Portugal Healthcare System: A Guide for Expats in 2024

If you plan to spend some time in Portugal, a thorough knowledge of accessing healthcare services is essential, especially if you hold Portugal’s Golden Visa or the D7 Retirement Visa.

In this article, we dissect everything about Portugal’s healthcare system, including the medical care available from primary care doctors and family physicians, the benefits of private health insurance plans, and emergency care considerations.

You’ll be able to find out more about:

• Portugal’s private healthcare
• Mental health services in Portugal
• Healthcare for residents and visitors
• Golden Visa health insurance requirements

Portugal’s Public Healthcare System

Portugal has universal healthcare through the publically financed Serviço Nacional de Saúde (SNS). It provides free healthcare for children under 18 and people over 65. State healthcare provides subsidized medical costs at a low rate for everyone else. Depending on the health center, physicians should administer medication during a procedure or even provide urgent care free of charge.

Basic national health coverage is administered through local and regional health centers and hospitals, which are under the jurisdiction of five regional health administrations.

It is comprehensive throughout Portugal, and while the SNS does not cover dental services for anyone other than those in a ‘vulnerable group,’ such as children, pregnant patients, older adults, or disabled residents, it is cheaper than in many other countries. For example, consulting an English-speaking dentist for dental services costs approximately €50 to €75.

The regions of Madeira and the Azores have their own health systems in place.

Who is Entitled to Portuguese Public Healthcare?

You are entitled to Portuguese healthcare if you are a citizen or a legal resident. The Portuguese state healthcare system is very similar to those in other countries—for example, it is broadly similar to the National Health Service in the UK, which provides hospitals and local health centers and where some people have private medical insurance.

This gives citizens and legal residents access to any public health facility or hospital, but not all health centers offer public coverage. For example, medical emergency care is free, but all other services incur a fee, sometimes due immediately. This may apply to consultations, medical emergency room visits, and ambulance services.

Everyone can receive hospital care at a local health center, but you will be charged if the Portuguese national health services, reciprocal healthcare agreements, or private health insurance do not cover you. In some cases, private healthcare systems offer a more seamless process.

Portugal’s Private Healthcare

Private doctors and healthcare facilities are widely available through private health insurance. Improvements to the healthcare system were made by introducing public-private partnerships for new hospitals, changing hospital management structures, pharmaceutical reforms, reorganizing primary care, and creating long-term care networks.

In Portugal, private healthcare costs are relatively low compared to numerous other nations, and private insurance allows you to get an appointment more quickly than the public healthcare system. You can also be assured that virtually all doctors in the private healthcare system speak English.

The average cost for private health insurance in Portugal is about €400 annually. Opting for a more extensive plan would cost you approximately €1,000 annually. Depending on the services you receive, there are instances where you might need to pay for private treatment at a local health center initially and then seek reimbursement through your healthcare coverage.

How Good is the Portuguese Healthcare System?

According to our Global Intelligence Unit’s US Retirement Trend report, Portugal ranks 4th in healthcare. “For retirees, Portugal presents several insurance options through companies like Médis, Multicare, and AdvanceCare, offering plans that range from basic to comprehensive coverage. These plans are tailored to various needs, covering hospitalization, outpatient care, specialist consultations, and sometimes even international coverage,” the report explains.

This is further reinforced by Numbeo’s Health Care Index for Mid-Year 2024, placing Portugal in 21st globally. In the annual Euro Health Consumer Index, Portugal regularly ranks in the mid to upper tiers among European countries.

Progress in medical care over the past few decades has led to an increased life expectancy for Portuguese people. The average life expectancy in Portugal in 2022 was 82.47 years, rising by 0.22% in 2023 to 82.65 and increasing by 0.18% to 82.80 in 2024.

The country has made several investments in telemedicine and electronic health records to improve service delivery, especially in remote areas, and implemented strategies like optimizing appointment scheduling and expanding capacity in high-demand specialties. It also places a strong emphasis on preventive medicine, with robust vaccination programs and public health campaigns targeting chronic diseases.

Healthcare in Portugal encompasses excellent private and public services and is overseen by the independent regulatory body Health Regulatory Entity (ERS).

Portuguese Healthcare Services for Women

Hospitals, health centers, and clinics all deliver Portuguese healthcare services for women. The Portuguese health system covers maternity and childcare services, and expectant mothers generally receive care at a public hospital close to home. Private medical care is also an option if the expectant mother has health insurance.

