Everything About the Portuguese Health Care System
World-Class, Affordable Public Healthcare
So, you’re thinking about moving to Portugal, and you’re not alone. The 2021 census showed that nearly 600,000 expats have chosen to live here, with more people every year being drawn in by the meandering blue of the Atlantic coast, the vibrancy of Lisbon and Porto; the beaches of the Algarve.
But living in Portugal is more than city breaks and beach trips. Whether you’re looking to retire here, coming for work, or looking for somewhere to raise a family, health care is vital for everyone. Happily, the Portuguese healthcare system is one of the most advanced and accessible in the world, with a higher life expectancy than the current European average and only around 2% of people unable to access services due to cost or waiting times.
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HOW DOES THE PUBLIC HEALTHCARE SYSTEM WORK IN PORTUGAL?
The healthcare system here is designed to be accessible and affordable to everyone. Let’s start with the basics. There are three kinds of healthcare providers in Portugal:
- The National Health Service, or Serviço Nacional de Saúde. You’ll often see this referred to as the SNS and this is the state-ran health system.
- Private insurance providers are similar to those you will find internationally.
- Specific health insurance plans that work in the same way as private providers but are linked to working in specific businesses or professional roles.
The Serviço Nacional de Saúde guarantees healthcare access to every legal resident of Portugal, whether they are newly arrived expats or were born here. This is by far the most popular healthcare service, with a reliably high quality of care and widely accessible, easy-to-use services, with English-speaking doctors and nurses available in the majority of facilities in the larger towns and cities.
There are some small charges depending on the service (these are discussed below) but the majority of consultations and regular check-ups are free at point of use, with the health system funded largely through workers’ social security contributions and general taxation.
Private insurance providers and more specific health plans are available to those looking for specific operations or procedures which may not be available through the central system or for those who are looking for shorter wait times.
DOES PORTUGAL HAVE UNIVERSAL HEALTHCARE?
This part’s simple, anybody who is a legal resident of Portugal has access to the national health service. It is a system designed to provide cheap, reliable healthcare to everybody in the country, whether you have just moved here or have grown up by Porto’s cobbled streets.
Depending on your nationality, you might have access to the SNS regardless of your residency status. If you are from an EEA area country or Switzerland, you have coverage for up to 90 days as part of the EHIC scheme. Alongside this, Portugal has a series of reciprocal health agreements with other countries, namely Andorra, Morocco, Tunisia, Brazil, Cape Verde, and the UK. Each of these deals means that the legal residents of Portugal and the linked country have access to healthcare for each other. Still, each is slightly different and we recommend researching the specifics of any arrangement if they apply to you.
ARE MY FAMILY INCLUDED?
Every adult who is a registered citizen has access to the public health system and their children are automatically provided access as well. Their coverage is funded by the taxes and social security payments of the working parent. If your child is born in Portugal, they have the automatic right to healthcare here.
And this free children’s healthcare is extensive. From the moment they are born until they are 18 and become legal residents themselves, they will receive regular health checks, vaccination schedules, and complete access to screenings and examinations. The vast majority of this will be through your local family doctor, who will keep records and be able to monitor your child’s health as they grow and develop. This free, reliable pediatric care is part of why so many young families choose to move to Portugal.
WHAT IS COVERED IN PUBLIC HEALTH CARE?
The Portuguese healthcare system is designed to cover everything you need, but there are a few exceptions.
For smaller problems and more everyday consultations, everybody has access to a General Practitioner, often referred to as your GP or family doctor. This is who you see for regular appointments and general check-ups and they will be your first port of call for everything except emergencies. They are usually found in Health Centers (centros de saúde) around the country.
Some of these Health Centers have the capacity for basic emergency services, but often if the situation is more serious or requires specialist treatment you will be referred to one of the larger Public Hospitals. You can find these in any large urban center. While some hospitals specialize more in one specific field, you will have access to everything from cardiology work to neurological experts.
