Best Private Health Insurance in Portugal? Cigna, Bupa, APRIL, Allianz and Multicare Compared

34 min read

If you are looking for the best private health insurance in Portugal, you will sooner or later face the same question: an international plan such as Cigna Global, Bupa Global or APRIL International, or a Portuguese one such as Allianz Saúde or Multicare? The marketing of all five sounds similar. The conditions, however, differ considerably, on entry age, pre-existing conditions, territorial scope and what applies if the contract is not renewed.

The comparison is based on the publicly available terms and benefit summaries of the five insurers, the Portuguese Insurance Contract Act and the information from the Portuguese authorities. The as-of date and the sources are given below the overview table, and the sources are linked where they are used.

There is deliberately no ranking here: which insurance suits you best depends on your age, your health, your travel and your budget.

International or Portuguese health insurance: the difference

International health insurance is aimed at people who live outside their home country and applies worldwide or worldwide excluding the USA. Portuguese health insurance (seguro de saúde) is aimed at residents of Portugal, works with a network of Portuguese clinics and doctors and, under its terms, applies essentially in Portugal. Both are private insurance, used alongside the national health service SNS.

Travel insurance versus international private medical insurance (IPMI)

If you search for health insurance for Portugal in English, you often end up with travel insurance. Travel insurance usually means protection for holidays and business trips, limited in time and meant for emergencies. If you live in Portugal, you need something different: insurance that also pays for the planned operation, the cancer treatment or the check-up with a specialist, year after year. These plans are called international health insurance, expat health insurance or international private medical insurance (IPMI).

The two models at a glance

The line is not entirely sharp: with Close Care, Cigna offers a plan that applies only in the country of residence and the country of nationality, and Allianz Saúde can include travel assistance for the first 90 days of a trip. For the comparison, what counts is therefore not the label but what the conditions say. Our page on health insurance in Portugal gives an overview of the plans we arrange.

Do you need private health insurance in Portugal?

Whether you need private health insurance depends mainly on your residence status and your pension situation. Anyone who lives in Portugal legally has access to the national health service SNS in principle. In practice, many newcomers take out private insurance anyway: because of waiting times in the SNS, because of the language and because the time until full registration has to be bridged.

The user number alone pays for nothing

Foreigners receive the SNS user number (número de utente) at their first visit to a health centre or hospital. The Portuguese administration states this expressly: “A atribuição do número de utente de saúde não garante a cobertura das despesas dos cuidados de saúde pelo SNS.” For the SNS to cover the costs, further data must be linked to the number, among other things a valid residence permit; gov.pt names the autorização de residência (gov.pt, Número de utente; gov.pt, Cuidados de saúde para migrantes).

EU retirees: the S1 form

If you receive a pension from another EU state and none from Portugal, the EU rules make the state that pays the pension responsible for your health cover. With the S1 form, which you request from your health insurance in the pension state and register in Portugal, you get access to care there on the same terms as locals (Your Europe, health insurance in the country of residence). The S1 gives access to state care; it does not automatically pay for treatment in private clinics.

Visa: travel insurance for nationals from outside the EU

EU citizens do not need a visa to move to Portugal. If you need a residence visa, as a British or American citizen for example, the general documents of the Portuguese Ministry of Foreign Affairs list a “Seguro de viagem válido, que permita cobrir as despesas necessárias por razões médicas, incluindo assistência médica urgente e eventual repatriamento”, that is, valid travel insurance with emergency medical care and repatriation (Portal Diplomático, Vistos de residência). The general documents do not require comprehensive health insurance; for individual groups, such as participants in certain training courses, the portal expressly names a seguro de saúde in addition. If you need treatment after arrival that is not an emergency, travel insurance usually leaves you without cover.

The five insurers at a glance

The five providers differ most clearly in territorial scope, entry age and the treatment of pre-existing conditions; the table shows what their public documents say about this. Where a figure appears only in the policy, the table says so.

Status of the documents: Cigna Global Benefits Summary, Customer Guide and Policy Rules (Cigna Global Insurance Company version) each 02/2025, Bupa Global Health Plans Sales Brochure 05/2026, APRIL Long-Term International Health Plan Policy Guide 2026-2027, Allianz Saúde Condições Gerais e Especiais 229 (06/2024), Multicare Condições Gerais D0028 (09/2026). With Cigna, the legal entity, the version of the conditions and the amounts can differ depending on place of residence and contract currency; your policy schedule is what counts. Other international providers we compare are PassportCard, Foyer and MGEN; their conditions are not evaluated here.