Prenatal care takes place at the hospital. During the initial appointment, the mother-to-be receives a pregnancy booklet, and her doctor will record the ongoing medical information as the pregnancy progresses. Maternity wards offer prenatal classes, although they are not generally subsidized through public health insurance. Midwives are on hand to help with the birth.

Gynecologists can be accessed through your GP. They work at health centers and clinics, providing health advice and performing routine examinations.

Healthcare Service for Children in Portugal

Children receive free healthcare in Portugal. They have regular health checks from birth and can access services such as screenings, examinations, vaccinations, and nutritional healthcare. They will also have a record that charts their progress. In Portugal, primary doctors and pediatricians are responsible for medical care for children.

Portgual has a national vaccination system for children through the SNS, vaccinating for diseases like Hepatitis B, Diphtheria, COVID-19, Tetanus, Pertussis, Polio, Measles, Mumps, and Rubella.

Portugal also has a system to help children under six who lag in development, called the Sistema Nacional de Intervernção Precoce na Infáncia (SNIPI). The SNIPI has units in all areas of Portugal, and it employs the following specialists: nurses, social workers, educators, speech therapists, and physiotherapists.

Mental Health Services in Portugal

Mental healthcare services in Portugal are provided through mental health teams that work in hospitals and health centers. Studies have shown that around one in five Portuguese people have experienced mental health problems.

While mental health and substance abuse are issues in Portugal, the mental healthcare system and the provision of mental healthcare are not as developed as in many other countries. Consequently, there is a shortage of mental health specialists relative to the Portuguese population. There are only 12.4 psychiatrists per 100,000 inhabitants, less than the EU average in Portugal.

Your GP should be your first contact to access mental healthcare services through the SNS. Depending on your situation and the service availability where you are living, your GP can:

• Prescribe medication
• Refer you to counseling or a specialist
• Refer you to an emergency or psychiatric unit in more serious circumstances
• Refer you to a community-based program

Portugal’s national health service only provides basic mental health assistance. To access a wider range of services, it is best to have private health insurance.

Pharmacies and Medication in Portugal

Pharmacies, known in Portuguese as farmácias, are widely distributed throughout Portugal. Many medicines, including over-the-counter medication, are subsidized if obtained with a prescription, which makes them very cost-effective.

Remembering the generic name of any medication or prescription drugs you might need is advisable, as brand names can vary from country to country. For example, Fluoxetine is commonly sold under Prozac in the US, but it is often sold under different brand names in other countries. In Portugal, it’s most commonly sold under the name Nodepe.

Urgent and Emergency Care

If you require assistance for a medical emergency, phone the European Emergency Number on 112. This number is directed to the ambulance, police, and fire services.

You can also call the SNS (public health services) information hotline: 808242424, available 24 hours a day, seven days a week. The service is available in English and is free of charge. Emergency departments in Portugal include semi-private, curtained-off areas like most US emergency departments.

Healthcare for Residents and Visitors

Short-term residents and visitors

To enter Portugal, short-stay visitors with a Schengen visa must have a minimum health insurance coverage of at least €30,000. A basic plan that would suffice for three months would probably cost you between €90 and €130. If you want a more comprehensive plan, it’s best to research some insurance companies and get quotes.

You can access travel insurance through companies such as World Nomads Travel Insurance and Atlas Travel. You can also access Schengen Zone insurance through companies like Europ Assistance and AXA Travel Insurance.

Applicants for temporary visas are required by law to have health insurance, which can be obtained in their current country of residence. International health insurance for European Union expats is available through companies such as Allianz Care International Health and Cigna International Healthcare.

Non-EU/EEA students must also have full private health insurance coverage to obtain their visas and enroll in schools in Portugal.

Long-term residents

Those living and working in Portugal who are not covered by reciprocal healthcare agreements with their home countries have two options for medical care. Legal residents can either pay into the social security system, which is incremental to income or opt for one of the many private healthcare insurance plans.

Non-Habitual Tax Residents

Those who signed up for Portugal’s non-habitual resident (NHR) tax regime and contribute to Portugal’s social security system can use the public Portuguese health service, whereas those who are not contributing must invest in private healthcare.

EU Citizens

Visiting EU citizens are covered by Portugal’s SNS through reciprocal agreements. When traveling to Portugal, they should bring their European Health Insurance Card (EHIC card) and present it to any hospital or doctor to guarantee government-funded care.