Maternity care is completely free and covered by the public health system, with expectant mothers generally receiving care at their local hospital.
In terms of mental health, Portugal has a full range of modern services, from medication to therapy, to specialized facilities or services. All of this is covered by the public health system. Your regular doctor would be the first person to speak to and they would then talk through the options that are available and find the best solution for you.
The two main areas that are lacking are dental care and eye care. Depending on where you are located, it is possible that your local public hospital could offer these services but would require you to pay more than the usual fee. We would not recommend relying on public coverage of these issues, especially in more rural parts of the country.
PAYMENT AND PLANS
Now, is there free healthcare in Portugal? The answer is slightly complicated. Aside from the high standard of care, the best thing about the public health system is that the majority of the time it is free at point of use. This means that it is funded by social security contributions by working residents and general taxes rather than direct payments.
Since 2021, all basic consultations, such as visits to the doctor, have been completely free, and more than half of the population are completely covered by exemptions, meaning that they don’t need to pay anything. But different services do require small fees and it is better to see the system as state-subsidized rather than free, with the costs being shared between the service user and the Portuguese state.
While prices vary depending on the specific service, fees generally range from €5 to €20. If you are seeing a specialist for extended treatment, this might be more, but every effort is made to keep these services affordable and accessible to everybody. There is a wide range of exemptions for groups that don’t have to pay any of these additional fees, such as the unemployed, emergency workers, pregnant women, seniors, children, and others.
WHAT DO YOU NEED TO APPLY?
The process of organizing healthcare in Portugal for expats is straightforward. The key item you need is a Número de Utente. This is your user service number for the healthcare system. Once you have this, you have complete access to the public healthcare system.
HOW DO YOU APPLY?
To register for your Número de Utente you will need to visit your local centro de saúde, or healthcare center.
Here, you will need three things. First, your social security number. If you are working here your employer will organize this, but if you are self-employed you will need to arrange this independently. Second, your passport or some form of photographic, national ID card. Third, proof of residency. If you don’t have this, don’t worry, you can get proof of address by registering with your local junta de freguesia, the Portuguese form of a local council.
Take all of these to one of the health centers and you will receive your Número de Utente in the form of a card that you can then use for any public healthcare. Once you have this, you will also be able to access the health system online portal that lets you see information about different services and locations and book appointments online.
WILL I HAVE INSURANCE TO TRAVEL TO FOREIGN COUNTRIES?
This all depends on the country you are planning to travel to. If you are covered by public health insurance in Portugal, you are able to register for an EHIC card which gives you free access to public health across the majority of Europe for 90 days at a time. On top of this, Portugal’s series of reciprocal health arrangements mentioned earlier in this blog may cover health services in those countries. Note that, although these arrangements may provide cover for any medically necessary health services in participating countries, they are not travel insurance. We always recommend taking out comprehensive cover before traveling.
Besides these exceptions, you will require a form of private travel insurance that covers health-related issues and medical expenses for the majority of countries.
PRIVATE HEALTH INSURANCE IN PORTUGAL
Because of its quality and ease, around 80% of the population exclusively use their public health coverage, with the other 20% either going fully private or supplementing the public healthcare with a few select services.
These private insurance plans work in the same recognized international way, with users paying an annuity that then covers either all or the majority of any health care expenses. There are premium private health facilities throughout Portugal and they are often used to supplement public health coverage, covering services such as dental care that are not usually part of the public health offers. They can also be used in situations where there is a long wait time on the public service for a specific service or procedure.
AFFORDABLE, AVAILABLE HEALTH
Of course, people love the landscapes, the food, the wine, the weather, but quality, affordable, and reliable healthcare is one of the reasons that living in Portugal as an expat is so satisfying. It provides the reassurance and comfort that lets you go on and live life, the confidence of knowing your health and the health of your family is protected through simple, cheap, available public services.
If you are looking for any further advice or are just curious about moving to Portugal, we’re always here to help.
