An expat guide to healthcare and health insurance in Portugal

The Portuguese health system is managed by the Serviço Nacional de Saúde (SNS). It was created in 1979, inspired by the British National Health Service (NHS), from which it took the name.

Unlike the British NHS, the SNS is not free: a financial contribution is required for each medical procedure. Certain categories of people are exempt from the user fee (pregnant women, children under 12, low-income people, people over 60, disabled, unemployed).

Foreign residents in Portugal have access to the SNS as long their own country of nationality also offers state healthcare to Portuguese nationals.

To benefit from the services of the SNS, one must register with the health centre (centro de saúde) nearest to their place of residence in order to obtain a health card (cartão de utente do SNS).

The SNS is well suited to accommodate English speaking patients: hospitals have personalised receptions and support services for patients where English is the basic language of communication.

What does the SNS cover?

The range of medical care covered by the SNS is very comprehensive compared to other Western countries. In addition to basic health care (general practitioners and specialists, maternity, hospital care, nursing care, prevention/diagnosis, treatment, prosthetics), the SNS also covers ophthalmology, dentistry, orthodontics and mental health. It is also possible to receive healthcare in private institutions authorised by the SNS.

The limits of the SNS

• In the SNS, you cannot choose your own doctor. Patients are assigned to a general practitioner (medico de familia) in their health centre. To see a specialist, you must be referred by your GP.
• Public hospitals lack medical staff and are often overburdened. The shortage of doctors has resulted in a lengthening of waiting lists for non-urgent operations. Basic health services are available in rural areas but for specialised healthcare you must travel to the city.

Waiting times in the public sector to get an appointment with a specialist or for a minor operation can discourage patients who turn to private healthcare.

Local private health insurance in Portugal

To avoid waiting lists, an increasing amount of the population opt for a private health insurance in Portugal in order to be covered privately.

As a foreigner, if you do not benefit from the SNS, taking out medical insurance in Portugal is mandatory in order to obtain a visa.

If you are eligible for the SNS, taking out health insurance is not mandatory but has many advantages compared to the local health system: free choice of doctor or healthcare facility, avoiding waiting lists, and having the option to seek treatment in Portugal or abroad.

When it comes to choosing a private health insurance in Portugal, you can also consider an international health insurance. An international cover is often more suited to the expatriate lifestyle than a local health insurance. It is also important to note that local private health insurance companies in Portugal only insure up to 55 years of age, while international policies provide cover for older ages.