The quality of healthcare in Portugal is strong and continues to improve steadily. In 2018, the Euro Health Consumer Index ranked the Portuguese healthcare system as the 13th best in Europe.
That is better than the UK, Spain, Italy, and Ireland. Just three years earlier, in 2015, Portugal’s healthcare system ranked 20th. And in 2012, it was ranked 25th.
High-quality privacy standards, patient rights, accessibility, and short waiting times all contribute to Portugal’s high standing. And the country is seeing the benefits. Currently, Portuguese people enjoy an average life expectancy of 81 years.
That is thanks in part to Portugal’s exceptional doctors and renowned university education and research programs. They include the School of Health Services at the University of Minho, the Faculty of Medicine at the University of Coimbra, and the Faculty of Medical Sciences at the New University of Lisbon.
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How the Portuguese Health System Operates
The healthcare system in Portugal consists of three components. The first is the National Health Service (in Portuguese: Servico Nacional de Saude or SNS).
This is a form of subsidized state care for people who contribute to the social security system. The SNS was created in 1979.
It operates under the supervision of the Ministry of Health and is defined as being national, universal, and free. It covers all of mainland Portugal. The regions of Azores and Madeira have their own healthcare systems.
The second system is a special social health care initiative called the Health Subsystem Program. It is responsible for providing medical care to members of certain professions or organizations.
For instance, it includes police, military, and banking services. The most important public health subsystem is the ADSE, which covers over 1.3 million public servants.
The third is voluntary private health care. Several private health networks operate in Portugal, including Multicare, AdvanceCare, and Medis. Residents also have the option of purchasing private coverage from non-Portuguese insurance companies. This is a popular choice for expats.
Challenges in the System
Addressing mental healthcare remains a challenge in Portugal. An estimated 30% of the Portuguese population has experienced some form of mental health struggle.
The country has higher-than-average levels of depression and substance abuse. And there are only about 12 psychiatrists for every 100,000 inhabitants.
To access mental care in Portugal, you first have to visit your GP. They can prescribe medication, refer you for counseling, or refer you to a specialist.
If receiving comprehensive mental healthcare is a priority for you, it is essential to check with your private health insurance provider to ensure that it is covered.
Costs Associated with Portuguese Healthcare
The public SNS system in Portugal is funded through general taxation. It is also subsidized by contributions from workers paying into the social security system.
However, the system covers people who are not employed, as well as dependent family members and retirees.
SNS services include everything from GP services and maternity care to hospital treatments and community medical programs.
Portuguese residents are required to pay a small portion of their medical expenses. This includes a small contribution to the cost of doctor and specialist visits, hospital care, and prescriptions.
The amount is usually around 5 Euros or so. Portuguese residents also cover most of their own healthcare costs, including vision and dental care. However, there are exceptions for members of the population who are vulnerable or have low incomes.
For the uninsured, basic medical costs in Portugal are reasonable. The cost of consulting a general practitioner is usually less than 60 Euros.
Basic dental cleaning typically costs around 30 Euros. Visitors to Portugal are not covered under the country’s public healthcare system and thus should carry their own private travel medical insurance.
The Differences Between Private and Public Care
Approximately 20% of Portuguese residents carry private health care to supplement their public health care. Private healthcare covers additional services that the public system does not include, such as dental and vision care. It can also offset patients’ out-of-pocket costs.
Private health care also means that you can see specialists more quickly than in the public system. For expats, the private system also improves your chances of seeing an English-speaking practitioner.
In general, when using private health care, hospital and clinic visits are quicker, more comfortable, and more private.
However, there is a downside. When using private care, you typically pay upfront for services and then submit a claim for reimbursement from your provider.
This can be an expensive undertaking if you are not prepared. With the public system, services are either free or carry just a nominal fee.
As well, in Portugal, some doctors work in both the public and private healthcare systems. Furthermore, some hospitals operate on both a private and public basis.
When in doubt, make your treatment choice clear upon arrival to avoid confusion.
Who is Eligible for Coverage?
The public health system in Portugal is available to Portuguese citizens and permanent residents.
As well, European residents who hold a European Health Insurance Card are eligible for the same standards of public coverage as Portuguese residents. The EHIC is available at no charge, but you must apply for it before you leave home.
In addition, several non-EU countries have reciprocal agreements with Portugal, including Andorra, Brazil, Cape Verde, and Morocco. Citizens of these countries can access public healthcare in Portugal at no cost or at a reduced rate.
Healthcare Options for Foreigners in Portugal
Expats interested in obtaining coverage must first obtain a Portuguese número de contribuinte, equivalent to a social security number.
Once you have obtained it and a residence permit, you should visit the nearest health center. Your application will be processed, and you will receive a user’s card which contains your healthcare number. This allows you to access the public healthcare system.
Note that to get a residence visa or any other kind of visa, you have to demonstrate proof of private medical insurance. Non-EU students must also prove that they have a form of private insurance that fully covers them.
Here are some of the best private medical plans for expats and international citizens living in Portugal.
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Cigna Global Insurance Plan
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IMG Global Prima Medical Insurance
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What is a Portuguese “Social Hospital”?
One of the most unique things about Portugal’s healthcare system is the “social hospital”. These are hospitals that private institutions once operated, focusing on social solidarity.
These institutions were primarily the misericórdias, a name that translates to “holy houses of mercy”. Historically, the misericórdias were the leading providers of hospital care in Portugal, dating back to the late 1400s.
They retained prominence until the 1970s. That changed when the SNS was born. Today, the social hospitals have an agreement with the SNS.
They are publicly subsidized and offer services much in the same way as public hospitals. You may be able to see traces of the building’s religious past in the architecture, decor, and personnel.
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Joe Cronin, President of ICI, is a leading expert in international health, life, and travel insurance. An MBA and founder of multiple global businesses, he helps expatriates and travelers access trusted, comprehensive insurance solutions worldwide.
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