Cigna Global

Cigna Global is an international health insurance with three levels, Silver, Gold and Platinum, and an annual maximum of EUR 800,000, EUR 1.6 million or no upper limit; in dollar plans it is USD 1 and 2 million (Cigna Global Health Options Customer Guide, 02/2025; Benefits Summary, 02/2025). The basic building block is inpatient care (International Medical Insurance), to which selectable modules are added, such as outpatient care with EUR 12,000 (Silver), EUR 25,900 (Gold) or full reimbursement (Platinum) per year, and building blocks for medical repatriation.

Territorial scope, country of nationality and Close Care

You choose between worldwide with and worldwide without the USA. If you exclude the USA, there is a separate limit for inpatient emergency treatment on short trips outside the territorial scope, in euro plans EUR 75,000 (Silver) and EUR 200,000 (Gold), only with prior authorisation. Important for anyone who is often in their country of nationality: under the Policy Rules (Cigna Global Insurance Company version, 02/2025) the plan is aimed at expats and pays for treatment in the country of nationality only during a temporary stay, at most 180 days per insurance year (clause 1.1).

For people who live between two countries, Cigna offers Close Care: the plan applies in your country of residence and in your country of nationality, for example Portugal and the UK, with an annual maximum of USD 500,000, a limit of USD 250,000 per illness and, in hospital, a semi-private room instead of a private room. More on our page on Cigna Close Care.

Excess, pregnancy, renewal

At Cigna the excess consists of two parts: a fixed amount per year (in euros between EUR 0 and EUR 7,400) and a percentage of 0, 10, 20 or 30 per cent on every further invoice, which is capped per year at EUR 1,480 or EUR 3,700. Benefits for pregnancy and birth exist only in Gold and Platinum, and only once the mother has been insured for at least twelve months. On renewal, Cigna writes in the customer guide: “You are not re-underwritten at renewal if you are not making material changes to your policy.” The Policy Rules add that a decision against renewal is not based on your claims or illnesses (clause 13.1).

Neither the customer guide nor the public Policy Rules state a maximum age for application; they give only the minimum age of 18 years. Ask in writing for the entry limit before you apply. Cigna regulates pre-existing conditions through the health questionnaire and individual exclusions in the policy schedule. Our page on Cigna Global describes the plans in detail.

Bupa Global

Bupa Global offers residents of Portugal the plans Major Medical, Select, Premier and Elite, with an annual maximum of EUR 2.5 million, EUR 1.25 million, EUR 1.875 million and EUR 3.75 million (Bupa Global Health Plans Sales Brochure, 05/2026; Bupa Global, Portugal). Major Medical is geared to serious illness and, despite the narrowest scope of benefits, has the second-highest limit; the other plans mainly extend outpatient care. The brochure also lists the Ultimate plan without an annual maximum, which Bupa’s Portugal page does not include in the plan comparison but offers only through the separate Private Client by Bupa.

Pre-existing conditions against a premium loading

With Bupa, pre-existing conditions are excluded in all plans, “unless you have applied for cover that includes a medical loading to cover these conditions”. With a premium loading shown in the quote, certain pre-existing conditions can therefore be included, depending on the result of the underwriting. Chronic illnesses diagnosed after the start of the contract are covered according to the brochure.

Waiting periods and renewal

Bupa has no general waiting period from the start of the contract, but it does for individual benefits: 18 months for pregnancy and birth (in the plans listed for Portugal only Elite), 10 months for preventive check-ups, 6 months for routine dental treatment. For all plans the brochure names automatic renewal and the waiver of cancellation because of previous claims (“No cancellation of policy based on claims pattern / history”). The brochure does not state a maximum age for application. More on our page on Bupa Global in Portugal.

APRIL International

With the Long-Term International Health Plan, APRIL International offers four plans (International, International Plus, Executive, Executive Plus), all with an annual maximum of EUR 1.5 million. Area One applies worldwide excluding the USA and the Caribbean, Area Two worldwide. You can apply up to the age of 70: “The maximum age you can apply for a Plan is seventy (70).” (APRIL, Long-Term International Health Plan Policy Guide 2026-2027).

Three routes through medical underwriting

APRIL describes the underwriting procedures in detail in its Policy Guide. Under 65 there are three routes, from 65 only full underwriting:

Cancellation by the insurer

APRIL writes: “We will not invoke cancellation as a result of your age or health record whilst you are insured under the Plan.” APRIL may cancel on 14 days’ notice for other reasons, such as non-payment of the premium, a change in risk that makes cover impossible, or if you fail to provide requested information. On the anniversary, both sides can end the contract. Our page on APRIL in Portugal shows the plans.

Allianz Saúde

Allianz Saúde is a Portuguese health insurance with the variants Base, Mais, Extra and Total as well as the plan 55 Mais for people aged 55 and over. Under the general conditions, the contract applies in Portugal and Spain (Allianz Saúde, Condições Gerais e Especiais 229, 06/2024, Cláusula 5.ª).

