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Anyone moving to Portugal and looking for health cover soon comes across Cigna. The US group offers expats two families of plans: Cigna Global Health Options with the Silver, Gold and Platinum tiers, which cover you worldwide, and Cigna Close Care, which covers only your country of residence and your country of nationality. On top of that come four optional modules that you add one by one, each at the level of your core cover. That freedom is exactly what makes the choice difficult: two policies both called “Gold” can cover very different things.
This guide explains which Cigna expat insurance is available in Portugal, who it is designed for, what the tiers and modules pay, and where the traps are, such as seeing a doctor without the outpatient module or spending long periods back home. It is based on Cigna’s Customer Guide, Policy Rules and the Close Care Insurance Product Information Document, all dated February 2025. How Cigna compares with Bupa, APRIL, Allianz and Multicare is covered in our comparison of private health insurance in Portugal; this article is only about choosing within Cigna.
- Expats only: Cigna Global and Close Care are for people living outside their country of nationality. If you hold Portuguese nationality (including as a second nationality) and live in Portugal, you are not an expat in Portugal under the policy. You must be at least 18 to buy a policy; the documents do not state a maximum age.
- Three tiers: Silver pays up to €800,000 a year, Gold up to €1.6 million and Platinum has no annual limit. Childbirth is covered only from Gold upwards and after 12 months.
- Outpatient only with a module: the core cover mainly pays for hospital and day-patient treatment. Doctor visits, prescribed drugs and tests outside hospital are paid only with the International Outpatient module; the main exceptions are cancer care, mental health care, MRI, CT and PET scans and the emergency room.
- Home country 180 days at most: in your country of nationality Cigna pays only while you are temporarily there, no more than 180 days in total per policy year. This applies to Cigna Global and to Close Care.
- Close Care: a leaner plan for two countries (Portugal and your home country) with an annual limit of €400,000, without childbirth and without organ transplants.
- Get approval first: inpatient and day-patient treatment and some outpatient treatment, such as MRI scans or cancer care, need Cigna’s prior authorisation; otherwise Cigna reduces what it pays by 20 per cent.
Who Cigna expat insurance in Portugal is for
Cigna does not sell residents of Portugal a Portuguese health plan in the usual sense, but international private medical insurance for expats. The Policy Rules say so in their very first sentence: the policy is only offered to beneficiaries who are expatriates (Cigna Global Health Options, Policy Rules, February 2025, clause 1.1). An expatriate, as defined, is someone residing outside their country of nationality, and country of nationality means any country of which you are a citizen.
For British, American, Canadian or other foreign nationals who have moved to Portugal, that fits. Three situations are worth knowing before you ask for a quote:
- Dual nationality: if you also hold Portuguese nationality and live in Portugal, you are not an expat in Portugal within the meaning of the policy.
- Naturalisation or moving back: if you stop being an expat during the policy year, for example by becoming a Portuguese citizen or moving back home, you must tell Cigna. You can then either keep the policy until the end of the policy year or cancel it in writing; at renewal Cigna will check whether another plan from the group can be offered (clause 11.4).
- Age: you must be at least 18 when you buy the policy (clause 1.3). The public documents do not state a maximum entry age; whether Cigna accepts you depends on medical underwriting. What other insurers require from 60 and 70 is explained in our guide to health insurance in Portugal over 60 and 70.
Which Cigna company insures your policy depends on your residence and the policy version. The Policy Rules this article relies on name Cigna Global Insurance Company Limited in Guernsey; the product information documents for Close Care name Cigna Life Insurance Company of Europe in Belgium. What counts is what your Certificate of Insurance says.
Silver, Gold or Platinum: the three tiers
The core cover of Cigna Global is called International Medical Insurance and mainly covers hospital and day-patient treatment. The three tiers differ in the annual overall maximum and in many individual limits. Amounts are per beneficiary per policy year in euro plans (Cigna Global Health Options Customer Guide, February 2025, International Medical Insurance section):
| Benefit in the core cover | Silver | Gold | Platinum |
|---|---|---|---|
| Annual overall maximum | €800,000 | €1,600,000 | paid in full |
| Hospital charges (accommodation, surgery, intensive care) | paid in full, private room | paid in full, private room | paid in full, private room |
| Mental and behavioural health care | €3,700 | €7,400 | paid in full |
| MRI, CT, PET scans | €7,400 | €12,000 | paid in full |
| Out of area emergency (inpatient) | €75,000 | €200,000 | paid in full |
| Routine maternity (after 12 months) | not covered | €5,500 | €11,000 |
| Newborn care, first 90 days (one parent covered for 12 months) | €18,500 | €55,500 | €122,000 |
| Emergency room without admission | €370 | €740 | €1,600 |
| Cancer care | paid in full | paid in full | paid in full |
Source: Cigna Global Health Options, Customer Guide (February 2025), benefit tables International Medical Insurance and Parent and Baby Care. Amounts in US dollar and sterling plans differ.
