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Health Insurance in Portugal C1 Broker

Health Insurance In Portugal

We are the right partner to take out  your health insurance in Portugal. Know the differences between Health Plans and Health Insurance with free choice of doctors, the limits and national and international coverage. We also have health insurance without co-payment for residence / Visa in Portugal. We work with the best insurance companies: Allianz Health, Cigna, Fidelidade – Multicare, DKV, Medis, Liberty, Zurich, etc.

C1 Broker, insurance broker in Portugal, offers a variety of health insurance and policies with different coverage. We work with serious and reliable insurance companies, to offer our clients quality products and suitable cover for each situation. We study hundreds of health insurance products and health plans every year, to always know which is the right solution for each client. Let us advise you.

If you are a foreign resident in Portugal and do not rely on the public health system through Social Security, we also have full health insurance products so that your health is well covered, both in Portugal and in anywhere in the world.

In our range of health products, we also include health insurance without co-payment for those who need insurance to apply for residence or Visa in Portugal.

If your profession or company requires you to travel abroad frequently, we have health insurance that offers unlimited coverage wherever you are.

C1 Broker: we are specialists in health insurance and will be happy to counsel you on the most suitable health insurance products in Portugal for you and your family.

Which is the right choice: Health insurance or health plan?

If you are thinking about taking a health insurance in Portugal, you will be confronted with these two options. Because the differences are not always clear, we would like first to explain the basic differences between health insurance and health plans.

The first thing to bear in mind is that a health plan is not an insurance, neither health nor any other kind of insurance. Therefore, health plans are not subject to the supervision of the Portuguese Insurance and Pensions Supervisory Authority (ASF) on insurance matters. The companies that offer this type of “health plan” can operate freely without having to obey the ASF rules, which leaves the way clear for certain irregularities… On the contrary, the insurance companies that sell health insurance must comply with the strict control of the ASF and the respective Portuguese and European rules and laws.

Unfortunately, the situation is a little confusing for consumers, as it is common to see and hear in the media in Portugal, advertisements and (misleading) publicity about these health plans. It’s easy to confuse the products and think that we’re being offered health insurance, but it’s a health plan.

Also, on the Internet and specifically on social media, there are several advertisements promoting “health plans” that are sold as health insurance, confusing the most incautious consumer, who ends up buying “a pig in a poke”. We will now explain the difference between a health plan and a health insurance in Portugal:

What is a Health Plan?

A health plan is not a health insurance, in fact, it is a discount scheme. By joining a health plan, the customer has access to medical care (consultations, treatments, examinations) at a lower price than under normal circumstances.

The amount of the discount varies, and he can only use doctors and clinics from the agreed network and that belong to the provider’s centres.

In other words, the consumer is not free to choose the doctors he or she wants and is often limited to only one specialist in a given region. There is no reimbursement for services outside the provider’s own centres.

The system for paying for a health plan is through a reduced monthly fee, which allows the client to benefit from these discounts.

The company providing these health plans can terminate the contract with the client at any time, since it is not insurance and therefore not subject to Portuguese insurance legislation.

What is health insurance?

Health insurance allows you to benefit from medical services such as consultations, exams, operations or hospitalisation as a private patient in private clinics and medical centres.

These services are reimbursed in two ways: through a free choice of doctor and a system of reimbursement to the client or through direct billing by chip card in the centres and clinics with which the insurance company has a contract.

Depending on the type of health insurance you have contracted, the co-payment system may or may not apply (reduced amounts that you have to pay each time you use the card)

In the free choice of doctor system, maximum limits may apply in the inpatient or outpatient area, these can vary between 150,000 euros and 2,000,000 euros.

So, which is the right choice? Health Plan or Health Insurance?

Let’s look at the advantages and disadvantages of these two systems

Advantages of Health Plans in Portugal:

  • They are suitable as a Supplement – never as the sole option for looking after your health especially if you are a foreign resident without Social Security benefits.
    • If you are entitled to medical care through Social Security (public system), another system (ADSE, etc.) or a medical insurance, a health plan may make sense.
    • However, health plans are completely inadequate as a single system as they are not subject to any legislation, have many exclusions, can be cancelled by the insurer and is a pure discount system.
  • They are inexpensive – Evidently, the premiums are much less than those of a health insurance. You can contract a health plan from 17 euros per month, but you cannot expect the covers or benefits of a full health insurance.
  • They can be taken out at any age – There is no age limit for hiring and this is an obvious advantage if you compare it to health insurance.
    • They can be a good option for people who can no longer afford health insurance due to their age or who cannot afford the higher premiums.
  • No waiting periods and no exclusions: Health plans have no waiting periods (you can start using the discount systems immediately) and no exclusions for pre-existing illnesses or medical conditions.

Disadvantages of Health Plans in Portugal

  • They offer limited services – There is no greater inconvenience than needing a specialist and he/she does not exist in the medical chart of the health plan. The plans offer a limited range of medical centres, and no reimbursements are available if the medical services, examinations, or treatments take place outside the agreed network.
  • No free choice of doctor – As the reimbursement system is not available, the patient will not be able to choose the clinic, specialist or centre suitable for his/her examination or treatment but will have to abide by the framework of specialists and centres offered by the health plan in Portugal.
  • Product not regulated by the ASF – This opens the way to various irregularities that appear when the patient needs to use the health plan and does not have the supervision of the ASF nor the backing of the legislation. For example, imagine you are diagnosed with a serious and chronic illness, now that you are going to start using the health plan frequently, that company decides to notify you that they want to cancel the contract.

Advantages of Health insurance:

  • Free choice of doctors and clinics – With the reimbursement system, the patient has a variety of choice in terms of medical centres and clinics, specialists, both in Portugal and abroad.
  • Medicines included – Some Health Insurances offer reimbursement of medicines and also prosthesis, glasses, etc.
  • They are regulated products – Insurance companies must comply with the legislation and rules of the regulatory authority (ASF) and cannot, for example, cancel the contract to patients whenever they wish, here the consumer has rights that are vehemently fulfilled.

Disadvantages of Health Insurance:

  • Exclusions – Health insurance in Portugal has certain exclusions, for example occupational diseases and accidents at work. These are covered by the compulsory occupational accident insurance.
  • Exclusion of Pre-existing Diseases – Pre-existing diseases and the patient’s medical history must be declared at the time of contracting and may result in exclusions from the contract or rejection of the policy.
  • Waiting periods – You will have to wait a certain period before you can use certain insurance benefits. For example, to have heart surgery you will have to wait
  • Has Age limits for admission – Normally you cannot take up health insurance from the age of 65, which is a big problem for elderly patients who want to take up this product.
  • Unaffordable prices – As the age of the patient advances, the value of health insurance premiums will also increase, which can be tricky for people on tight budgets.

C1 Broker ®, Insurance Broker, we work with a selection of the best Insurance Companies in Portugal and Spain: