Moving to a new country can be tricky, and one of the challenges you’ll face is getting to know the healthcare system. This article guides you through Portugal’s healthcare system—a blend of public and private services that’s among the best in the world. Portugal’s healthcare system ranks higher than the UK, Spain, Italy, and Ireland in several health parameters, offering comprehensive coverage through its National Health Service.
But as a foreigner, you might find yourself swirling with questions: How easy is it to access healthcare? How much does it cost? Is private insurance an option? Are dental and mental health covered? This article will answer all these questions, giving you a clear path to navigate healthcare in Portugal. Reading this can make your transition smoother and ensure you get the healthcare you need while living in Portugal.
Overview of Portugal’s Healthcare System
The National Health Service (NHS), or Serviço Nacional de Saúde (SNS), is the heart of Portugal’s healthcare system. The NHS is Portugal’s public healthcare system and is mainly funded through general taxation. It offers all residents a broad range of services, regardless of socioeconomic status, employment, or legal status. The SNS covers all of mainland Portugal, while Azores and Madeira have their own separate healthcare systems.
The SNS offers primary care and acute general and specialized hospital care. Public providers mostly deliver primary care with a gatekeeping system in place. Secondary care is mainly provided in hospitals, grouped into Hospital Centres covering a given geographical area.
Besides the SNS, Portugal has a unique healthcare system called “social hospitals,” once run by private institutions focused on social solidarity. These hospitals, known as “misericórdias,” were Portugal’s primary hospital care providers until the 1970s. Today, social hospitals have an agreement with the SNS and offer services similar to public hospitals.
Public vs Private Healthcare
While the SNS provides comprehensive coverage, Portuguese residents must pay a small portion of their medical costs, including doctor visits, hospital care, and prescriptions. This cost-sharing has been increasing over time, with the highest level for pharmaceutical products.
About 20% of Portuguese residents have private health insurance to supplement their public healthcare. Private healthcare covers extra services and can provide quicker access to specialists and English-speaking practitioners. Some doctors and hospitals in Portugal operate in both the public and the private medical insurance systems.
Private healthcare in Portugal is also an option for expats and foreigners, providing access to private practitioners and clinics. Suppose you’re an expat residing in Portugal and making the necessary social security contributions. In that case, you’re entitled to access the Portuguese healthcare system. Once your Golden Visa or D7 Visa is approved, you can use public healthcare services. To gain access, you must first register with the SNS to benefit from its services.
The public health system in Portugal is available to citizens and permanent residents. Suppose you’re a European resident with a European Health Insurance Card (EHIC). In that case, you’re also eligible for the same public health insurance coverage standards as Portuguese residents. Several non-EU countries, including Andorra, Brazil, Cape Verde, and Morocco, have reciprocal agreements with Portugal, allowing their citizens to access public healthcare in Portugal for free or at a reduced cost.
Despite the robust public healthcare system, certain areas like mental healthcare and dental care may require private health insurance for comprehensive coverage. Mental healthcare in Portugal remains a challenge, with a high prevalence of depression and substance abuse. Access to mental care requires a visit to a general practitioner (GP) who can prescribe medication, refer for counseling, or refer to a specialist.
The public healthcare system does not generally cover dental care in Portugal unless you’re part of a vulnerable group, such as children, pregnant patients, older adults, or disabled residents. Private dental services are available, and private health insurance plans can cover the costs.
How Good Is The Portuguese Healthcare System?
The Portuguese healthcare system’s high standards and efficiency are reflected in its ranking of 17th in the 2021 World Index of Healthcare Innovation and 25th globally by Numbeo. The NHS negotiates drug prices, ensuring affordability for its members. This, coupled with the high standard of care, makes Portugal’s healthcare system quite appealing compared to other Western European countries.
The system is particularly recognized for its patient-centered care, ranking 3rd in this category in the WIHI analysis. This indicates that the system is designed to meet the needs of the patients rather than just the convenience of the providers. However, Portugal ranked lower for science and technology, indicating a slower rate of adoption of Electronic Health Record (EHR) and contributions to medical and scientific innovation than expected.
The fiscal sustainability of Portugal’s healthcare system is a concern, ranking 20th overall. This is largely due to a high debt-to-GDP ratio, which could affect the country’s ability to fund its healthcare system in the future.
Emergency services are known for quick response times, and public and private healthcare services are excellent. English is widely spoken by healthcare professionals in both sectors, facilitating communication for expats and tourists.
Maternity and childcare services are also covered. Expectant mothers usually receive care at a local health center or a public hospital. Children can access public healthcare for free, with regular health checks and access to screenings, examinations, vaccinations, and nutritional healthcare.
However, mental healthcare services aren’t as developed as in many other countries, with fewer mental health professionals. This is an area that the country needs to work on to ensure comprehensive access to healthcare services for all its residents.
Can Expats Get Free Healthcare In Portugal?
The SNS, funded by public finances, is open to all citizens and legal residents, including expats, and offers a wide range of medical services (excluding dental costs).