The area of cover is worldwide in all three tiers, either including or excluding the USA. If you exclude the USA, you are covered there only in an emergency through the out of area emergency hospitalisation benefit, for inpatient and day-patient treatment, up to 21 treatment days per trip and 60 days a year, and only if you were free of treatment, symptoms and advice for that condition before you travelled (Customer Guide, Out of Area Emergency Hospitalisation Cover).
For couples planning a family, the maternity row is decisive. Silver pays no childbirth, and Gold and Platinum pay only once the mother has been covered for at least 12 months. More on this in our guide to health insurance for pregnancy, childbirth and newborns.
The four modules and when you need them
Four optional modules can be added to the core cover. Which ones you need decides more about the value of the policy than the choice between Silver, Gold and Platinum.
International Outpatient: the module for seeing a doctor
Without this module, Cigna pays outpatient treatment only in a few cases, mainly for cancer, mental health, MRI, CT and PET scans and emergency room treatment without admission (up to €370 in Silver, €740 in Gold, €1,600 in Platinum). For everything else outside hospital, such as seeing a specialist, prescribed drugs, lab tests and X-rays or physiotherapy, you need to add the International Outpatient module, as the Customer Guide states for the core cover. If the main reason for your insurance is a quick specialist appointment in Lisbon or the Algarve, you need this module. The annual maximum is €12,000 in Silver, €25,900 in Gold and unlimited in Platinum, each with its own limits per benefit.
For beneficiaries aged 60 and over, the module includes 60+ Care: if you declared high blood pressure, type 2 diabetes, glaucoma, arthritis, joint or back pain or osteoporosis or osteopenia on your medical questionnaire and the condition is therefore excluded on your Certificate of Insurance, Cigna still pays for the ongoing outpatient treatment of it, up to €370 in Silver, €740 in Gold and €1,480 in Platinum a year, but not for complications or conditions arising from it, and the benefit does not apply if you included the condition for an additional premium (Customer Guide, 60+ Care).
Unlimited video and phone consultations with general practitioners (Global Telehealth) are already part of the core cover, with no deductible or cost share.
International Evacuation and Crisis Assistance Plus
The core cover pays for an ambulance within one country. Transport across a border, for example to the nearest suitable hospital in another country, or repatriation is paid only with this module (Customer Guide, Local ambulance section). For expats who travel a lot or would want serious treatment back home, it matters.
International Health and Wellbeing
This module pays for preventive care for adults aged 18 and over: an annual health check, cancer screenings, dietetic consultations and footcare, plus a mental health support programme with up to 20 counselling sessions per condition and year. In Gold the limit for the routine physical examination is €500 a year.
International Vision and Dental
This module pays for glasses, contact lenses and dental treatment with refund percentages and waiting periods: preventive and routine treatment after 3 months, major restorative work such as crowns at only 50 per cent in the first 12 months and at the full rate after that (80 per cent in Gold), orthodontics after 18 months and only up to the age of 18, at 50 per cent in Gold. The annual dental limit in Gold is €1,850 (Cigna Benefits Summary, February 2025; euro amount from the Customer Guide). What a dental plan from a Portuguese insurer offers instead is compared in our guide to dental insurance in Portugal; what braces cost is in our guide to braces in Portugal.
Cigna Close Care: cover in two countries
Close Care is the leaner option for expats who do not need worldwide cover. It applies only in your country of habitual residence and your country of nationality, so for a British national in Portugal, in Portugal and the UK. The annual overall maximum is €400,000, with a limit of €200,000 per condition; in hospital you get a semi-private room. Maternity, congenital conditions and organ transplants are not covered. Unlike Cigna Global, cross-border transport is already included, up to €37,000 for medical evacuation and €74,000 for repatriation. When you travel outside the two countries, emergencies, including outpatient emergencies, are covered up to €29,600 a year, for no more than 21 treatment days per trip and 45 days a year. Outpatient treatment again needs a module (Outpatient and Wellness Care, up to €3,700 a year) (Cigna Close Care Insurance Product Information Document, February 2025).
