Portugal Health Insurance for Expats – The Portuguese Healthcare System

Portugal is a highly popular EU country for expats. It has the best sunny weather and offers several pathways for expats to move there, such as an investment visa and a retirement visa. However, one important aspect expats need to remember when moving to Portugal is the healthcare system. It’s important to know how the healthcare system works, who can qualify for medical care, and how to obtain health insurance. This information will make moving to Portugal much easier and stress-free for expats.

How Does the Healthcare System in Portugal Work?

There are three main components within Portugal’s healthcare system:

1. The national healthcare system (Serviço Nacional de Saúde- SNS). The Ministry of Health organises national healthcare in Portugal, covering all residents who contribute to the social security system.
2. Healthcare subsystem program. Healthcare subsystems in Portugal are a part of the national healthcare system, designed to cover employees of specific organisations, i.e., civil servants, military personnel, police officers, banking services, etc.
3. Private healthcare. Private healthcare mostly plays a supporting role in addition to national healthcare, but those who cannot enrol with the SNS use private insurance as their main provider.

All residents are included in one of the systems mentioned above and can receive healthcare services whenever they wish. Usually, GPs are the first point of contact, and they refer patients to specialists when necessary— referrals are not required for emergencies.

Portugal Health Insurance for Expats

Expats in Portugal can access health insurance via one of the following options:

1. Sign up with the National Healthcare Plan (Serviço Nacional de Saúde- SNS). The SNS is the public healthcare system which provides almost free medical services for all residents and citizens in Portugal. Usually, when you are employed, you are included in the system since taxes are deducted from your salary. Still, self-employed people must pay their social contributions independently to qualify for the SNS.
2. Purchase voluntary private issuance. Private insurance is a second option for expats regarding healthcare in Portugal. Those who stay only short-term, i.e., less than 90 days, do not qualify for the SNS and need private health insurance instead. While others still prefer to buy additional private insurance for more extensive coverage.

If you are travelling to Portugal for a holiday, a business trip, or another type of short-term visit which lasts less than 181 days, then you should get travel insurance for Portugal.

Public Health Insurance for Expats in Portugal

Public healthcare is managed by the National Healthcare System (Serviço Nacional de Saúde- SNS), which is generally funded by taxation and social contributions. Those who are not employed, i.e., children and retirees, do not have to pay contributions.

The SNS system in Portugal is loosely based on the NHS in the UK, and it offers unrestricted access to healthcare services for all residents. If you’re an expat working and living in Portugal, you also benefit from the SNS.

Under the SNS you can seek care in any of the following medical centres:

• Health centres groups (agrupamentos de centros de saúde- ACES). These healthcare centres provide primary healthcare for local regions. Each municipality has at least one healthcare centre, which might have additional extensions.
• Hospital centres (centro hospitalar). Hospital centres usually include general, district, central, or specialised hospitals, i.e., oncologic or psychiatric centres. This is where secondary care is administered.
• Local health units (unidades locais de saúde- ULS). These are usually joint administrations of health centre groups and hospitals within one city or region. Here both primary and secondary care is administered.

What Does Public Insurance Cover in Portugal?

The public healthcare system (Serviço Nacional de Saúde- SNS) in Portugal covers most of the medical needs, which include hospital stays, doctor consultations, preventative care, diagnosis and treatment of emergency and non-emergency cases. However, it usually does not provide coverage for dental care and cosmetic surgery. For any services not included, you can buy a private insurance policy to include those services as well or pay for the services out of pocket.

Pros and Cons of Public Healthcare in Portugal

While the SNS offers excellent care, it comes with its own pros and cons for expats:

Expat Private Health Insurance in Portugal

Private insurance in Portugal plays an important role for expats alongside the public healthcare system. Expats who don’t qualify for the SNS must take out private insurance to cover the medical costs they incur. However, some expats also prefer private health insurance since it allows them access to private hospitals, coverage for those areas not included in the SNS, access to an English-speaking doctor, and fewer waiting times for examinations.

Best Private Health Insurance Companies for Expats in Portugal

Here are some of the best international health insurance companies for expats in Portugal:

• Cigna
• GeoBlue
• AXA
• Allianz

Cost of Private Health Insurance for Expats in Portugal

Private health insurance prices in Portugal vary between hundreds to thousands of euros per month, with an average of €400. Several factors affect the price of your private insurance, such as your age, your medical condition, the level of coverage you want, the length of your stay in the country, etc.

Is Healthcare Free in Portugal?

Healthcare is mostly free in Portugal. You have to contribute to the social security system via your salary— which funds your health insurance— and pay an extra fee for some services when you visit a healthcare centre in Portugal.

Portugal Health Insurance for Foreign Workers

If you’re an expat working in Portugal, you can sign up with the national healthcare system (Serviço Nacional de Saúde- SNS) by following these steps:

1. Get your social security number NISS (Número de Identificação de Segurança Social). If you’re working under a Portuguese employer, they will usually take care of this for you. But, if you’re self-employed, you must visit the social security office (Seguranca Social) and apply for your social security number along with several documents such as your tax number and residence permit.
2. Find your local healthcare centre. Once you get your social security number, find your nearest health centre (centros de saude) and apply to join the SNS. Make sure to bring the required documents, which usually include your social security card, passport or national ID, and residence permit. Make sure you contact the healthcare centre beforehand to ask them which other documents you need.
3. Retrieve your healthcare card. Finally, after your application has been processed, you can retrieve your healthcare card (cartao do utente), proof of your eligibility to access public healthcare. Then, you also have access to the SNS online portal, where you can make appointments and view your digital health information.

Student Health Insurance in Portugal

If you’re a non-EU student who needs a visa to study in Portugal, you must provide proof of valid Schengen visa insurance to enter the country. Then, after receiving your student permit, you need valid health insurance once you enter the country. First, you need to check with your educational provider whether you can benefit from the SNS or not. Otherwise, you must purchase private health insurance.

EU students staying for less than 90 days can use their EHIC (European Health Insurance Card) to receive treatment like Portuguese citizens. But, for stays longer than 90 days, they need health insurance (either public or private).

How Can Self-Employed Persons Get Health Insurance in Portugal?

Self-employed expats in Portugal are entitled to public healthcare and can benefit from the SNS. In this case, you need to make sure you retrieve your social security number (Número de Identificação de Segurança Social) and your tax ID number (Número de Identificação Fiscal). Then, you must make sure you pay your social contributions to benefit from public healthcare.

Because you are self-employed, you have to pay these social contributions by yourself, which varies based on several factors. But, you usually have to pay around 21.4%. As a result, you are entitled to social security benefits, including health insurance, pension insurance, unemployment benefits, etc.

Most expats also prefer to purchase additional or top-up health insurance to cover the gaps in the public health insurance scheme.

Health Insurance for Retirees in Portugal

If you’ve worked and lived in Portugal for several years, you’re entitled to social security, including public health insurance, when you reach retirement age. However, if you apply for a Portugal retirement visa, you can benefit from the SNS only after your residence permit is issued. Until then, and from the moment you enter the country, you must purchase private health insurance. You can choose an international health insurance policy or purchase it from a local insurance company.

You should remember that private insurance companies are more expensive the older you are and if you need coverage for pre-existing conditions.

Do EU Citizens Get Health Insurance in Portugal?

EU citizens staying for less than 90 days in Portugal can use their European Health Insurance Card to benefit from the Portuguese national system free of charge. However, if they plan on staying in Portugal for more than 90 days, they need to register their new place of residence and sign up with the SNS and receive their healthcare card.