The Portuguese Public and Private Health Systems: Everything You Need to Know

Many foreigners wonder about the Portuguese health system, and one of the biggest concerns is whether there is public health care. In this guide, you will be able to clarify this and other questions. We will also discuss several ways to make the best use of all the services offered by the Portuguese health system.

Is there a Public Health System in Portugal? 

Portugal has become an increasingly popular country to live in due to its quality of life and career progression. According to the Immigration and Border Service (SEF), there has been a large increase in the number of foreigners residing in Portugal in recent years, especially in the Brazilian community.

Portugal has a public health system; it’s called National Health Service, in Portuguese Serviço Nacional de Saúde (SNS) and grants access to health care to the entire population, regardless of socioeconomic status. 

The SNS offers a wide range of health services, from medical appointments to diagnostic examinations, surgeries, rehabilitation treatments, and palliative care. Moreover, the SNS develops health promotion and disease prevention activities, such as vaccination campaigns, disease screening programs, etc.

How does SNS work? 

To use SNS, the first step is to choose a family doctor. The family doctor is a general practitioner who monitors the patient’s health condition and refers the patient to other medical specialties, if necessary. Immigrants who hold a valid residence or stay permit can register at the health center in the area of residence or at a Loja do Cidadão.

Once registered at the health center, the patient can schedule appointments and exams through the SNS service line (808 24 24 24), which is available 24/7, the SNS website or their family doctor. Some examinations and treatments may have longer waiting times, depending on the medical specialty and the type of service.

It’s important to mention that although the SNS is free of charge, some services may require the payment of a basic fee, which varies according to the type of service provided and the patient’s condition (for example, in some cases, children, people with chronic diseases and the elderly are exempt from the basic fee). Besides the SNS, there are also some private health insurances in Portugal that can be used as a complement to the SNS or as an alternative, depending on each person’s needs and preferences. 

Who is Entitled to Use the SNS service?

Any Portuguese citizen, people residing in Portugal, or people who are legally in the country are entitled to use the SNS services.

To enroll in the SNS and use its services, some documents must be presented, such as:

  • Passport or other valid ID;
  • Valid residence or stay permit;
  • Proof of residence in Portugal (e.g. rental contract, utility bills, etc.);
  • Taxpayer number (NIF) or social security number, if applicable.

If you don’t have a taxpayer number or social security number, you can register directly at the health center or hospital by presenting the above-mentioned documents.

With these documents in hand, all you need to do is go to a health center or hospital and enroll in the SNS; from that moment on, you will have access to the services available at the SNS.

How is the Portuguese National Health System Seen by Europe?

The Portuguese National Health Service (SNS) is often referred to as a positive example of a public health system. According to the Euro Health Consumer Index 2021, which compares the performance of health systems in 30 European countries, Portugal ranks 13th with an overall score of 700 out of 1000, ahead of countries like Ireland (14th place), Spain (15th place), and the UK (17th place). The report highlights the ability of the SNS to provide universal and equitable access to health care, as well as its public health effectiveness and the provision of specialized medical services. In general, Portugal’s national health service is recognized for providing quality health care to its citizens, with a wide range of services available for free or at affordable rates.

European Health Insurance Card – What is It?

With the European Health Insurance Card (EHIC), citizens of European Union countries, as well as Iceland, Liechtenstein, Norway, and Switzerland, can access healthcare services in other European countries during travel or temporary stays. The EHIC is issued free of charge by the national health systems in each country and includes information about the holder, such as name, date of birth, and national identification number, as well as the country in which the holder is insured and the coverage period. With the EHIC, the holder is entitled to receive medical treatment under the same conditions as residents of the country visited, without having to pay for health services in advance. This is particularly important in cases of emergency or need for medical treatment during travel or temporary stays in other European countries.

However, it should be noted that the European Health Insurance Card does not cover all medical expenses, nor does it replace travel insurance. It is always advisable to take out additional health or travel insurance to guarantee full coverage if needed. The European Health Insurance Card is not a mandatory document, but it is highly recommended for those who intend to travel or move temporarily to another European Union country.

To obtain the European Health Insurance Card in Portugal, the applicant must contact the national health system (SNS), and it can be requested online through the SNS Portal or in person at any SNS office. Immigrants legally residing in Portugal are also entitled to apply for the EHIC as long as they present a valid ID and proof that they are covered by Portuguese public health insurance.

