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Anyone moving to Portugal soon asks how healthcare works here. The answer starts with the Serviço Nacional de Saúde (SNS), the national health service. It is open to everyone who lives in Portugal legally and is registered. You do not pay a separate contribution for it; access runs through the health centre where you live.
This guide explains how Portugal’s healthcare system is organised, how you register, what you pay yourself, how the path from family doctor to hospital works, where the SNS reaches its limits and when private health insurance makes sense. It is based on the information published by the Portuguese administration on gov.pt, publications of the health regulator ERS, the European Commission’s Your Europe portal and the UK government’s guidance on healthcare in Portugal.
- Access through residence: Anyone legally resident in Portugal receives an SNS user number (número de utente). For the SNS to cover the costs, your ID document, Portuguese tax number (NIF), address and a valid residence document must be on record.
- No contribution: You do not pay a separate contribution for the SNS.
- Hardly any charges: A user charge (taxa moderadora) is only payable in hospital emergency departments, and not if the SNS referred you there or you are admitted to hospital. For medicines from the pharmacy you pay a share.
- First point of contact: the health centre with your family doctor (médico de família). Specialist appointments in public hospitals require a referral.
- Waiting times: In the second half of 2024, 53.1 % of patients waited longer than the legal limit for their first specialist appointment in a public hospital (ERS).
- Pensioners: If you receive a UK State Pension and live in Portugal, you may be entitled to state healthcare paid for by the UK through the S1 form. The same form exists for pensioners insured in other EU countries.
How Portugal’s healthcare system is organised
Healthcare in Portugal rests on two pillars that exist side by side. The first is the national health service SNS, with its health centres (centros de saúde), which gov.pt also calls family health units (Unidades de Saúde Familiar, USF), and the public hospitals. The second consists of private hospitals, clinics and practices that you pay yourself or through private health insurance.
At the health centre you will find your family doctor and a team of nurses and other professionals. According to the Portuguese administration on gov.pt (guide “Migrantes: cuidados de saúde em Portugal”), this includes nutrition advice, psychology, oral health and social support. Specialists mostly work in hospitals. Hospitals and health centres of a region are generally grouped into local health units (Unidades Locais de Saúde, ULS).
Madeira and the Azores are an exception. There, regional health services with their own rules are responsible instead of the SNS; on Madeira this is SESARAM. What we write about the SNS in this guide applies to mainland Portugal.
Public and private healthcare side by side
In Portugal, as in the UK, private health insurance works alongside the public service rather than replacing it. The table shows what each side covers in everyday life.
| Topic | SNS (public) | Private healthcare |
|---|---|---|
| Who can use it | Legal residents registered with the SNS | Anyone who pays, directly or through insurance |
| What you pay | No contribution; a user charge only in the emergency department, with exceptions; for medicines the SNS reimburses 15 to 90 % of the price depending on the drug group, you pay the rest | The full price, or the premium and your share under a private policy |
| First point of contact | Health centre where you live, with a family doctor if one is available | A doctor or clinic of your choice |
| Specialists | In public hospitals, with a referral from your family doctor or a hospital | Direct appointment, usually at short notice |
| Waiting times | Legal maximum of 120 days for a first specialist appointment and 180 days for surgery at normal priority; for first specialist appointments often exceeded | Usually short |
| Dental care | Limited, among other things through dental vouchers (cheque-dentista) for certain groups | Paid privately or through a dental plan |
| Language | Mainly Portuguese | English often available in larger private groups |
The most important point for your planning: private health insurance in Portugal does not replace the SNS. The SNS remains your basic cover even if you are privately insured. Private insurance comes on top so that you can see specialists, have tests and planned operations in a private hospital without a long wait. How the SNS compares with the NHS is covered in our article Comparing the UK and Portuguese health systems.
Registering with the SNS: user number and health centre
Registration has two steps, which are often done together at one appointment: the user number and enrolment at the health centre.
The user number (número de utente). According to gov.pt, foreign nationals receive it the first time they go to a public health facility, such as a health centre or hospital. The number alone does not mean that the SNS will pay for your treatment. For that, four details must be linked to your number:
- an identity document
- your Portuguese tax number (Número de Identificação Fiscal, NIF)
- your full address in Portugal
- a valid residence document
Citizens of the EU, the EEA and Switzerland do not need a visa. They still have to prove their residence; ask the health centre beforehand which document it accepts. According to the UK government, UK nationals must register as residents before they can register for healthcare. Take your residence document with you to the health centre.
