Many clients and prospects ask us about the Portuguese Healthcare system and benefits, in case they were to move to Portugal for longer periods of time rather than only the 14 days every 2 years required for the Portuguese Golden Visa. Some of the main questions that many potential Portuguese Golden Visa and D7 visa investors have asked are:
1. What are the health care benefits provided by the state for a Temporary Residents of Portugal under a D7 or Golden Visa Program? Are they any different if you have a Permanent Residency in Portugal or become a citizen?
2. Is there any monthly contribution to be made to be eligible for the same healthcare benefits?
3. Under what conditions would one need to avail of private health care services? Are there any services that are not covered under state healthcare?
4. Is it advisable to also get Health / Medical insurance? What are the advantages? And what are the approximate costs?
If you are considering moving to Portugal or spending extended periods of time in the country, it is indeed important to know a bit more about healthcare for foreigners in Portugal.
Below you can find the answers for the questions previously stated, as well as some information on how to have access to the Portuguese National Health Service (SNS).
Portuguese Healthcare Overview
The Portuguese state healthcare system has improved over the last years, ranking fairly high in international indexing websites. According to CEOWorld Magazine's Health Care Index, Portugal has been considered as having the 22nd best healthcare system in the world, enjoying consistent levels of trust among expat communities in the country.
The healthcare system in Portugal consists of three main coexisting systems:
The National Health Service (Serviço Nacional de Saúde, also known as SNS)
Social health insurance subsystems that are job-based schemes available only for people working for the State and in certain professions such as police, the military and banks
Private health / medical insurance systems
The SNS covers all of mainland Portugal; the regions of Azores and Madeira have their own independent healthcare systems, but as long as you have a Portuguese Social Security Number (more about that later), you will be able to have access to their public health services also.
Who Can Access the Portuguese Healthcare System
All Portuguese citizens have an automatically generated SNS number directly added to their ID card, along with the Portuguese Tax number (NIF), thus having automatic access to Serviço Nacional de Saúde in Portugal. Also, everyone who is a legitimate resident of Portugal is eligible to gain access to the country's public healthcare system. Therefore, Portuguese Golden Visa residents and D7 visa residents may also benefit from public healthcare services, regardless of their age or pre-existing medical conditions.
Non-residents and transient visitors, on the other hand, should purchase private health insurance to cover their time in Portugal. Only citizens of Andorra, Brazil, Cape Verde, and Morocco may get public healthcare, as their countries have established reciprocal healthcare agreements with Portugal.
This means that applicants of the Portugal Golden Visa Program who travel to the country before obtaining their Portuguese golden residence permit, will need extra travel insurance that covers medical expenses outside their country of origin. These documents should state that this insurance is valid in Portugal.
Visitors from the EU, EEA, or Switzerland can also access public healthcare during short stays in Portugal, as long as they carry their European Health Insurance Card (EHIC) with them.
Portugal Healthcare for Golden Visa Residents
If you are a Golden Visa holder with a legal residence in Portugal, you may be covered by the public healthcare system. However, you don’t automatically get healthcare. You will have to register to the Serviço Nacional de Saúde in order to benefit from its services.
Until you get your Portuguese residence by investment or D7 visa, it would be advisable to get private health insurance in order to have access to private healthcare while in Portugal.
This doesn’t necessarily mean that you cannot have both, should you be eligible to do so, quite the opposite. In fact, around 20% of the population also opt for private health insurance to cover extra services that the Portuguese public healthcare system does not include, or to cover 100% of costs. Getting private health insurance also allows access to treatment from private doctors and healthcare providers in Portugal, which can be much quicker and usually have more modern facilities than most public healthcare hospitals and clinics.
How to Access the Portuguese Healthcare System
To register for public healthcare in Portugal as a legal resident, you will have to go to the health center that is closest to your residence area and register there. In order to do so, you need to take the following documents:
Portuguese Tax Number (NIF)
Passport or national ID card (not essential, but recommended)
Work permit (if applicable)
Portuguese residence permit
After registering, you will receive a healthcare card at your local address. You will need this card whenever you access healthcare services in Portugal. You will also have a doctor from that same health center assigned to you. Except for emergencies - in which case you are entitled to go directly to a state hospital - this doctor (called Médico de Família - Family Doctor) will be the person in charge of your medical history and evolution while you are in Portugal and will also be the person to give the necessary referrals for you to get treatment from the public hospital whenever needed.