Important: the 180-day limit for stays in your country of nationality applies to Close Care as well. The plan does not cover two equal homes, but Portugal as your residence and your home country for temporary stays. A practical look at who Close Care suits is in our article Cigna Close Care in Portugal; benefits and limits are on our page Cigna Close Care.
If you are a US national, note one more rule from the Close Care brochure: USA cover is only possible if the USA is your country of residence or nationality, and if you do not buy it, visits home are not covered.
Deductible, cost share and premium
Cigna builds your excess from two parts, set separately for the core cover and the outpatient module (Customer Guide, Deductible and Cost Share section):
- Deductible: a fixed annual amount, in the core cover €0, €275, €550, €1,100, €2,200, €5,500 or €7,400, in the outpatient module €0, €110, €370, €700 or €1,100.
- Cost share: 0, 10, 20 or 30 per cent of each further claim once the deductible has been reached.
- Out of pocket maximum: the cap on the cost share, €1,480 or €3,700 a year in the core cover and €2,200 in the outpatient module. The deductible does not count towards the cap.
An example with assumed figures: you chose a €370 deductible and 20 per cent cost share on the outpatient module. A €1,000 specialist bill then costs you €370 plus 20 per cent of the remaining €630, €496 in total; Cigna pays €504. The next €1,000 bill costs you only the 20 per cent, €200, until the €2,200 cap is reached.
Cigna calculates the premium individually from age, residence, tier, modules, area of cover and excess, and it changes every policy year. You can pay monthly, quarterly or annually by credit card, or annually by bank transfer. How premiums in Portugal rise with age and what a deductible saves is explained in our guide How much does private health insurance cost in Portugal?
Pre-existing conditions, waiting periods and approval
Pre-existing conditions: Cigna asks about your health when you apply and can exclude individual conditions on your Certificate of Insurance. Conditions you were aware of, or should reasonably have been aware of, are excluded unless Cigna has expressly agreed to cover them; in some cases this is possible for an additional premium (Policy Rules, clause 1.2 and exclusions). Also report changes to your health between application and start date, otherwise Cigna may treat it as misrepresentation (clause 1.5). How other insurers handle pre-existing conditions is covered in our guide to pre-existing conditions and waiting periods.
Waiting periods: there is no general waiting period in the core cover, but there are waiting periods for individual benefits: 12 months for routine maternity, complications from maternity and homebirth, 24 months for obesity treatment, 12 months for cancer preventative surgery; in the dental module 3, 12 and 18 months (Benefits Summary, February 2025).
Approval: every inpatient and day-patient treatment needs Cigna’s prior authorisation, as do outpatient MRI, CT and PET scans and outpatient cancer care; with the outpatient module, so do individual benefits such as physiotherapy from the eleventh session. Without it Cigna reduces what it pays by 20 per cent. Cigna also reduces payment by 20 per cent for treatment in the USA outside the Cigna network, except in an emergency, where there is no network provider within 50 km (30 miles) or where the treatment is not available elsewhere. In an emergency, get treated first and contact Cigna within 48 hours (Customer Guide, Prior Authorisation). You pay the deductible and cost share directly to the hospital, clinic or pharmacy.
Changing plan: you can change your tier, deductible or cost share only at renewal, not during the policy year (Policy Rules, clause 8.2). Moving up a tier can mean new medical underwriting, and for maternity the limits of your old tier still apply for the first 12 months after an upgrade. If you plan a family, choose the right tier from the start.
Term and cancellation: the policy runs for one year and renews automatically. The minimum period of cover is three months; you can cancel without reason within 14 days of the start date. After that you give 14 days’ notice in writing (clause 6.5). According to the Policy Rules, any decision by Cigna not to renew is not based on your claims history or any illness (clause 13).