Enrolment at the health centre. According to gov.pt, foreign nationals with a residence permit can enrol at a health centre, preferably the one in their area of residence. If you do not yet have a user number, you will receive it at that point. If you live temporarily in another municipality (concelho), for example for work or study, you can enrol there temporarily for up to twelve months.
Allow time for registration. Take copies of all documents, ask on site whether a family doctor is available and ask for your user number in writing. Register even if you have private insurance: it does not replace access to the SNS.
Pensioners and workers from abroad: who is responsible
Whether the SNS treats you as a Portuguese resident or on behalf of another country depends on where your income comes from.
UK State Pension
According to the UK government, you may be entitled to state healthcare paid for by the UK if you are resident in Portugal and receive a UK State Pension. Once you have an S1 form, you register it with the Portuguese social security system.
Pension from an EU country
Pensioners who receive their pension only from another EU country and have no entitlement of their own in Portugal usually stay insured there and receive an S1 for treatment in Portugal.
Working in Portugal
If you are employed or self-employed in Portugal and live here, you use the SNS as a resident.
Frontier workers
If you work in another country and live in Portugal, you are entitled to treatment in both countries according to Your Europe and need an S1 for the country where you live. UK frontier workers check their eligibility with HMRC. If you work remotely from Portugal for an employer abroad, clarify beforehand which country is responsible.
Details for UK nationals are in the UK government’s guidance Healthcare in Portugal, including Madeira. The rule for workers who live in another country is on the European Commission’s portal Your Europe. For temporary stays, for example before you actually move, a European Health Insurance Card or a UK-issued GHIC is meant for visitors; it does not replace registration as a resident. What pensioners can add privately is explained in our guide Health insurance in Portugal over 60 and 70.
What you pay yourself in the SNS
Registered users no longer pay charges for doctor visits at the health centre or treatment in public hospitals. Older guides, including some government pages, still mention charges at the family doctor; the current rules are the ones below. The health regulator ERS summarises the legal position in its Alerta de Supervisão 6/2025 of December 2025: user charges (taxas moderadoras) are now only payable in hospital emergency departments. Even there they do not apply if the SNS referred you to the emergency department beforehand or if you are then admitted to hospital.
Costs still arise, just in other places:
- Without registration: According to the ERS, anyone who cannot show they are an SNS user must pay for the treatment unless, within ten days of being asked to pay, they prove that they hold or have applied for a user card.
- Accidents caused by others: After a road or work accident, the responsible third party or their insurer pays for the treatment. You only have to show that you are an SNS user and provide the details of the person responsible.
- Medicines: For medicines from the pharmacy, the SNS reimburses a fixed share of the price depending on the drug group (comparticipação): 90, 69, 37 or 15 % under Portaria 195-D/2015. You pay the rest at the pharmacy.
- Dentist: In the SNS, dental care is mainly provided through the oral health programme with dental vouchers (cheque-dentista), aimed at children and young people, pregnant women and other defined groups.
- Private doctor: If you go to a private clinic to save time, you pay the full price there or claim it from a private policy.
How to cover dental treatment privately is shown in our guide to dental insurance in Portugal.
From family doctor to emergency department: finding your way
The SNS works in a fixed order. If you know it, you get the right appointment faster.
- SNS 24 health line (808 24 24 24): available around the clock. It assesses how urgent your problem is and refers you to the health centre or the emergency department, or gives advice for home. On Madeira, the SRS24h line (800 24 24 20) applies instead.
- Health centre (USF): appointments with your family doctor, check-ups, vaccinations, prescriptions, certificates. Almost every treatment starts here.
- Specialist in hospital: According to gov.pt, appointments in the specialist departments of public hospitals require a referral (credencial) from your family doctor or a hospital.
- Emergency department (urgência): for real emergencies. In an emergency, call 112. For less urgent complaints, call SNS 24 first; several hospitals now direct patients who arrive without a referral to other services.
Portuguese is the main language in the SNS. In private hospitals of the larger groups and in areas with many international residents you will more often find doctors who speak English. Which public and private hospitals are available in your region is shown on our health insurance pages for Lisbon, Porto, the Algarve, Braga and Madeira.
Where the SNS reaches its limits
The biggest weakness of the SNS is the time until treatment. For planned care there are legal maximum waiting times (Tempos Máximos de Resposta Garantidos, Portaria 153/2017): at normal priority, 120 days until the first specialist appointment in hospital and 180 days until surgery.
