Health insurance in Portugal

Healthcare coverage is one of the very first things you’ll need to sort out if you’re moving to Portugal. Along with finding a job, renting a home, and getting temporary residency, securing health insurance is key to feeling settled in a new place. Through Portuguese public health insurance, most medical treatment is totally free of cost. However, private insurance can help cover eye care and dentistry, plus give more choice and shorter wait times.

For more on health insurance options in Portugal, keep reading about the following topics:

The Portuguese healthcare system

Portugal’s national public healthcare system is the Serviço Nacional de Saúde (SNS). The SNS covers only mainland Portugal, while the Azores and Madeira have separate systems. The Ministério de Saúde (Ministry of Health) is the Portuguese government agency that operates the SNS and guarantees public health insurance to all residents.

The Portuguese healthcare system provides high-quality care, focusing on preventative medicine like cancer screenings. There is also a large population of doctors working in the country. Although Portugal only ranked 22^nd out of 32 countries on FREOPP’s 2022 World Index of Healthcare Innovation due to lack of affordability, it has since abolished user fees on the public scheme.

Who needs health insurance in Portugal?

Anyone planning to stay in Portugal either short- or long-term needs health insurance.

Internationals living and working in Portugal have the same healthcare rights as nationals. As long as you are a legal resident and contribute to social security, you will be entitled to public health insurance.

Tourists and non-residents, on the other hand, must secure health insurance coverage on their own. If you’re visiting from the European Union (EU), European Economic Area (EEA), or Switzerland, you can use your European Health Insurance Card (EHIC) in Portugal.

Certain countries have bilateral healthcare agreements with Portugal that allow them to access medical care with their home insurance. These include:

• Andorra
• Brazil
• Canada (only Quebec)
• Cape Verde
• Morocco
• Tunisia

If you’re from a country other than these, you must take out private travel health insurance to cover your stay in Portugal.

What happens if I am not covered by health insurance?

Health insurance coverage is typically a Portuguese visa requirement for long and short stays. If you cannot provide proof of health insurance to the appropriate authority, you may not be allowed to enter Portugal.

You can still receive treatment at a Portuguese hospital or emergency room without health insurance, but should expect to pay all medical costs.

If you work in Portugal, you will be entitled to public health insurance based on your contributions to the Instituto da Solidariedade e da Segurança Social (Social Security Institute).

Portuguese public health insurance

Everyone who will legally reside in Portugal for more than 90 days qualifies for public health insurance. The public scheme completely covers all medical care, including doctors, specialists, and emergency services, with very few exceptions.

Who does public health insurance cover?

• Employees and their dependents: Portugal’s state system is open to all workers who pay social security (segurança social) and their dependent family members (e.g., children)
• Retirees: Subsidized prescriptions and contributions towards additional healthcare, such as dental treatment and eye care, are included.
• Short-term visitors: Short-term visitors do not qualify for public healthcare unless they have an EHIC or come from a country with a bilateral health agreement.
• EU/EEA citizens: The EHIC allows access to Portugal’s public healthcare system
• Students: As long as they have the legal right to live in Portugal, students are covered under the SNS.

What does public health insurance cover?

Public health insurance fully covers medical care, but is less comprehensive in other areas of healthcare. If you need more clarification about whether Portuguese public health insurance covers a specific provider or procedure, you can consult the MySNS mobile app or contact the SNS24 hotline at 808 24 24 24.

Doctors and specialists

When visiting the doctor in Portugal, your public health insurance scheme will cover all costs. You can easily book an appointment with a doctor at your local health center online, over the phone, or in person. The SNS also covers specialists, but you likely need a referral from your primary doctor in order to get an appointment.

Medical emergencies

If you need an ambulance for a critical medical emergency, call 112. If you can make your own way to the hospital, you should be able to find an open emergency department regardless of time of day.

Treatment for medical emergencies is free in Portugal, but with one exception. If a patient uses emergency services without a referral from the SNS and is not admitted to the hospital as a result, they will have to pay medical fees.

Mental healthcare

If referred by a general practitioner, mental healthcare services are covered under the Portuguese public health system like medical treatment. This means the first step in getting mental health support is usually an appointment with your general doctor in person or on video.

The SNS offers a free 24/7 psychological support hotline where you can talk to a clinical psychologist over the phone. To access the hotline, call the SNS24 main line at 808 24 24 24 and press 4 for psychological counseling (aconselhamento psicológico).

Wait times for a mental healthcare appointment can be quite long in Portugal due to a low population of psychiatrists. For quicker access to a psychiatrist in Portugal, you may want to consider private health insurance.

Maternity care

All checkups and emergency medical attention are free for pregnant patients under public health insurance. Your local hospital or health center provides most routine maternity care during pregnancy. Pregnant people receive a Pregnancy Booklet (Boletim de Saúde da Grávida), where parents can track their baby’s progress.

Dental care

The SNS only covers dental care for certain groups. If you belong to what the Portuguese government deems to be a vulnerable group, you can get dental vouchers to cover costs.

If you are not in one of these groups and need dental work done, you may want to consider insurance from a private provider. You can get dental coverage as part of a comprehensive health insurance plan or an optional add-on.

Eye care

If you want to see an eye care professional under Portuguese public insurance, your local health center books appointments with specialists. Waiting times are often long for checkups or non-urgent issues. The SNS doesn’t cover optical care, so you must pay out of pocket. Separate vision insurance is available from various providers in Portugal and is a good option if you wear glasses or contacts.