SNS Service Centers

The Portuguese National Health System (SNS) has a wide network of service centers throughout the country, including:

  • Health Centers: Health centers are the entry point to the health system and offer primary health care, such as medical consultations, examinations, and vaccinations.
  • Public Hospitals: The SNS has several public hospitals throughout the country, which offer specialized services and more complex treatments.
  • Family Health Units (USFs): USFs are health centers managed by family health teams, which provide comprehensive and personalized care to individuals and families.
  • Long-Term Care Units: These facilities provide long-term care for patients with chronic diseases or permanent disabilities.
  • Permanent Attendance Services (SAP): Urgent care services that provide immediate health care for patients with urgent and emergent conditions.
  • Clinical Analysis Laboratories: Laboratories that carry out laboratory tests, such as blood, urine, and stool analysis.
  • Pharmacies: Facilities where medicines prescribed by SNS doctors can be obtained.

In addition to these service centers, the SNS also offers other health services, such as emergency services, home support services, and public health programs. It should be noted that the health care services offered by the SNS are free of charge for all Portuguese citizens and legal residents in the country.

How Does the Private Health System Work?

In Portugal, the private health system operates in parallel with the public health system, offering health care services to individuals who choose private health coverage. Private health insurance can be purchased from insurance companies or health plans can be subscribed to by private health insurance providers. Private health plans may cover a wide range of medical services, including medical appointments, examinations, treatments, surgeries, and hospital stays, depending on the coverage contracted.

In the private system, patients usually have the freedom to choose the doctors, specialists, and hospitals where they wish to receive care. This gives more flexibility and control over health care compared to the public system, where the allocation of doctors and hospitals can be more restricted. The private health system is also known for its shorter waiting times compared to the public system. Usually, patients can obtain medical appointments, examinations, and treatments more quickly, which can be an advantage for those who prefer more immediate medical attention.

How do Private Health Services and Health Insurance Work?

Depending on whether the insurance company has an agreement with the specific health care facility, patients may be required to pay directly for the health care services received and then submit the receipts to the insurance company for reimbursement, according to the terms of their health insurance plan. As an alternative, they may enjoy a discount at the time. Hence the importance of checking which clinics or hospitals have an agreement with the insurance company and the coverage and limits of the private health insurance plan before making use of the services, to understand the costs. The private healthcare costs in Portugal may vary according to the healthcare plan contracted, the age of the insured, coverage offered, and other factors. It’s best to check the monthly costs of health insurance premiums, as well as additional costs such as co-payments, deductibles, and coverage limits.

The coverage of private health in Portugal may vary according to the contracted health care plan, with some plans offering more comprehensive coverage, whereas others may be more limited. It’s important to carefully read the terms and conditions of the plan before purchasing it to understand what services and treatments are covered. The private health system in Portugal is generally complementary to the public system, which means that patients still have access to the public health system even if they have private health insurance. This allows patients to use both systems, depending on their needs and preferences.

In short, the private health system in Portugal is an alternative option to the public health system, allowing you to obtain health care services in private hospitals and clinics with greater flexibility and shorter waiting times. It’s important to investigate and understand the details of the private health plan.

Are Immigrants Eligible for Health Insurance?

Yes, immigrants in Portugal can contract private health insurance, as long as they meet the requirements set by the insurance companies and private health operators. Generally, immigrants in Portugal can acquire private health insurance as long as they have a valid residence permit and comply with the immigration laws in force.

The requirements and conditions for taking out private health insurance by immigrants in Portugal may vary depending on the insurance company or private health insurance provider, as well as the coverage and costs involved. It’s worth researching and comparing the different private health insurance options available in the market, considering the services offered, the costs involved, exclusions, and coverage limits before making a decision.

Moreover, immigrants in Portugal should be aware of their rights and duties in the health system, both public and private, and understand the differences between the two systems. The SNS is a universal health system that offers free or low-priced services to legal residents in Portugal. However, the private health system may offer additional benefits. It is important to carefully consider your financial needs and possibilities when choosing private health insurance as an immigrant in Portugal.

Fortunately, companies in Portugal usually include health insurance in contracts with their employees, just as KWAN does. In this case, you don’t have to make any payments or worry about researching insurance, since this benefit is already included.

The Portuguese Public and Private Health Systems: Final Remarks

There are many reasons why it’s beneficial to use the health system in Portugal, including the fact that Portugal has a comprehensive network of hospitals, health centers, and clinics, both public and private, that offer health care services throughout the country, making medical care accessible and available. It features a screening system, where patients are classified according to the severity of their health condition, ensuring that the most urgent cases receive priority care. The medicines prescribed by the public health system in Portugal are usually subsidized by the government, which can make them more affordable and accessible to patients. It has a health system with highly trained and qualified doctors and health professionals, many of whom are fluent in English, which can be an advantage for expatriates and tourists.

In short, the health system in Portugal offers universal access, comprehensive coverage, qualified doctors and health care professionals, affordable medicines, and a comprehensive health care network with a focus on prevention and preventative health care.