How often these limits are exceeded is measured by the ERS every six months. According to its report on the second half of 2024, 53.1 % of patients waited longer than intended for their priority level for their first specialist appointment in a public hospital. For operations in public hospitals the share was 15.1 %. There are clear differences between regions.
Three further points are noticeable in everyday life:
- Family doctor not guaranteed: Not every health centre can immediately assign a family doctor to everyone enrolled. Ask when you enrol.
- Language: Appointments, results and forms in the SNS are in Portuguese.
- Little choice: Your family doctor and hospital are largely determined by where you live.
When private health insurance makes sense
Private health insurance in Portugal does not replace the SNS, it fills its gaps. It makes sense above all if you want specialists and tests without waiting, do not want to put off a planned operation for half a year, or prefer doctors who speak English.
Which type of plan fits depends on your aim:
Hospital plan
Covers stays and operations in private hospitals. Inexpensive and for many the sensible addition to the SNS, which provides basic outpatient care.
Plan with outpatient cover
Also covers specialist visits, tests and treatment in practices. More expensive, but the solution if you want to avoid waiting for specialist appointments.
International plan
Also covers treatment outside Portugal, for example if you spend a lot of time in the UK. The premium depends on age, area of cover and deductible.
Before you take out a policy, you complete a health questionnaire. According to the consumer organisation DECO PROteste, Portuguese insurers generally exclude known conditions, and waiting periods apply to many benefits. What that means for you is explained in our guides to pre-existing conditions and waiting periods, to the cost of private health insurance and to the best private health insurance in Portugal.
Five mistakes after moving
Frequently asked questions
How does the healthcare system in Portugal work?
Basic care is provided by the national health service SNS with health centres and public hospitals. Anyone who lives in Portugal legally and is registered uses it without paying a contribution. Alongside it there are private hospitals and clinics, which you pay yourself or through private health insurance.
Is healthcare free in Portugal?
For registered users, almost. User charges no longer apply at health centres or for hospital appointments; a charge is only payable in the emergency department, and not if the SNS referred you or you are admitted. For medicines you pay a share; private doctors charge the full price unless an insurer pays.
How do I get an SNS user number?
Foreign nationals receive the number the first time they go to a public health facility, usually when enrolling at the health centre. For the SNS to cover costs, your ID document, Portuguese tax number (NIF), full address and a valid residence document must be on record.
Can I use the SNS as a UK pensioner?
According to the UK government, you may be entitled to state healthcare paid for by the UK if you are resident in Portugal and receive a UK State Pension. You register the S1 form with the Portuguese social security system. Everyone registered as a resident can use the SNS on the same basis as a Portuguese citizen.
How long are waiting times in the SNS?
At normal priority, the law allows up to 120 days until the first specialist appointment in hospital and 180 days until surgery, with shorter limits for urgent cases. In the second half of 2024, 53.1 % of patients in public hospitals waited longer than the limit for their priority level for a first specialist appointment, according to the ERS.
Do I need private health insurance in Portugal?
As a resident with access to the SNS, it is not compulsory. It makes sense if you want specialists, tests and planned operations without long waits, or prefer English-speaking doctors. For residence visas from outside the EU, Portugal requires proof of insurance covering medical costs.
Does the SNS apply in Madeira and the Azores?
No. Madeira and the Azores have their own regional health services with their own rules and phone numbers, on Madeira SESARAM. Ask at the health centre where you live how to register.
Our advice as an independent broker
After moving, register with the SNS first, whether or not you later take out private insurance. Before you move, check whether you are entitled to an S1. Then decide calmly which gaps in the public system you want to cover privately: hospital only, specialists as well, or treatment outside Portugal.
As an independent broker, we compare plans from several insurers, check which hospitals in your region are in the network and explain the terms in English. You will find an overview on our page Health insurance in Portugal.
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As of 30 October 2026. This article reflects the information available on the date stated and does not replace legal or insurance advice in individual cases. Sources: information from the Portuguese administration on gov.pt (“Obter o número nacional de utente do SNS”, “Inscrever-se no centro de saúde”, “Migrantes: cuidados de saúde em Portugal”), Alerta de Supervisão 6/2025 and the report on waiting times in the SNS in the second half of 2024 by the Entidade Reguladora da Saúde, its study on oral health in the SNS, Portaria 195-D/2015 on the reimbursement of medicines, the DECO PROteste analysis of 21 November 2024, the UK government’s guidance “Healthcare in Portugal, including Madeira” and the European Commission’s Your Europe information on health insurance in the country of residence.