How to get Portuguese public health insurance

If you work in Portugal, your employer should automatically enroll you in the social security system. After you begin making payments, you automatically qualify for public health insurance. However, self-employed people still need to register with the Social Security Institute directly.

Once registered, you must visit your local health center (centro de saúde), where you’ll be assigned to a doctor. You will need to register with a doctor before making an appointment.

If you’re waiting for your residence permit, you can get a certificate from your local parish (freguesia) confirming that you’ve lived in Portugal for 90 days. Show this and the necessary paperwork to your local health center to get your SNS user number (número de utente do SNS).

Private health insurance in Portugal

As of 2017, about 25% of the population in Portugal had private health insurance.

When you start working in Portugal, your company might offer you a private insurance plan. If you change employers, it typically ceases, and you may lose coverage for certain factors if you change companies.

Keep in mind that if you don’t qualify for the state healthcare system, you will need to get private health insurance in Portugal. This includes those on tourist and short-stay visas.

The advantages of private health insurance

Despite the affordability of public healthcare in Portugal, many expats choose to take out a private plan to cover other services, such as dental or vision care. Using private hospitals and clinics also helps avoid potentially long waiting times compared to public services.

Since private health insurance offers wider choices, it’s easier to find English-speaking providers. While English-speaking doctors on the public system are easy to find in major cities, this isn’t always the case in a small town.

Private health insurance offers additional benefits such as repatriation or evacuation, coverage for non-urgent issues abroad, and direct payment for treatment in any country.

How to choose a private provider

Private health insurance in Portugal is widely available from well-known international private insurers as well as local companies. Quotes vary depending on the level of coverage, so using comparison websites can help with your search. Insurance brokers specializing in expat coverage can also assist you. In Portugal, these include:

• C1 Broker
• Winsurance

Before signing up for private health insurance in Portugal, check your policy for clauses giving insurers the right to change your policy at a certain age. Changing or taking out a new policy after retirement age is considerably more difficult and expensive. If you’re older, you may need to get cover from an international insurer.

Some of the largest private health insurance companies in Portugal include:

• Allianz Care
• Cigna Global

Health insurance quotes in Portugal

Get direct quotes from international health insurance companies to compare their coverage and prices:

How much is Portuguese health insurance?

In 2022, the SNS abolished user fees and copayments for medical treatment under the public scheme. This means that public health insurance is almost completely free in Portugal, with a few exceptions.

The following groups are exempt from paying medical fees in any instance:

• Pregnant patients and new mothers
• Children 12 and under
• Disabled persons
• Blood donors
• Organ, cell, and tissue donors
• Transplant patients
• Firefighters
• Those currently in the military
• Those formerly in the military with permanent disability as a result of service
• Households that make less than €653.64 per month

Regarding private health insurance, the cost varies depending on the level of coverage you choose. Most schemes also come with a deductible before your insurance kicks in. In addition to individual policies, getting private healthcare packages to cover your whole family is possible. You often get a more competitive rate with more people insured under a single policy.

However, most private insurance in Portugal will typically cover the full costs of specialist or hospital treatments. The higher the monthly premium, the greater your choice regarding doctors, hospitals, and specialists.

Portuguese pharmacy costs

Although user fees and medical treatment costs are abolished, this does not include pharmacy costs. Under state health insurance in Portugal, you’ll be expected to pay a portion of the cost of your medicine. How much you have to pay depends on how common the medicine is, whether it’s for a serious illness, and if you belong to a vulnerable group.

To check the estimated cost of a prescription drug, you can use Infarmed’s medication price search feature (in Portuguese).

Older adults, disabled people, and those with low incomes may qualify for financial help with pharmaceutical costs through social security. People living with chronic illnesses can access their usual medications for free through the SNS by applying online.

Most Portuguese pharmacies (farmácias) are open from Monday to Friday (closing for an hour during lunchtime) and on Saturday mornings. In larger towns, some pharmacies are available on Sundays. For urgent medical issues, there are always 24-hour service pharmacies (farmácias de serviço) in each area.

Health insurance for seniors

Older people moving to Portugal for longer than 90 days are covered by public health insurance. EU citizens who retire early may qualify for free or subsidized healthcare for up to two years of residence with form S1. Meanwhile, other early retirees can pay voluntary social security contributions or get private health insurance in Portugal.

As detailed above, pensioners receive subsidized prescriptions and other healthcare. However, many seniors opt for supplementary insurance to cover more extensive services and speedier access to specialists. Providers of private health insurance in Portugal include:

• Allianz Care
• Cigna Global – also provides a dedicated policy tailored to seniors

Health insurance for unemployed or low-earning residents

Almost all Portuguese public healthcare is free, and those who are unemployed or low-earning can be exempt from fees entirely. The SNS calls this a user fee waiver (isenção de taxa moderadora), and the Autoridade Tributária e Aduaneira (AT – Tax and Customs Authority) manages eligibility.

You can request a waiver directly with the SNS through the online portal, by phone, or in person at your local health center and Citizen Space (Espaço de Cidadão). Your request must be approved or denied within 10 days.

Useful resources

• Instituto da Solidariedade e da Segurança Social – government agency that manages social security
• Serviço Nacional de Saúde – Portuguese national healthcare service
• Infarmed list of pharmacies – search for licensed pharmacies by region
• Infarmed Pesquisa de Preços de Medicamentos – check the price of any prescription drug online
• MySNS – mobile apps for those covered by the SNS