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Healthcare in Portugal: Complete Guide

22 de August, 2023

Healthcare in Portugal: Complete Guide

The values charged in the public network are symbolic. And those who want to complement their coverage can always hire insurance and health plans, which do not cost much here.
Reading: 10 min

One of the things that has led many foreigners to
move to Portugal
is the quality and cost of health services. Since June 2022, when they stopped charging user charges, the public health network has been mostly free. And those who want to supplement their healthcare coverage can always take out insurance and health plans, which in Portugal are not expensive. In this article we’ll talk about how healthcare works in Portugal, what the associated costs are and what the advantages are of having Portuguese nationality.
Portuguese nationality
to be entitled to the local national health system.

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Are there public health services in Portugal?

Yes! The National Health Service (NHS) was created in 1979 with the objective of ensuring the right to health (promotion, prevention, and surveillance) to all citizens in a universal, comprehensive, and equitable manner. Through it, all residents can obtain care, in a universal and equitable way, in emergencies, specialties, perform exams and surgeries, and even undergo complex treatments.

Who is entitled to the National Health System in Portugal?

In Portugal, all residents, nationals and foreigners, regardless of their economic and social status, can enjoy the full right to health: its promotion, prevention, and follow-up. This includes legalized foreigners.

Those who have Portuguese citizenship and live abroad can also obtain these services as long as they are registered with the National Health System (SNS): the number of the user (patient).

Read also: 8 Facts You Need to Know About Health in Portugal

Can expatriates be cared for in the public health system?

Yes, foreign residents can also rely on the public health system. To be treated in the public health system, you need to have a user number (registration with the SNS). Those who already have a citizen’s card should not worry, as it already contains this information. To apply for a user number, you need to present the following documents at a Family Health Unit in the parish (neighborhood) where you live.

  • Residence permit and proof of residence;
  • Tax Identification Number (NIF);

If the person wishing to apply for the user number and is not yet a legal resident in Portugal, other documents will be required, in addition to those already mentioned:

  • CDAM or PB4 form – for Brazilians who are not officially resident in Portugal;
  • Valid passport;
  • Proof of address;
  • Social Security Identification Number (NISS)

How to be attended to in the public health network?

First you have to register at a Family Health Unit (popularly called Health Center), in your area of residence, preferably as a utente (patient). Each patient has his or her own family doctorwho acts as an intermediary between the patient and the wider health care system, including specialist doctors. The family doctor is responsible for caring for the patient, prescribing examinations and medication, and making referrals to specialist consultations.

And in the case of medical specialities?

The NHS does not allow the user to make an appointment directly with a specialist doctor. It is necessary to speak first with the family doctor, who will evaluate the situation and make the referral. The same applies to diagnostic tests.

Is Portugal’s public health service free of charge?

Generally, yes. This is one of the frequent questions asked by those who choose to live in the country. Nowadays, the vast majority of services, including consultations and exams, no longer require the payment of user charges. Although these fees still apply in certain scenarios, the amounts are quite affordable. In addition, there are limits to the amounts that can be charged.

What are user fees?

This is a system whereby patients share the cost of accessing medical care. More than half the countries in the European Union have some kind of scheme. In Portugal,the amount is almost symbolic.

As of June 1, 2022, the vast majority of SNS user fees are no longer charged, facilitating access to public healthcare. Payment is maintained only in emergency services, when users have no prior SNS referral (through health centers or the SNS 24 line) or are not hospitalized after the emergency.

Moreover, even in situations where fees are still charged, the exemption is maintained for some users, as shown below. You can consult fee amounts and details about exemption on the website of the Health Regulatory Authority.

It is also worth remembering that the amounts of the user fees can be deducted in the IRS, Portugal’s annual tax declaration. These amounts go into the health deduction, at 15% and up to a maximum limit of 1,000 euros per household.

Who is exempt from this payment?

According to the legislation in force (Decree-Law no. 113/2011, of November 29th), some users are entitled to an exemption from paying user fees in establishments of the National Health System (SNS). The exemption request can be made at any time, in person at your health centre, or online, through the Electronic Health Record | Citizen Area. It takes, on average, 10 days to be approved or refused.

The following are exempt from the payment of user fees :

  • Pregnant and parturient women;
  • Under 18s;
  • Users with a degree of incapacity of 60% or more;
  • Users in a situation of economic insufficiency, as well as the dependents of the respective household;
  • Donors of blood; cells, tissues and organs;
  • Fire fighters;
  • Transplant patients;
  • Unemployed persons registered at the employment center;
  • Military and ex-military personnel of the Armed Forces who are permanently disabled due to military service;
  • Users in a situation of economic insufficiency and their dependants (the household to which they belong cannot have an average monthly income higher than 1.5 times the value of the Social Support Index (IAS), the equivalent to EUR
  • Minors under the Protection of Children and Young People in Danger Act, who cannot prove their condition of economic insufficiency;
  • Minors under guardianship measure of internment, or under custody measure, who cannot prove their economic insufficiency condition;
  • Minors integrated in any of the social responses of reception by judicial decision;
  • Asylum seekers and refugees and their spouses and lineal descendants;
  • Users in a situation of economic insufficiency and their dependents.

How to be referred for admission to hospital emergency services?

Hospital referral, or rather, referral to hospital, is done through the SNS 24 Line (808 24 24 24 24) or the health center. Thus, before going to the hospital, the user should call the SNS 24 Line or go to the health center.

Santo António Hospital in Porto, Portugal

How to book appointments in the public network?

