monthly amount you pay depends on the insurance company you choose, your age, and what procedures are included in your policy.

There are insurance options that offer only basic coverage for consultations and exams, up to more complete ones that can cover hospitalization, surgeries, childbirth, and other more complex treatments for serious illnesses.

Difference from the health plan

It is worth making it clear that in Portugal there are no health insurance plans with characteristics similar to those in Brazil. As mentioned above, users choose a plan with monthly payments, which guarantee discounts on health care.

Plans like those available in Brazil, in which the monthly fee can cover all medical and hospital expenses, are not a reality in Portugal.

But even so, for those who want health insurance in Portugal, it is worth taking out insurance. A doctor’s appointment, for example, can cost between €80 and €100 on average, depending on the professional or hospital chosen. With health insurance, consultations can cost from €15 to €30 on average.

The choice of professionals

This is an important difference with public health care. In private insurance, the patient is free to choose the doctor or clinic he or she will see, and can even make an appointment directly with a specialist.

When we use public health care it is not possible to make an appointment with a specialty doctor directly, nor to choose the professional.

In the NHS procedure, you must see your family doctor first, and he or she will make a referral to a specialty if they feel it is necessary in your case.

How much does health insurance cost?

As stated above, costs vary depending on your age, the coverage you take out, and the insurance company you choose. Generally speaking, the cheapest health insurances have an initial cost of €20 per month.

Here are some examples of health insurance values in Portugal at Médis and Tranquilidade, with simulated values in July 2022.

Insurance CompanyAge of the insuredServices includedMonthly Value
Médis35 years oldConsultations, exams and hospitalization23,88€
Médis65 years oldConsultations, exams, hospitalization, assistance and flu vaccine34,62€
Tranquility35 years old8 consultations, 2 exams, 2 analyses and hospitalization21,97€
Tranquility35 years old8 consultations, 2 exams, 2 analyses and hospitalization66,29€

You can simulate the costs of other health insurance directly on the insurers’ websites. Besides the ones mentioned above, you can contact Saúde Prime, Fidelidade, Medicare, LOGO and OK teleseguros. Another option is to make a quotation in Deco Proteste’s simulator.

How to get health insurance in Portugal?

Before you decide which health insurance you will take out in Portugal, we recommend that you check the insurance companies’ websites to find out which plans are available and how much they charge.

After you have made your choice, all you have to do is sign up, which is usually very simple and can be done over the internet or by telephone, upon registration and payment of the first monthly fee and the cost of the policy.

Depending on the plan contracted, payments can be monthly, semiannually, or annually. Usually, plans paid per semester or per year have discounts.

Once the contracting is completed, you will receive a card (physical or digital), which you must use to make the consultations, exams, and other procedures.

Pay attention to the contracting details

Before you sign up for health insurance in Portugal, find out what the insurance coverage is and what the co-payment amounts are for each type of service. All of them should be described in the insurance policy or service contract.

This prevents you from being surprised when you need to use a medical service – either because of the cost or because the service is not included in your contract.

What is the best health insurance in Portugal?

According to the Portuguese Insurers Association, in data referring to 2020, the three groups that offer health insurance that were most contracted by the Portuguese are:

  • Fidelity/Multicare;
  • Médis;
  • Generali.

Together, these brands are the ones chosen by about 77% of the people who chose to have health insurance in Portugal.

Do the Portuguese take out a lot of health insurance or do they use public health care more?

The number of Portuguese people who have subscribed to health insurance in Portugal has increased greatly in recent years. On the other hand, as we have seen, 70% of the population is uninsured and uses the services offered by the National Health System.

As stated earlier, there are currently 3.3 million Portuguese who have private health insurance. Just over a decade ago, in 2011, there were 2 million users of private health services.

As can be seen in the following graph, since 2018 the number of Portuguese beneficiaries of private health insurance has grown every year.

Chart with health insurance data
Health insurance beneficiaries in Portugal. Source: Jornal Expresso, with data from Associação Portuguesa de Seguradores.

According to ECO Seguros, 205,353 new health insurance policies were taken out in Portugal in the first three months of 2022 alone.

Do you need health insurance to enter Portugal?

In order to enter Portugal you must have insurance, but not the health insurance that we explain here. The requirement is for travel insurance, which is mandatory for all foreigners entering the Schengen Area.

This insurance must have a minimum coverage of 30,000 euros for possible medical and hospital expenses.

So pay attention to this clarification: health insurance and travel insurance are different. Health insurance in Portugal is optional, if you want to take advantage of private healthcare in the country.

Travel insurance is mandatory for those entering Portugal, and, according to the Superintendence of Private Insurance of Brazil(SUSEPE), it serves to guarantee the insured:

  • Coverage of medical, hospital, and/or dental expenses;
  • Indemnity in case of occurrence of the other risks covered in the contract.

Travel Insurance

To make it even clearer, it is worth clarifying that travel insurance for Portugal (or other countries) has other types of coverage besides medical and dental care.

The most common are:

  • Compensation for lost or damaged baggage;
  • Compensation for flight cancellation or delay;
  • Health return;
  • Medical or body transfer;
  • Covid.

What about PB4?

You must have heard about the PB4, right? Know that travel insurance to Portugal can be replaced by this document, which is the result of an agreement between Brazil and Portugal to guarantee care in the public health services of both countries.

Therefore, Brazilian citizens who are going to live in Portugal or travel for tourism and have the PB4 will be entitled to receive medical and hospital care in Portugal, free of charge.

The PB4 can be applied for online, on the Brazilian government’s website, on the official CDAM (Certificado de Direito à Assistência Médica) page.

When it comes time to start planning to live in Portugal, get to know the Programa Morar em Portugal. Through video lessons and an updated ebook, Euro Tips helps you organize your move, accompanying you until the moment you arrive in the country.

Article originally published on our partner site EuroDicas.

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Author:

Atlantic Bridge

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