Which Cigna plan suits whom
These rules of thumb do not replace a quote, but they help you ask for the right one:
| Your situation | Obvious choice | What to watch |
|---|---|---|
| Retired couple living in Portugal, visiting family in the UK | Close Care with the outpatient module, or Cigna Global Silver/Gold excluding the USA with International Outpatient | 180 days a year in the UK; clarify pre-existing conditions first |
| Couple planning a family | Gold or Platinum | Maternity only after 12 months; Silver and Close Care without maternity |
| Family with children who travel a lot | Gold with International Outpatient and Evacuation | Orthodontics in the dental module only up to age 18 and after 18 months |
| Self-employed or remote workers with stays outside Europe | Cigna Global worldwide, USA only if needed | Evacuation only with the module; excess as the lever for the premium |
| Mainly hospital and serious illness cover | Silver or Gold without the outpatient module, with a higher deductible | You then pay doctor visits and medication yourself |
Also check whether a Portuguese health insurance plan suits you better. It is often cheaper but essentially covers Portugal and has entry age limits. An overview of all providers is on our page Health Insurance in Portugal; Cigna’s plans in detail are on our page Cigna Health Insurance for Expats in Portugal.
Five mistakes when choosing a Cigna plan
Frequently asked questions
Can I get Cigna health insurance in Portugal?
Yes, if you live in Portugal and do not hold Portuguese nationality. Cigna Global and Cigna Close Care are only offered to expats, meaning people living outside their country of nationality. You must be at least 18 to buy a policy.
What is the difference between Cigna Silver, Gold and Platinum?
Mainly the annual overall maximum and the individual limits: Silver pays up to €800,000 a year, Gold up to €1.6 million, Platinum with no annual limit. Childbirth is covered only from Gold upwards, after 12 months. Mental health care is limited to €3,700 in Silver and €7,400 in Gold and paid in full in Platinum.
Does Cigna Global pay for doctor visits in Portugal?
Only with the International Outpatient module. The core cover pays outpatient treatment mainly for cancer care, mental health care, MRI, CT or PET scans and the emergency room up to a limit per tier. Video and phone consultations with general practitioners are included without the module.
Am I covered in my home country with Cigna?
Yes, if it is your country of nationality and lies within your area of cover, but only while you are there temporarily and for no more than 180 days in total per policy year. This applies to Cigna Global and to Close Care.
What is Cigna Close Care?
A plan that only covers your country of residence and your country of nationality (there for no more than 180 days a year), with emergency cover only when travelling elsewhere, and an annual overall maximum of €400,000 and €200,000 per condition. Maternity and organ transplants are not covered, cross-border evacuation and repatriation are included. Outpatient treatment requires a module.
Does Cigna have a maximum age?
The public documents only state a minimum age of 18, no maximum age. Whether Cigna accepts you, and on what terms, depends on medical underwriting when you apply. According to the Policy Rules, a decision not to renew is not based on your claims history or any illness.
How does the Cigna deductible work?
You choose a fixed annual deductible, between €0 and €7,400 in the core cover, and a cost share of 0 to 30 per cent of each further claim. The cost share is capped each year, at €1,480 or €3,700 in the core cover. The outpatient module has its own deductible and cost share.
Does Cigna cover pre-existing conditions?
Conditions you were aware of, or should reasonably have been aware of, before cover started are excluded unless Cigna has expressly agreed to cover them. In some cases they can be included for an additional premium. The outcome of underwriting is shown on your Certificate of Insurance.
Can I cancel a Cigna health insurance policy?
You can cancel without reason within 14 days of the start date. After that there is a minimum period of cover of three months, and you give 14 days’ notice in writing. The policy runs for one year at a time and renews automatically.
Our advice as an independent broker
Cigna suits expats in Portugal best when they need more than Portugal: travel, treatment back home for limited periods, high annual limits or a policy that can continue if they move to another country, possibly at a new premium. What matters is less the tier than the combination: whether you cover outpatient treatment through the module, whether you need the USA, how high your excess should be and whether Close Care with two countries is enough. If you mainly live in Portugal and want affordable cover, put a Portuguese health plan next to it.
As an independent broker, we compare Cigna’s plans with other international and Portuguese insurers, work through the excess options with you and support your application through medical underwriting. We speak English.
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Last updated: 2 November 2026. This article reflects the information available on that date and does not replace individual legal, tax or insurance advice. Your policy terms, your Certificate of Insurance and the insurer’s offer are what count. With Cigna, the insuring company, policy version and amounts can vary by country of residence and policy currency. Sources are the Cigna Global Health Options Customer Guide (February 2025), the Cigna Global Health Options Policy Rules in the Cigna Global Insurance Company version (February 2025), the Cigna Close Care Insurance Product Information Document (February 2025) and the Cigna Global and Close Care Benefits Summary (February 2025).