There are also many private health clinics all over Portugal, which are relatively inexpensive. You can expect to pay around €40 for an appointment with a general practitioner.

Short-term working residents

If you’re a working resident of Portugal, you are contributing to Portugal’s social security system. Once you have NISS number, which provides the same rights as a social security card, you can obtain a Numero de Utente (NSNS). An NSNS is an identification number in the Portuguese public health system; once you have it, you’ll be assigned a general practitioner (GP) or family doctor.

Suppose you are not a permanent resident but have been in Portugal for at least 90 days. In that case, you can obtain a document stating this from the local Junta de Freguesia and use this document, a photo ID, IRS number, and a proof of address to obtain a Numero de Utente, which allows access to the Portuguese national health services at a discount.

Government-funded subsystems cover public employees. Private subsystems, similar to employer-provided health insurance and social security, are available for employees of companies such as banks and larger corporations. However, this type of coverage is uncommon, and most pay for private health insurance.

Portugal Golden Visa Applicants and Health Insurance Requirements

Golden Visa Portugal health insurance requirements

Applicants of the Portugal Golden Visa scheme who travel to Portugal before obtaining the Golden Visa must purchase private health insurance and travel insurance from their country of origin. Travel insurance documents should state that coverage is valid and renewable in Portugal.

Once applicants receive their Portugal Golden Visa, they are eligible for the Portugal National Health Service (SNS). However, they must first register with the SNS to benefit from its services. Note that dental costs are not covered.

Portugal Golden Visa recipients can also opt for private healthcare. This offers access to private practitioners and clinics, which traditionally provide faster treatment than public healthcare. Allianz and Cigna Global are two of Portugal’s most recognized companies that offer comprehensive private healthcare plans. Private healthcare can be a highly attractive benefit for those on the Portugal Golden Visa, looking for a higher average life expectancy.   

D7 Portugal health insurance requirements

The D7 Visa requires applicants to purchase travel insurance in their home country, which provides health coverage for one year. Proof of this coverage will be requested along with other required documents when applying for the D7 Visa. The same is also needed for the Entrepreneurship Visa.

If the initial application is approved in your country of origin, a four-month visa for Portugal will be issued to applicants. Applicants must present themselves to the Portuguese Agency for Integration, Migration, and Asylum (AIMA) within this period. Their travel insurance will cover applicants until the D7 residence permit is formally issued. Following a successful appointment with AIMA, the applicant will be granted a D7 residence permit (lasting two years).

Once the applicant receives the D7 Residence Permit, they can access public healthcare. Register with SNS to access your local health center, healthcare services and their benefits. D7 Visa holders can also purchase private insurance.

Language Barrier in Portuguese Healthcare

Portugal has a history of positively dealing with immigrants in terms of healthcare, and many medical professionals are sensitive to language barriers. Virtually all doctors in the public and private systems speak English.

Exploring Visa and Immigration Options for Portugal

If you're considering making the move to Portugal, it's essential to be informed about the various visa and residency options available. The Golden Visa Portugal program is an attractive option for many, offering residency to investors and their families. For those eyeing retirement in this beautiful country, the Retirement Visa (D7) is tailored for you. Digital nomads can take advantage of both short and long stay options with the Nomad Visa (D8). Meanwhile, the NHR - Non Habitual Tax regime provides significant tax benefits for new residents. 

For the entrepreneurial spirit, Portugal offers the Entrepreneurship/startup Visa (D2) - Start-up Visa (open company) tailored for those looking to establish their businesses in the country. Those with specialized skills can explore the Work visa for highly qualified employees (D3). Additionally, if you have Portuguese ancestry, you might be eligible for Citizenship by descent. 

However, moving to a new country isn't just about visas. If you're thinking of buying property, our guide on Buying Property in Portugal can offer invaluable insights. Dive deeper into the immigration process with our comprehensive Portugal immigration guide. For Americans specifically looking to relocate, we have curated information on Americans moving to Portugal. Lastly, one can't forget the importance of the NIF (Tax Registration Number), a crucial step in any relocation process. 

Frequently Asked Questions about Portugal's Healthcare for Foreigners

Is healthcare in Portugal good?

The Portuguese healthcare system is ranked amongst the highest in the world and has only improved over the past decade. 