If you have a medical emergency, you will be treated, even if you are not a resident and regardless of any insurance you might have or not. However, later on, you should present proof of residency, your SNS number, or private health insurance, in order to prevent higher medical costs after being discharged from the hospital.
How to Find Doctors and Arrange Appointments
As previously mentioned, your local state medical center in Portugal will assign you a "Family Doctor." However, it is important to keep in mind that these doctors may not always be available because they have a lot of patients to attend to. If you walk into your health center without an appointment and your allocated doctor is unavailable, you will be put on a waiting list and given the opportunity to see any other doctors who are available at that moment.
You can use the SNS website in order to schedule appointments, keep track of your previous appointments and have access to information related to the state health system and its providers. However, not all health centers may allow you to schedule appointments online. If that is the case, you can either call the health center or visit it in person.
When you need a specialist doctor in Portugal, you should first consult your family doctor so that he can refer you to a local specialist. However, it can take months to see said doctor. On the other hand, if you have private health insurance, you can browse for a specialist online and schedule an appointment with a private hospital or clinic. This is something you can also do without having private health insurance - the main difference will be the final costs of appointments and treatments, as private health insurance systems allow their clients to have access to private healthcare providers at a lower cost.
Typically, dental care is not free in Portugal, and this is one of the main reasons why people choose to pay extra to have private health insurance.
Besides, public hospitals generally have long waiting lists, even more in terms of specialty doctors. In fact, depending on the area of expertise, it may take you more than one year to have the first consultation with a specialist. Ophthalmology, for instance, not rarely exceeds the maximum limit of waiting time determined by the law. You can check the details of the waiting times according to the specialty on the SNS website.
Private Healthcare for Portugal Golden Visa Citizens
Private healthcare is naturally more costly than state healthcare in Portugal. There are different companies that provide private health insurance plans in Portugal, so it is recommended that you consult with a few before choosing the one that best suits your needs. Before making a final choice, you should take the following into consideration:
Private health insurance has fixed monthly costs that can go from 20€ to 100€, plus medical appointments, procedures or treatments
Dental coverage is usually considered extra/premium coverage and it is added to the standard monthly costs
Most companies include ambulatory services (appointments with doctors/specialists, blood tests and other types of medical exams), physical therapy, childbirth, ophthalmology, prosthetics, hospitalization and surgery, up to a certain amount
Some companies provide a limited number of services per month. If you exceed the number, you may need to pay the regular hospital or clinic fees
You may have to wait between 60 days and one year (for childbirth, of instance) until the insurance plan is activated, according to each medical specialty
Your pre-existing medical condition is taken into consideration and, in some cases, it is not covered, or has limited coverage. It is very important to confirm with each company what type of solutions they provide for each case / illness
It is possible to add other family members to the insurance plan for a more affordable total monthly expenses
In some cases you may have to pay for private services upfront and claim a reimbursement from your insurer. Check their policy for exact details and procedures
Final Thoughts
If you hold a Portuguese golden residence permit or a D7 visa, you are eligible to have access to its State Healthcare system, provided you are registered in the health center of your permanent residence in Portugal.
Private healthcare in Portugal exists alongside the public SNS, and some doctors even work in both sectors. The main differences lies in the facilities, type of treatments and shorter waiting times to have access to doctors, medical examinations and treatments.
The costs for private hospitals and clinics, specialists, exams and treatments can be covered by taking out complementary private health insurance in Portugal. Even though an average doctor’s appointment at a private medical facility may cost around €20-50 for private health insurance holders, private healthcare is not as expensive as in some countries and it’s growing in popularity among both the Portuguese and resident population, being regarded as a good option to gain access to a network of providers complementary to the State Healthcare system.
Disclaimer
The contents of this post do not constitute, and are not meant to be a substitute for legal, medical or financial advice. We do not take any responsibility for the accuracy, currency or sufficiency of the above information. Please do consult your legal, financial and tax professionals before making any decision regarding your Golden Visa, Healthcare or Financial Planning.