Healthcare in Portugal

The National Health System in Portugal, Servico Nacional de Saúde, offers mainly free healthcare services to all legal residents, including expats. EU citizens can get immediate access to the system via an EHIC (European Health Insurance Card), but this coverage only extends to short stays (3 months or less). Nationals from non-EU countries may also be eligible for the public system if a reciprocal agreement is in place with Portugal and their home country. Non-EU expats who do not benefit from such agreements must source private health insurance before residency makes them eligible for the public system.

The quality of care within the public system is generally viewed as very good, and it frequently ranks highly on many global rankings. Modern facilities with English-speaking staff are common, especially in cities such as Lisbon and Porto. However, rural areas often have limited services and significantly longer wait times, accompanied by a much more obvious language barrier.

Public healthcare in Portugal is, for the most part, free. Since June 2022, inpatient or outpatient treatments at a hospital no longer require payment. Only emergency services without prior referral or emergency services where no hospitalisation is required after treatment are chargeable. Charges may also apply to prescription medications, but these are normally small.

To register for SNS, you’ll need to be a resident. However, if you have not yet obtained a residence permit, it is possible to register provisionally and be granted a temporary número de utente do SNS. For expats who do hold a resident permit, the process is quite simple.

Despite the wide reach and low cost of the public healthcare system in Portugal, expats should still be aware of issues they may encounter. Whilst English is widely spoken in major cities such as Lisbon, it is considerably less common in rural areas like Piódão, Óbidos and Marialva. Expats may also find that wait times are long (more so in rural areas, but not uncommon in cities or large towns) and that some treatments are not available in all facilities or covered by SNS. To aid residents, the SNS set a guaranteed wait time for treatments. These vary by location and level of urgency, but provide patients with a clearer idea of how long a delay may be in receiving treatment.

Despite the public healthcare system in Portugal offering a broad range of services and having minimal co-pays, many expats and locals choose to supplement their healthcare coverage with a private health insurance plan. With access to a wider range of services (including dental and optical), reduced waiting times, and a more personalised service, private healthcare delivers where the public system often falters.

The costs associated with private healthcare in Portugal are more expensive than those in the public sector, but compared to those in the USA, UK and other parts of Europe, they are considerably more affordable. An appointment with a private GP, for example, may cost approximately €50, diagnostic testing may range from €150 to €300, and a hospital stay could cost €200 to €500 per day.

There is a wide range of well-respected private healthcare facilities in Portugal, including the CUF, Luz Saude and Hospital da Luz chains. These are located nationwide, and in the case of Luz Saude, put a focus on expat services. With modern equipment, bilingual staff and high-quality care, all three of these options provide expats with enhanced medical care.

Private health insurance is not a requirement for benefiting from the private hospitals and facilities in Portugal, but it is recommended. With high costs, sufficient coverage ensures fewer out-of-pocket expenses whilst still receiving the best possible care.

Health insurance in Portugal is not mandatory for legal residents as the public system is funded through taxes and social security contributions, and covers the vast majority of healthcare costs. However, during the initial residency process, a private health insurance plan is mandatory for certain visa applications. Non-EU expats must have private insurance before applying for residency, but EU/EEA/UK nationals can remain covered with their EHIC/GHIC for short stays, moving to a private plan before registering with SNS.

Private coverage is not mandatory once registered with SNS, but many expats look to a private plan to supplement their public sector coverage. This can be done in two ways. A local plan ensures comprehensive coverage within Portugal, and occasionally overseas. An international plan, on the other hand, offers global coverage, a wider range of benefits, and additional support specifically for expats.

Private plans typically include inpatient and outpatient services, surgery, hospital stays, diagnostic testing and much more. However, exclusions in coverage can mean some necessary treatments may incur full payment out-of-pocket. Pre-existing conditions and cosmetic surgery are commonly excluded, so it is advisable to check what is covered before committing.

The costs for a private healthcare plan vary. Insurers consider age, health and type of coverage before issuing a quote. A local plan is a cheaper option, but it provides a lower level of coverage than international plans.

Insurance is available through a host of international insurers or local providers. It is advisable to collect three to five quotes before committing to a policy. That way, you can check the premiums match your needs and budget.

English isn’t the main language of Portugal, but it can be found in many cities across the country. Public hospitals often have staff members who can communicate in English, but this becomes less prevalent as you move further away from big cities and urban developments. Private hospitals may offer specialist interpreter services, and/or have English-speaking staff and international patient departments to provide a more seamless service.

The main cities of Portugal are home to some of the nation’s best hospitals, but excellent facilities are found across the country. Centro Hospitalar de Leiria (Leiria), Hospital Lusiadas Lisboa (Lisbon), Hospital de Cascais Dr Jose de Almeida (Cascais) and Hospital Lusiadas Porto (Porto) are just four of the JCI-accredited facilities that can be found in Portugal.

Services offered in Portuguese hospitals are wide-ranging. Across both public and private facilities, expats can receive emergency treatment, maternity care, psychiatric care, post-operative care and surgery. Private hospitals may also provide treatments not always available in public facilities, such as cosmetic surgery, enhanced mental health support, and dental and optical care.

In Portugal, you must be referred to a public hospital by a Portuguese doctor before receiving treatment. In an emergency, walk-ins are welcome, but small costs may apply depending on the treatment required. You’ll also need to ensure you have your health card or ID available. Private hospitals do not require a referral; the patient can schedule an appointment directly with the hospital.

Public hospital care is heavily subsidised, meaning that it is often at little or no cost. In contrast, private facilities have much higher costs for their services. Basic appointments can cost anything from €50, whereas a long-term stay can easily cost several thousand euros.

Private hospitals in Portugal are excellent and are equipped with hotel-like facilities to ensure maximum patient care and a more comfortable stay. Private rooms with guest sleeping spaces are available, and the services offered are tailored to the individual rather than the masses. Public hospitals are considerably more basic but are still well-regarded for the services they provide.

Private hospitals accept international health insurance, but will likely require payment upfront, with reimbursement claimed later. This can vary between hospitals and insurers. In some cases, a direct billing agreement may be in place where the hospital simply bills the insurer.

There are no mandatory vaccinations required for travel to Portugal, but routine vaccinations such as MMR and DTP should be up to date before arrival. Once you are a resident in Portugal, you can benefit from the national vaccination programme that ensures everyone has access to free and accessible immunisations. Some diseases are not currently on the programme, so expats are advised to consider private coverage to ensure they can still be vaccinated against Hepatitis A, Rotavirus and Chickenpox at no cost.

6-8 weeks before travel, it is recommended that you visit a GP for the latest health advice and have any vaccinations scheduled.

Portugal is generally free of tropical diseases that blight other countries. That being said, tick-borne illnesses are common in some areas. Seasonal flu is also common during the winter months.

Whilst tap water is safe to drink in Portugal and food is generally cooked and stored safely, care should be taken. Bottled water is often preferred, and food should only be purchased from trusted vendors.

Heatstroke and dehydration can be common in Portugal in the summer, so preventative measures are highly recommended.

To ensure maximum safety, avoid prolonged exposure to the sun, remain hydrated and use sun protection when necessary. Whilst the risk of bites may be low in many areas, you should protect yourself, especially when visiting wooded areas or farmland. Apply insect repellent, wear suitable clothing and check yourself for bites.