Outside Portugal and Spain

If travel assistance (Assistência em Viagem) is agreed, it applies worldwide in case of accident or sudden illness during the first 90 days of a trip. Beyond that, Allianz reimburses treatment outside Portugal and Spain for particular medical conditions if a specialist justifies it and Allianz agrees in writing beforehand. International cover for serious illnesses (Cobertura Médica Internacional por Doenças Graves) can also be agreed. Which building blocks your contract contains is stated in the condições particulares.

Who is accepted

Under Cláusula 8.ª, those insured are people who live in Portugal, have a Portuguese tax number and complete a health questionnaire whose risk Allianz accepts. The age limits for entry:

Network, co-payment, waiting periods

Allianz distinguishes between services within its own network (Rede Allianz), where you make a co-payment, and services outside the network, which are reimbursed against an invoice, less an excess (franquia). Waiting periods (períodos de carência) apply to hospital treatment: in the hospital building blocks of all variants 365 days for a series of treatments such as childbirth (if included), hernias, gallstones and kidney stones, joint procedures or cataracts, 90 days for other hospital stays and operations, and none in case of accident. The maximum sums per building block are mostly not in the general conditions but in your condições particulares. Our page on Allianz health insurance in Portugal describes the variants in detail.

Multicare

Multicare is the health insurance brand of Fidelidade; the insurer of the contracts is Fidelidade, Companhia de Seguros. Under the general conditions for Multicare 1, 2 and 3, the insurance applies, “Salvo convenção expressa em contrário na Apólice”, only in Portugal and with doctors and clinics of the Multicare network abroad (Multicare, Condições Gerais D0028, 09/2026, Cláusula 5.ª). Outside the network in Europe, Multicare pays only after an accident or in case of urgent need for treatment, with a medical report, and only if the trip does not last longer than 60 days, unless the policy states another period.

Pre-existing conditions, age limit, standard product

With Multicare, pre-existing conditions are excluded under Cláusula 4.ª no. 6, except for illnesses and procedures for which separate waiting periods are agreed. Only those who meet the age limit for application set by Multicare are accepted (Cláusula 8.ª); the age at which cover ends is stated in the condições particulares or in the policy schedule. Waiting periods do not apply to an accident or a sudden illness if urgent hospital treatment is needed because there is a threat to life or of loss of function (Cláusula 8.ª no. 3). Multicare also offers health insurance under the standard conditions published by the insurance supervisor ASF in Circular 6/2025 (Multicare Proteção Padrão, Condições Gerais D0034; see also our article on Multicare’s standard health insurance). If you mainly want to be treated in Portugal, Multicare or Allianz give you a benchmark for the international plans; the same goes for Médis, another Portuguese health insurance.

Pre-existing conditions: what the law says and what the conditions make of it

Under the Portuguese Insurance Contract Act, pre-existing conditions that you know of when you take out the policy are in principle covered; the contract may, however, exclude them, in general or individually. Article 216 of Decreto-Lei 72/2008 reads: “As doenças preexistentes, conhecidas da pessoa segura à data da realização do contrato, consideram-se abrangidas na cobertura convencionada pelo segurador, podendo ser excluídas por acordo em contrário, de modo genérico ou especificadamente.” For pre-existing conditions the contract may also provide for a waiting period of at most one year (Decreto-Lei 72/2008, Art. 216, PGD Lisboa).

The law permits the exclusion; it does not prescribe it. Allianz Saúde and Multicare make use of this option in their general conditions: Allianz excludes costs for a “doença pré-existente, declarada ou não à Allianz Portugal”, which includes an illness you stated in the questionnaire (Cláusula 4.ª). With Multicare, the exclusion does not apply if a separate waiting period is agreed for an illness. Whether your contract differs is stated in the condições particulares.

How the international plans treat pre-existing conditions

• Bupa Global: excluded, unless you have agreed a premium loading for certain pre-existing conditions; acceptance depends on the underwriting.
• APRIL International: with the moratorium possible after two years free of symptoms, with full underwriting only what is declared and accepted.
• Cigna Global: information in the health questionnaire, individual exclusions in the policy schedule. In the outpatient module, the benefit 60+ Care exists from age 60: according to the customer guide it pays for the ongoing outpatient treatment of some common conditions such as high blood pressure or type 2 diabetes, if these are declared in the questionnaire and recorded as an individual exclusion, up to EUR 370 (Silver), EUR 740 (Gold) or EUR 1,480 (Platinum) per year.

For the comparison, this means: if you have a pre-existing condition, you are not comparing plans but acceptance decisions. Submit the request to several insurers with the same, complete health information and compare what each one includes or excludes. More in our article on pre-existing conditions in health insurance.