If you’re under 18 or over 65, you won’t have to pay for healthcare in Portugal’s national and international health insurance system. The state healthcare system offers medical services at a subsidized, low rate for everyone else. So, if you’re a resident of Portugal, your medical fees will be quite low.
Suppose you’re an expat working in Portugal. In that case, you’ll be able to use the SNS by paying into Portugal’s Social Security system and getting a Numero de Utente, which gives you a general practitioner. Even if you’re not a permanent resident, as long as you’ve been in Portugal for at least 90 days, you can get a Numero de Utente and access the Portuguese national health services at a discount.
If you’ve got a Golden Visa, you’re eligible for the SNS, but you’ll need to register with the SNS first to use its services. Remember, though, dental costs aren’t covered. Private health insurance is also an option for Golden Visa holders, giving you access to private doctors and clinics.
Non-EU students in Portugal need valid health insurance, either through the SNS or private insurance, depending on their circumstances.
Private health insurance is also a good choice if you prefer it. It comes with extra benefits like evacuation coverage and direct payment for treatment in any country. The cost of private health insurance in Portugal depends on your coverage level.
While healthcare in Portugal isn’t entirely free for expats, it’s highly accessible and affordable. Whether you use the public healthcare system or go for private health insurance, you can expect top-notch care.
How Much Does Health Insurance Cost For Expats In Portugal?
The price can vary significantly depending on whether you opt for public or private healthcare, with the latter generally being more expensive.
While the SNS provides a wide range of medical services, it does not cover dental care and cosmetic surgery. The affordability of the SNS is one of its main advantages, with low consultation fees being the norm. However, one downside is the long waiting times for non-urgent procedures.
Private health insurance, on the other hand, offers additional flexibility and security, allowing quicker access to specialized care. It’s important to note that this is not the same as purchasing private health insurance but rather an additional paid service that covers private healthcare costs.
The cost of private health insurance can vary based on factors such as age, medical history, and any pre-existing conditions. This insurance covers a variety of services, including doctor appointments, hospital visits, prescription drugs, wellness care, and medical devices. Depending on the level of coverage, it might also cover glasses and dental work.
Private health insurance also covers additional services not included in the SNS, such as alternative therapies, elective procedures, and certain prescription medications that are not fully covered. Many expats and foreign residents in Portugal opt for private health insurance to ensure continuity of care for dependent family members and access to specialized treatments in their preferred language and with familiarity with international medical practices.
Private health insurance in Portugal can cost between $30 to $160 per month, depending on the coverage and your age. Private hospitals in Portugal offer modern facilities with the latest technology and private patient rooms. Emergency room triage units include semi-private, curtained-off areas similar to U.S. emergency departments.
Private healthcare clinics in Portugal offer a range of services, including dental care, clinical analysis, diagnostic exams, and consultations. You’ll even find private healthcare clinics in many shopping centers for convenience. Medications in Portugal are generally affordable, and most medicines available in North America can also be found in Portugal at lower prices. Some medications require a doctor’s prescription, while others can be bought without one.
Healthcare In Portugal For Foreigners And Non-Residents
The healthcare system is a significant consideration for those contemplating a move to Portugal. The Portuguese healthcare system is composed of three main components: the SNS, health subsystems, and voluntary private healthcare.
Health subsystems cater to specific professions or organizations, such as the police, military, and banking services. The most substantial public health subsystem is the ADSE, catering to over 1.3 million public servants.
Private healthcare is an alternative, with a variety of networks and insurance options. It covers additional services not included in the public system, such as dental and vision care.
You’ll need a Portuguese social security number and residence permit to obtain coverage as an expat. Non-EU students must demonstrate full coverage by a private insurance scheme.
Mental healthcare is an area that needs improvement, with an estimated 30% of the Portuguese population having experienced some form of mental health issue. To access mental health care, a visit to your GP is required, who can then prescribe medication, refer you for counseling, or refer you to a specialist.
The distribution of public healthcare facilities in Portugal is skewed towards urban areas. Expats in rural Portugal may have fewer options and may need help finding English-speaking doctors and pharmacists. However, the private healthcare system offers a high standard of care, with many of the comforts that expats would expect. While it is a more expensive option, it provides the advantage of bypassing some of the long queues and waiting lists associated with the public healthcare system in Portugal.
Emergency medical services in Portugal are generally efficient. Expats in urban areas should experience sufficient waiting times for emergency medical care.
The cost of healthcare in Portugal is relatively affordable compared to other Western European countries, making it an attractive option for foreigners and non-residents.
Portugal’s healthcare system is a mix of public and private services aimed at ensuring you receive top-notch patient care. It has an impressive global ranking and offers a wide range of services, covering residents and expats. Even with the excellent public and private healthcare systems, you should consider getting additional private health insurance for more comprehensive coverage, especially when it comes to dental and mental health services.
The affordability and accessibility make Portugal’s healthcare system a great choice if you’re considering relocating or retiring in this vibrant Southern European nation. Sure, there might be a few minor challenges. Still, Portugal’s healthcare system shows just how committed the country is to the health and well-being of its residents and visitors.
