The WHO’s 2019 World Health Report ranked the Portuguese healthcare system number 12 of the 190 UN-member countries due in part to its successes in high vaccination rates and high life expectancy, among other factors. It may help you to know that life expectancy in Portugal is around 81 years, which is one of the top three highest in Europe.
The IPBN is hosting an online event looking at Healthcare in the Algarve through the eyes of medical professionals and ex-pats who have been through the system. In light of the upcoming event on May 11, we have done some digging to give anyone interested in relocating to Portugal the basics to get them started.
Portugal has an extensive, tax-funded public healthcare system known locally as the Serviço Nacional de Saúde (SNS). The good news is that most essential medical services are totally free under the SNS: think pregnancy from start to finish, medical checkups, vaccinations, etc. Non-essential services and treatments are available for a small co-payment. Whether or not an ex-pat qualifies to use this system will depend on their residency status and their nationality.
Internations.org mentions that even though the Portuguese public healthcare system is mostly free, you may still be asked to pay for doctor’s visits and emergency room visits, but generally the cost is less than 10€. You would also be asked to pay for a percentage of diagnostics exams unless they have been prescribed by your family doctor.
According to this article, EU citizens with a valid passport and European Health Insurance Card (EHIC) or equivalent will be able to use the Portuguese public healthcare system free of charge for up to 90 days but will need to be registered as residents to continue doing so. Citizens of some European Economic Area (EEA) countries will also be able to take advantage of this reciprocal healthcare agreement.
Non-European Union nationals (now including the British) will be unable to use the public healthcare system until they have been registered as residents. That process is detailed here in this handy e-book. Keep in mind you’ll need to provide proof of adequate health insurance during your residency process. There are plenty of companies out there that can give you month-to-month options at minimal cost to this end if you don't already have a plan.
First thing is first: If you plan to live in Portugal, you will have to go through the residency process to be granted a Social Security Number in order to have full access to the SNS. That means paying taxes and making social security contributions. The residency process is not for the faint of heart, but it can be done, especially if you enlist the help of a lawyer.
One thing to consider on the healthcare front is that you will need to provide a letter from a doctor that states that you are in good health and free from any communicable disease as one of the mandatory pieces of paperwork to get started on your residency process. Private hospitals like the CUF can supply you with the tests necessary to get this signed document, but you should be ready to pay upwards of 300€ for these services, as you are outside the system. If your letter comes from a doctor in your home country, you will need to have it translated and notarized here in Portugal, and you might still be told that the letter needs to come from a Portuguese doctor. It just depends on the day.
To enjoy your right to state medical services, you must first be registered with your local council (junta de freguesia). Here you must provide proof of address and sometimes, a neighborhood representative (it could be anyone who lives by you) to sign your declaration, providing you with a copy of their citizen card on which their address within the neighborhood can be seen clearly. Once you have been registered with the junta de freguesia, you can go to your local healthcare center, (centro de saúde) and submit the paper along with your residency card (título de residência), and your work visa, if applicable.
After registering with the health center, you will be given your healthcare number, Número de Utente. It will be printed on a sheet of paper which you will need to show whenever accessing public healthcare services, so keep it in a safe place! Do not expect to choose your own public physician—these are always assigned to you as they will be your first point of contact within the public health system. The good news here is that most medical professionals speak at least a basic level of English.
If you prefer, there are also many excellent private health care institutions that offer a high level of care if you want to avoid the often long waiting times for elective procedures and appointments within the public system.
Hospitals have been catering to ex-pats by implementing personalized patient care and monitoring services in English. There is also an Integrated Medical Emergency System, which guarantees the fast and accurate provision of healthcare to accident victims or anyone suffering a sudden illness.
Private insurers can offer a range of insurance plans, from the most basic coverage to all-encompassing. In general, you should opt for an insurance plan that best fits your medical needs.
Hospitalization and surgery are the basic features of private health insurance coverage in Portugal. You can add some extras depending on your specific medical needs including doctor’s and specialist’s appointments, exams, and even physical therapy. Childbirth and dentistry are also covered by many of these plans along with ophthalmology, prosthetics, and other special medical needs and treatments. You can add several people to the same insurance plan, meaning your entire family could be covered by the same insurer.
If you’re just looking to pick up some over-the-counter items for your medicine cabinet, pharmacies are available all over Portugal to help you, identifiable by their green cross outside the entrance. According to this article, on Live and Invest Overseas.com there is not one set prescription charge in Portugal, but subsidized prescription medicines are available from 15% to 90%, depending on their use.
Due to qualified pharmacists managing most of the pharmacies in Portugal, you can get many medicines without a prescription, and many pharmacists speak enough English to help guide you through “white label” brands of medication that can cost you less than you are likely used to paying back home. Keep in mind that some products that are over-the-counter back home might not be so in Portugal and vice-versa.
Lastly, the thing you will need most is support — support from lawyers, accountants, banking staff, colleagues, and certainly, friends who have either been through it themselves or who can simply talk you through the times when the paperwork gets to you. We at the IPBN have the members and contacts that you can trust to help you go through this process. That's precisely what we are here for. That said, do not miss our special webinar Healthcare in the Algarve next Tuesday, May 11 with medical experts who will be able to answer all your questions to get you started.