Portugal’s healthcare system offers comprehensive coverage and high-quality services, combining public and private healthcare sectors. Whether you’re a resident, expat, or a visitor, understanding the structure, services, and access requirements of the Portuguese healthcare system is crucial to making informed decisions about your health needs.
The Structure of Portugal’s Healthcare System
Portugal has a dual healthcare system consisting of public and private sectors. The backbone of the system is the Serviço Nacional de Saúde (SNS), or National Health Service, which provides public healthcare to residents and certain visitors.
Public Healthcare: Serviço Nacional de Saúde (SNS)
The SNS is the government-funded healthcare system available to residents of Portugal, and it also extends to European Union (EU) citizens through the European Health Insurance Card (EHIC). Non-EU visitors may also access public healthcare services, but they are usually required to pay out-of-pocket or arrange for private health insurance.
To access the public healthcare system, residents must first register with the local centro de saúde (health center) by obtaining a Numero de Utente, which is a personal health number used for all medical services in Portugal.
The public system covers a wide range of services, including:
- Primary care (general practitioners)
- Hospital care (including surgeries)
- Mental health services
- Maternity and pediatric care
- Emergency care
Though the public healthcare system is comprehensive, there may be waiting times for certain services, particularly elective treatments. As a result, many residents and expats opt for the private healthcare sector, where access to services is faster.
Private Healthcare
Private healthcare in Portugal is available alongside the public system and offers shorter waiting times and additional services. Many private clinics and hospitals operate at a lower cost compared to those in other European countries, and private doctors often work in both sectors.
The cost of private healthcare varies depending on the service, but a typical consultation with a private doctor can cost between €80 and €120. Expats and residents who prefer private healthcare typically purchase private health insurance, either through a national or international health insurance provider.
Access Requirements for Healthcare in Portugal
For Expats: Registering with the SNS
Expats who become legal residents in Portugal are eligible to register with the SNS and access public healthcare. The registration process involves the following steps:
- Register with the Junta de Freguesia: This is the local council where you reside. You will need to provide proof of address and your residence card.
- Register at your local health center (centro de saúde): Bring your proof of address and residence card to register and obtain your Numero de Utente, which is required to access public healthcare.
- Use your health number: Once registered, you can use your Numero de Utente to book appointments, access hospital care, and receive prescriptions
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For EU Citizens: Access via the European Health Insurance Card (EHIC)
EU citizens are eligible to use their European Health Insurance Card (EHIC) in Portugal. This allows them to access public healthcare for free or at reduced rates during short stays (up to 90 days). After this period, they must either register with the SNS (if they become residents) or opt for private health insurance.
For Non-EU Citizens: Health Insurance Requirements
Non-EU citizens are not eligible to use the EHIC and must either:
- Obtain private health insurance to cover medical expenses while in Portugal.
- Register with the SNS once they become residents, provided they meet the residency and legal requirements.
Services Offered by the Healthcare System
Primary and Specialized Care
Portugal’s healthcare system offers primary care through general practitioners (GPs) at local health centers. Primary care is often the first point of contact for patients, who may be referred to specialists for further treatment. Specialists in areas such as cardiology, dermatology, and orthopedics are widely available both in the public and private sectors. However, there may be longer waiting times in the public system for specialized consultations.
Emergency Care
Emergency medical services in Portugal are efficient and accessible. In urgent cases, patients can call the 112 emergency number, which provides access to ambulances, paramedics, and emergency rooms at hospitals. Emergency care is available to both residents and visitors, with costs covered for those eligible under the SNS or EHIC.
Maternity and Childbirth Services
Maternity care is well-established in Portugal. For those registered with the SNS, childbirth in a public hospital is free, and women receive comprehensive prenatal and postnatal care. Portugal’s approach to maternity care emphasizes natural childbirth, with cesarean sections only performed if medically necessary
For those who prefer private maternity care, the cost of giving birth in private hospitals can range between €2,900 and €6,000, depending on the type of services and room chosen.
Mental Health Services
Mental health services are accessible through the SNS, and there are several programs available for both adults and children. Therapy and counseling services are available at health centers and hospitals, though private clinics may offer faster access and a wider range of specialized treatments.
Subsystems of the SNS: ADSE and Other Specialized Plans
In addition to the general services provided by the Serviço Nacional de Saúde (SNS), Portugal has several subsystems that cater to specific groups of people, offering additional benefits or tailored healthcare services. These subsystems are designed to provide more comprehensive coverage for certain populations, such as public servants or military personnel, who may receive enhanced access to healthcare or supplementary benefits not available through the standard SNS.
ADSE (Assistência na Doença aos Servidores do Estado)
One of the key subsystems within the Portuguese healthcare system is ADSE, which primarily serves public sector employees, including civil servants, teachers, and members of the armed forces. ADSE provides supplementary health insurance that covers a range of medical services not fully included in the standard SNS plan. This includes reimbursements for a variety of healthcare services, such as specialist consultations, hospitalizations, surgeries, and pharmaceuticals.
For eligible individuals, ADSE helps reduce out-of-pocket costs associated with both private and public healthcare providers. This system operates alongside the SNS, offering expanded options for faster access to certain services. ADSE enrollees typically pay a monthly premium, which varies depending on their income and specific employment status.
Other Specialized Systems
Portugal also has other specialized healthcare schemes aimed at certain professions or demographics. For instance, the SAMS system (Serviço de Assistência Médico-Social) is available to employees of some specific companies, such as public transport companies. SAMS offers a range of health services, including outpatient and hospital care, but its access is limited to those working within the organizations that provide it. Additionally, there are private healthcare funds for employees in various sectors, which operate similarly to ADSE but are tailored to private sector employees.
Coexistence with SNS
These subsystems often work in conjunction with the SNS, meaning that individuals who are covered by systems like ADSE can still access the public healthcare services provided by the SNS. However, these subsystems typically offer advantages such as reduced waiting times, enhanced coverage for private care, and additional services that complement the public system
By offering tailored benefits and access to faster services, these subsystems play a key role in ensuring that specific populations within Portugal have greater healthcare access and coverage options.
Private Health Insurance Options
Expats and residents may choose private health insurance to avoid long waiting times and to access additional services not covered by the public system. Private health insurance plans in Portugal range from basic packages that cover hospitalization and outpatient care to comprehensive plans that include dental care, vision services, and even alternative therapies.
Insurance premiums vary depending on the age, coverage level, and insurance provider. On average, a basic health insurance policy costs around €70 per month, but older individuals or those requiring more extensive coverage may face higher premiums
Conclusion
Portugal’s healthcare system is one of the most accessible in Europe, offering a wide range of services through both public and private options. Residents, EU citizens, and even some non-EU visitors can benefit from comprehensive healthcare coverage, though non-residents may need private health insurance to cover their medical costs.
For expats looking to navigate the system, it’s essential to understand the registration process with the SNS, the services available through both public and private providers, and the costs associated with different types of care. By familiarizing yourself with the structure of the Portuguese healthcare system, you can make well-informed decisions to ensure your health and well-being while living in Portugal.
