Smiling female doctor holding medical records.

Relocating to a new country is both exciting and daunting. You have to consider so many things when deciding if moving to Portugal is right for you. One of those is access to healthcare and although as a resident, you are entitled to access the state health system, sometimes it’s good to have the extra flexibility and security that private health care can offer.

But what health insurance for expats exisits in Portugal, is it any good and how can you get it? Hopefully this article will help you inderstand the options a bit better.

For a number of years we’ve enjoyed the flexibility that having private health insurance through Mike’s employers has given us. We’re currently looking at alternatives for when that cover stops but haven’t quite decided what to go for yet – we’re still getting quotes to help us decide what suits our needs best. Each of you will have different needs so what works for us may not be the best solution for you.

Let’s take a look at some of the things to consider.

Portugal’s National Healthcare System (SNS)

A patient signing a form at the doctors.
A visit to the doctor

Healthcare in Portugal is not dissimilar to many of the healthcare systems across the EU. The Portuguese health system ranking is very high, consistently making it into the top 20 listings of health care systems in the world. For example, it ranked 17th in the 2021 World Index of Healthcare Innovation.

The cost of healthcare in Portugal varies greatly based on whether you opt for public or private healthcare.

If you’re an expat, you’ll need to register with the authorities as a resident and get a social security number from the Portuguese Social Security Department to get access to public health care. While not always completely free, it is extremely cheap, e.g. a consultation with your family doctor usually costs €5 unless you’re under 18, over 65 or fall into certain other exempt categories.

Notes for non-residents: Europeans may have a European health insurance card (EHIC), which gives you access to state-provided healthcare during your vacation but is not relevant for residents.

Once the paperwork is sorted you can show up or make an appointment at your local Centro da Saude (Health Centre) but even before Covid, getting an appointment with a family doctor for non-urgent complaints would take a couple of months. Now it’s all but impossible, at least in my area.

That’s one reason I’ve been grateful to have private health insurance as I’ve been able to get checked out for various issues a lot more quickly and easily than relying on my local Centre da Saude who don’t even answer the phone any more.

Healthcare insurance for expats in Portugal

Filling in claim and using a calculator. Calculating the cost of your insurance
Calculating the cost of your insurance

You might be wondering if it’s worth getting private health insurance in Portugal if the national health service is so cheap. While it’s by no means essential, depending on your health and finances the pros might outweigh the additional cost.

Private healthcare in Portugal works the same as anywhere else, you pay a fee to get prioritised on a surgery list, seen quicker, or to get access to a better quality of healthcare.

It’s not the same thing as health insurance, which is an additional paid service. Once you have private health insurance you can make a claim on any of your private healthcare costs and get back all, or part of, the fee, depending on your level of coverage.

What does health insurance cover in Portugal?

Insurance companies usually have agreements with specific hospitals, dentists and other healthcare providers to offer cheaper fees, e.g. €30 for a doctor’s consultation instead of the €90 you would pay without insurance. You may also be able to claim part of that €30 back on the insurance so seeing a doctor would cost less than €10.

Typically your private health insurance will cover doctor appointments and hospital visits, prescription drugs, wellness care, and medical devices. It may cover glasses and dental work but not at the basic level.

When you’re looking for the right healthcare insurance for you, keep an eye on the details and exclusions and check to see whether the discounted partnerships the company has are available in your local area.

How much is health insurance in Portugal?

The amount that your health insurance costs you will depend on an array of factors. Some of the most influential are age, medical history, and pre-existing conditions. But even your job and lifestyle will be taken into account.

A standard policy will typically cost around four hundred euros a year per person, but they can cost thousands depending on who you are and whether you choose to take out additional policies like dental and eye care coverage.

Don’t rush into buying your health care insurance, take some time to get quotes from different providers and then compare the pros and cons of each company’s policies. Make sure to check in the small print whether you’re covered for ambulance rides, maternity care, non-emergency surgery costs, eye care costs, and dental costs.

What factors will affect the cost of my health insurance?

Elderly couple keeping fit with Nordic walking
Keeping fit and healthy means cheaper insurance

Health care insurance works much like car insurance in that the fewer incidents you’ve had in the past, the cheaper the insurance. Unfortunately, this can make it more complicated for patients with pre-existing conditions (like diabetes, autoimmune diseases, a history with cardiac problems, etc.) to get affordable health insurance.

That said, there are a range of options out there and whatever your circumstance, you should be able to find something that works for you.

Age is an important consideration

Some health insurance providers in Portugal stop offering insurance coverage once their clients reach the age of 55, though others stop their coverage at 65 years. Unsurprisingly, this is because health care insurance companies are expecting older patients to need more assistance.

That doesn’t mean that if you’re getting on, you won’t be able to find healthcare insurance. There are companies who will insure you, just not as many (see below for some options).

How to buy health insurance in Portugal

Two Health insurance cards Total and Dental care on top of Test results
Health insurance cards

There are various providers you can get your healthcare insurance through. The most popular choices are to get your insurance through your bank, directly from the insurance provider online, or through a broker. Let’s have a look at some of the pros and cons of each.

Your Portuguese bank

If you go through your bank it can be more simple as they already have most of the information they’ll need. The bank tends to act as an intermediary between you (the client) and an insurance company.

The healthcare insurance providers design specialised policies for the bank’s customers. Because of this they tend to be pretty inflexible, less personalised, and designed for groups. There also tend to be less policies to pick from.

However, if you want to take out healthcare insurance for you and your family, going through a bank can save you a lot of time, and possibly money.

Buying health insurance online

Another way you can get healthcare insurance for expats is online. That way you can do it from home, all you’ll need is your laptop and a Wifi connection. That might sound pretty idyllic, but once you start scanning each of the documents the insurer needs and exchanging endless emails you might start to question your choice.

One advantage is that you can do extensive amounts of research and find a plan that works for you. Plus you can easily get price comparisons online, so you could save yourself a fair bit of money.

However, researching health insurance providers and reading through each one’s policies takes time so if you’re in a hurry to get health care insurance in place, this might not be the best option.

It can also be hard to get in touch with online healthcare insurance providers. When Mike was researching for a new policy he would find a plan which looked suitable, send off his contact details and would never receive a call back. Quite strange considering you’re after their business!

Be aware that making claims can take a long time too.

Companies to look into

These are some of the main health insurance companies in Portugal, although there are plenty of other reputable companies:

If you’re older than 65 another option is to find an international health insurance company that will cover you as a Portuguese resident instead. One worth looking into is Cigna Global, which has no age limit for their coverage. If you’re under 75, you could also consider William Russell.

If you’re under 70, and a member of Afpop, you can get insurance through their partner, Medal Seguros, and once you’re in, they won’t kick you out based on age.

Going through a broker

Taking out healthcare insurance through a broker has a few advantages over doing it yourself online. You’ll get a personalised experience, and essentially have an assistant in finding the ideal healthcare insurance for you.

The broker’s vast knowledge of different companies and types of insurance will save you a lot of time. The only drawback is that it’s an added cost.

Is health insurance the best option for you?

If you’re not convinced that health insurance is for you then it’s worth considering Portugal’s Medicare.

A subscription to Medicare gets you discounts of up to 50% across a range of healthcare services (dental, pharmacy costs, hospitals, opticians, and more) at select medical providers, known as the Medicare Health Network.

The only drawback is that if you live somewhere outside of a large city, they may not have partners in your area so check what facilities are near you before considering Medicare.

That said, one of the major advantages of Medicare over health insurance is that there is no age limit and they don’t withhold their services from those with prior illnesses. Coverage is immediate and they don’t require medical exams either.

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