It is possible to book appointments with your doctor locally at the Health Unit or through the NHS website itself. All you need to do is register online with your User Number and from there you can book appointments from your own home. It is also possible to download the app, MySNS, on smartphones. All in a practical and modern way.

Does the Portuguese Government provide medicines free of charge?

Yes, in some cases. In Portugal there are subsidized medicine programs. Many medications are subsidized, i.e. the government pays part of the cost and the user pays the rest. The discounts depend on the class of medicine, type of illness, and the profile of the user. Pensioners, for example, can get up to a 95% discount on their medication. There are also some types of diseases whose medication can be provided free of charge, such as insulin needed by diabetics, or treatment for diseases like Crohn’s Disease, Lupus, Hemophilia, among others. others.

In addition, the country has private institutions of social solidarity, such as Associação Dignitude which provides support for families that need financial help to buy medicines.

Finally, it should be noted that in order to buy medicines in Portugal you must have a medical prescription. This rule does not apply to all medicines, but to the vast majority of them, such as anti-allergic, antibiotics, immuno-suppressants, corticosteroids, stronger painkillers, among others.

How does Portugal deal with emergencies?

Portugal has an Integrated Medical Emergency System (SIEM), a group of entities that act together to provide medical assistance to victims of accidents or sudden illness. Several entities cooperate together: the police, firefighters, the Portuguese Red Cross, hospitals and health centers. Coordination is the responsibility of the National Institute of Emergency Media, the INEM which is contacted through the number 112.

Emergency assistance provided by the INEM, through 112, is not charged to the user. Simpler emergencies can be attended to in health centers, and this assistance is usually provided immediately.

How much do I have to pay in case of emergency?

The amounts of the user fees to be paid for emergency care are as follows:

Service (*)Value
Multipurpose emergency service18 €
Medical-surgical emergency service16 €
Basic Emergency Service14 €
(*) To these values are added the fees for complementary diagnostic and therapeutic resources. However, for each emergency service, the user will pay a maximum of 40 euros.

How does private healthcare work in Portugal?

Contrary to what one might imagine, the public health network has excellent professionals. Really! Still, many people like to choose their doctors in the private network. Sometimes care in the public network can be more time-consuming or limited, with a reactive rather than preventive profile. So if you want to choose a doctor of your choice, are in a hurry, or want to be tested more often, you will have to pay more money for a private consultation.

According to the Portuguese Insurers Association, more than 3 million Portuguese have some kind of insurance or health plan, a number that has greatly increased since 2020, when the pandemic began.

How much does private healthcare cost?

The price of the consultations will always depend on the city, the doctor and the medical specialty to be considered. A specialty consultation (dermatology or gynecology, for example) costs around 80 euros in the city of Porto. Many Portuguese choose to take a health insurance as a complement to the SNS. In general, health insurances in Portugal are not expensive, but they work with a co-payment scheme. That is, in addition to the monthly amount, it is still necessary to pay an amount at the time of use. The average policy prices for the insured vary greatly in relation to the type of coverage contracted and the capital limit for each specific coverage. In 2020, the Portuguese paid an average of 30 euros per month for individual health insurance. With insurance, a private medical consultation that costs around €80 may cost only €30. It should be noted that these values are an average, and that policies have different coverage, capital, exclusions and limits. Health plans can cost from €5, depending on the services covered.

Health insurance vs. health plan

In Portugal, there are health insurances and health plans, which are different things.

Health care plan is a network of discounts on health care.

Advantages:

  • no grace periods
  • no age limit
  • no previous illness exclusions
  • without the need for prior authorisation
  • no co-payment and no deductibles

Disadvantages:

  • exclusive use at doctors, clinics and hospitals associated to the plan (more limited);
  • tuition fees without IRS benefits;
  • only offers discounts on consultations and exams, does not include outpatients and hospitalisation;

Health insurance works like insurance, with specific policies.

Advantages:

  • possibility of choosing the place and the doctor of your choice for analyses, exams and consultations
  • possibility of seeking doctors outside the network of coverage and claiming reimbursement
  • monthly payments with tax benefits in the IRS.

Disadvantages:

  • has a waiting period, which varies according to the type of procedure and the insurance contracted. On average, 1 year for scheduled deliveries and surgeries, 90 days for hospitalizations and 60 days for outpatient assistance
  • with an annual limit (plafond) in each category according to the coverage chosen in the insurance
  • maximum age limit for insuring the user if the insurance is taken out at the age of 55 years or over (in most cases)
  • no coverage for pre-existing ilness to the contracting of the insurance.


Click here and learn more about private healthcare in Portugal.

Do Portuguese doctors speak English or another language?

Yes, in many cases! In the CUF network, for example, information about the languages spoken by each professional is included in the online description of each doctor. In the public network there is also a great chance of getting doctors who know English, since the language is spoken by a large percentage of the Portuguese population.

Which are the best hospitals in Portugal?

According to the SCImago Institutions Ranking, the best Portuguese hospitals in 2021 are:

  • Francisco Gentil Portuguese Oncology Institute, in Porto;
  • Santa Maria Hospital, in Lisbon;
  • Coimbra University Hospitals, in Coimbra;
  • Francisco Gentil Portuguese Oncology Institute in Lisbon;
  • Centro Hospitalar de Lisboa Norte, in Lisbon,
  • Centro Hospitalar do Porto, in Porto;
  • National Institute of Health Dr. Ricardo Jorge, in Lisbon;
  • Hospital da Luz, various locations around the country;
  • Centro Hospitalar de São João, in Oporto;
  • Centro Hospitalar de Lisboa Central, in Lisbon.

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Author:

Atlantic Bridge

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