Reading the excess, the maximum benefit and the exclusions correctly

What you bear yourself in the event of a claim depends, with international plans, mainly on the excess you choose; in addition, individual limits and general exclusions restrict the benefit. Cigna explains the calculation in the customer guide like this: first you pay the fixed annual amount, then the chosen percentage of every further invoice, until the annual cap for the percentage part is reached. The insurer bears the rest. Bupa and APRIL also offer selectable excesses; the quote states the levels.

Maximum benefit: year, benefit, illness

The annual maximum alone says little if individual benefits have limits of their own. For mental illness, for example, Cigna states EUR 3,700 (Silver) and EUR 7,400 (Gold) per year in euro plans, and Close Care has, alongside the annual limit of USD 500,000, a limit of USD 250,000 per illness. With the Portuguese plans, the sums per building block, for hospital and outpatient care for example, are in the condições particulares. Lay the benefit tables side by side before you compare premiums. With the international plans the waiting periods are in the benefit table, with the Portuguese ones in the conditions and the policy; if you are planning a family, compare the period for pregnancy and birth explicitly (more on waiting periods in health insurance in Portugal).

What the conditions exclude in general

Besides pre-existing conditions, each of the five sets of documents evaluated contains a list of general exclusions that applies to all benefits. Some points recur in several of them:

• Aesthetic and cosmetic treatment is excluded by Allianz, Multicare, Bupa and APRIL.
• Consequences of alcohol, drug and medication abuse appear in the exclusion list of all five, with different wording.
• Fertility treatment is excluded by Allianz, Multicare, Bupa and APRIL in their general exclusions; Bupa pays for assisted conception in Elite and Ultimate, APRIL only for certain examinations, if the benefit is agreed.
• War, unrest and disasters are named by all five, with different scope.
• Accidents in certain sports are excluded by Allianz, Multicare and Cigna, with lists and exceptions of their own; Bupa and APRIL name professional sport, APRIL in addition racing of any kind except on foot.

The lists are longer and differ in detail. Read the general exclusions of your quote as carefully as the benefit table.

Cancellation, renewal and continued payment

Portuguese health insurance contracts run for one year and renew automatically unless one side gives notice at least 30 days before expiry; this applies under the conditions of Allianz Saúde and Multicare. If the contract, or the cover for one person, is not renewed, Article 217 of the Insurance Contract Act requires the insurer to keep paying for up to two years for insured illnesses that arose during the term, until the sum insured of the last year is used up (Decreto-Lei 72/2008, Art. 217, PGD Lisboa). The conditions: you report the illness within 30 days after the contract ends, unless there is a justified impediment, and no later contract covers the risk accordingly. Allianz (Cláusula 15.ª) and Multicare (Cláusula 16.ª) have adopted this rule in their conditions in substance.

Whether the Portuguese Insurance Contract Act, and with it Article 217, also applies to an international contract depends on the law the contract provides for. Check the choice-of-law clause in your policy. What Cigna, Bupa and APRIL themselves promise on cancellation and renewal is in the sections on the three insurers.

The Portugal column is based on the Allianz and Multicare conditions and Decreto-Lei 72/2008. If you are giving up a private health policy in your home country, ask that insurer before cancelling whether you can suspend it instead.

Which health insurance suits whom?

Four questions mainly decide which health insurance in Portugal suits you: where do you want to be treated, how old are you when you apply, which pre-existing conditions do you have, and how much excess can you bear in a serious case. The following profiles are starting points, not a recommendation for a particular plan.

How premiums in Portugal develop with age is explained in our article How much does private health insurance cost in Portugal?.

Six comparison mistakes that get expensive

Six mistakes make comparing health insurance in Portugal expensive, from the travel insurance on the visa application to the gap when changing insurer.

Frequently asked questions

Answers to common questions from English-speaking expats about health insurance in Portugal.

Our advice as an independent broker

When comparing health insurance in Portugal, compare the conditions first and the premiums second. Clarify where you want to be treated, whether your age already rules out a plan and how each insurer deals with your pre-existing conditions. Only then is it worth looking at the price and the right excess.

As an independent insurance broker, we are not tied to any insurer. We submit your request to several insurers with the same health information, lay the acceptance decisions and benefit tables side by side for you in English and explain what is in the condições particulares. If there is a claim, we support our clients in English in their dealings with the insurer. You will find all plans at a glance on our page on health insurance in Portugal.

As of: 12 October 2026. This article reflects the information available on that date and does not replace individual advice or legal advice. It is based on the publicly available documents of the insurers, in the versions and as-of dates given below the overview table; the original-language version is authoritative in each case. Only your own insurance conditions, your policy schedule and the condições particulares are binding for your contract; benefits, limits and age rules can change and can differ depending on place of residence, legal entity and contract currency. The selection of the five insurers is not a statement about the market. The information on the SNS, the visa and the S1 form reflects the pages of gov.pt, the Portuguese Ministry of Foreign Affairs and the EU on the date stated. The worked example and the practical example are based on assumed amounts and persons.