Portugal’s healthcare ranking is higher than the UK, Ireland, Spain, and Italy in terms of patient rights, accessibility, information, waiting times, and overall health outcomes. In some cases, as with many healthcare systems, the public system may have longer waiting lists than private healthcare.

Is healthcare free in Portugal?

When it comes to Portugal’s healthcare costs, the national healthcare service, the Serviço Nacional de Saúde (SNS), is entirely free for children under 18 and over 65. SNS also provides reduced medical fees.

Expats can access the SNS by making social security contributions. Private healthcare will cost you, although, compared with other Western European countries, it is quite affordable.

Are you entitled to Portuguese healthcare?

Whether you’re on the Portugal Golden Visa, the D7 Visa, or another visa option, any legal resident in Portugal who makes social security contributions is entitled to access the Portuguese healthcare system.

Do healthcare professionals in Portugal speak English?

When it comes to Portuguese healthcare for expats, the vast majority of healthcare professionals speak English in Portugal.

Following my Golden Visa or D7 Visa application, when can I start using the Portuguese National Health Service (SNS)?

Expats can use public healthcare services when their Portugal Golden Visa or D7 Visa is approved. However, you must first register with the SNS to benefit from the national healthcare system.

Do I need private insurance if I move to Portugal under the Golden Visa or the D7 Visa?

As an expat living in Portugal under the Golden or the D7 Visa, you can benefit from Portugal’s public healthcare once registered. The national healthcare system is very good.

However, expats are welcome to purchase a private insurance policy if they require or wish to have extra coverage. Private healthcare is widespread across Portugal.

Is healthcare in Lisbon, Portugal, affordable?

If you are a resident of Portugal, you have access to the Serviço Nacional de Saúde (SNS) and will only pay a small fee. The Portuguese healthcare system is affordable and of high quality compared to other Western European countries.

Private medical insurance offers access to private hospitals and healthcare services. English is widely spoken in both public and private healthcare, ensuring good communication with doctors and practitioners.

What is healthcare like in Madeira, Portugal?

Madeira has three major public hospitals. Public healthcare in Portugal is both affordable and very good. If you are a Portuguese resident, you will have access to the Serviço Nacional de Saúde (SNS) in return for a small fee. You will also find excellent private services if you want to go this route.

Where does Portugal rank in healthcare?

Portugal ranks 25th in the 2023 Health Care Index, making its healthcare system one of the best globally. Portugal’s healthcare system is a hybrid system, offering excellent public and private healthcare services, with private healthcare being relatively affordable compared to other Western European countries.

The World Index of Healthcare Innovation 2022 ranked Portugal 22nd, considering factors like quality, choice, science and technology, and fiscal sustainability. Emergency services in Portugal are noted for their rapid response times, and medical costs remain minimal for Portuguese residents.

Which EU country has the best healthcare?

Switzerland, Luxembourg, and Germany are often considered to have excellent healthcare systems. Portugal’s healthcare system is also very good.

Is there healthcare for tourists in Portugal?

Portugal’s healthcare system does not offer free medical treatment for tourists and visitors and requires non-EU citizens to have medical insurance covering emergency medical treatment.

UK citizens can use their UK Global Health Insurance Card (GHIC), which replaced the European Health Insurance Card (EHIC) following the UK’s departure from the EU.  

Are there specific health insurance requirements for the Portugal Golden Visa? 

Portuguese Golden Visa holders do not automatically get access to public healthcare. Those who do not decide to live in Portugal full time are required to get private healthcare insurance that covers your healthcare while you are in Portugal.

However, if you decide to live in Portugal for more than six months, and become a full-time resident, then the public healthcare system will cover you.

Can I use public healthcare in Portugal to meet the Golden Visa healthcare requirement? 

No, Golden Visa holders do not automatically get access to healthcare services if they are not a full-time resident in Portugal.

Do I need to prove that I have comprehensive healthcare coverage for my family as well?

If your family members are coming to stay in Portugal for under half the year, it is a good idea to get healthcare coverage for them.

If you become a full-time resident, then dependent family members are also entitled to medical care under the public healthcare system in Portugal.

How does the Portugal's healthcare system work?

Portugal’s healthcare system consists of the National Health Service (SNS), special social health insurance, and private healthcare. The system provides a high standard of care with mostly free access through its public system. However, there can be long waiting times for non-emergency procedures, especially in the public sector. Quicker access to certain treatments may require additional private healthcare. While medical staff are highly qualified, facilities in larger cities may be overburdened.