So that you can enjoy living in Portugal to the full once you have made the move, we've broken down the process of getting yourself and set up with healthcare, along with any family members joining you on your adventure.
If you’re planning on living in Portugal, or perhaps buying a holiday home that you’ll visit many times over, you’ll need to be aware of the healthcare available to you as an expat.
The good news is that Portugal enjoys a similar system to the National Health Service in the UK. The quality of care is good, and hospitals and local surgeries are well equipped. However, it’s fair to say the more rural areas are not so well covered and there might be lengthy waiting lists.
While British expats, as part of the European Union, are entitled to use the service, not everything is free. Visitors would use their usual EU citizen health card, but those moving permanently to the country would need to register as a resident. With a residence certificate in hand, they can register with a GP at a local state-run health centre. Those of a pensionable age also need to obtain an S1 form.
What might you have to pay for in Portugal?
The Serviço Nacional de Saúde is the Portuguese equivalent of the NHS. Visitors from Britain must present their European Health Insurance Card to receive treatment, but those who have moved to the country and enjoy living in Portugal will also be treated, thanks to their residence certificate.
While services are ostensibly free, most do come with a small payment requirement. It’s the equivalent of British Citizens having to pay a prescription charge back home. In general, visits to the doctor might cost a couple of euros, while tests, X-rays and scans will cost a few euros more.
Many Brits buying property in Portugal like to cover all bases by taking out private health insurance to sit alongside the provision they are entitled to, or simply paying to go private if the need arises.
With Britain’s position within the European Union currently open to question, it’s unknown what future free treatment will be available to visitors, which is worth bearing in mind if family or friends from Britain come over to stay with you.
Private health insurance in Portugal
Because there’s a small charge for public services anyway, and because private health insurance is relatively cheap, many British expats living in Portugal elect to pay for private health insurance. Together with peace of mind, private insurance gives the individual the choice of public or private hospitals or GP visits.
To give you an idea of the convenience and cost, it might set you back €40 to see a private doctor immediately, rather than wait to see a public one which will cost a few euros anyway.
Taking out health insurance might mean you only pay €10 or €20 to see the private doctor. The rest is paid up by the policy.
You can pay all scenarios privately if you so wish. For instance, while childbirth is covered by the public health system (with a small charge), it is quite an old-fashioned experience. British parents looking for a more modern birthing plan approach might prefer the private route, which would cost in the region of €4,000.
With services sometimes underfunded and busy, some people prefer to take out private health insurance for extra services like dental care and vision.
Healthcare for the family
If you’re buying property in Portugal and taking your dependents to live there with you, everyone will be entitled to the public health care. Like you, they need to have a residence certificate to register at the local health centre.
Adults need to have obtained a NISS, or social security number and show that alongside the residence certificate at the health centre. You won’t be given a NISS number unless you’re working or dependent upon someone who is.
That means that the head of the household should be working in Portugal to receive the public healthcare benefits. If you are retired, then you jump through one more form-filling hoop to get started.
If you get an exportable pension from the UK, you should apply for an S1 form from the Department of Works and Pensions’ International Pensions Centre.
If you’re employed, your employer will register you in the social security system in Portugal. If you’re self-employed, you’ll need to register with the Social Security Institute directly before applying for health insurance.
Private health insurance can run from the low hundreds to thousands of euros a year depending on your age and health history. Most schemes also come with an excess payment policy, meaning you’ll have to pay a small fee before making a claim.
Like in the UK, you can add dependents on to your private health care policy.
How does the Portuguese health system work?
The service is similar to the UK in that you must get a referral from a local GP before being admitted to hospital for treatment. Of course, emergencies are the exception to the rule, and you should dial the emergency services on 112. Operators are generally able to understand English, as indeed are most Portuguese GPs.
The small fee payable for all public health care even applies to the trip in an ambulance if you are unlucky enough to need one.
If you’ve got a minor ailment, you’ll get many medicines over the counter at the local pharmacy (farmacia de service), which have a green cross sign outside. Some medicines require a prescription from your GP. You’ll be expected to contribute to the cost of your prescribed medicine, ranging from 15% to 90%.
Different tiers of hospitals
When you move into your new Portuguese home, investigate what public healthcare you have available locally. Not all hospitals are the same but are generally classified according to the services they offer.
There are around 200 hospitals in Portugal, half of which are private. The different types of hospital are below:
- Central hospitals in the big towns and cities provide specialised, hi-tech services.
- Specialised hospitals provide a broad range of services
- District level hospitals are the same as those in major UK towns and provide a range of specialist services
- District level 1 hospitals provide some surgical procedures and perhaps a couple of basic specialities.
If you’re planning on living in Portugal, you’ll be able to use the “free” public healthcare once you have your social security number and residence permit. But, because you have to make a small payment for just about every “free” part of the health service, and because there can often be a bit of a waiting list, many Brits planning on moving to Portugal take out private health insurance as well, giving themselves a wider choice of care.