How does the private healthcare system work in Portugal?

 

Just like in Spain and Great Britain, there are 2 healthcare systems that co-exist in Portugal: the public and the private healthcare systems. Thanks to European cooperation agreements, English expatriates may benefit from the Portuguese public healthcare system based on universal and nearly-free care. However, those who’d like to choose their doctors and avoid waiting lists look to the private healthcare system which, unlike with the English private system, do not have agreed rates partially paid by the “Social Security” system. For a better understanding, we suggest reading this quick introduction to private health insurance and how it all works.

 

What are the differences between the two healthcare systems in Portugal?

Each Portuguese resident must register with the Portuguese Social Security (SNS) office nearest their home: generally, it’s the health centre (community clinic) where any future general medicine consultations take place. The public healthcare system is basically free yet imposes a primary healthcare provider on each patient who must be consulted for all general medicine needs as well as before seeing any specialist in order to obtain a referral. General medicine appointments are of fairly easy access in urban areas; nevertheless, the waiting times can sometimes be quite long to see a specialist or get an operation… so much so, they often discourage many ill patients!

The private healthcare system was, therefore, developed to mitigate the failures of the public system which is of good quality yet has greatly felt the effects of the economic crisis. The private healthcare system operates on free pricing which is sometimes a deterrent to patients… Thanks to private health insurance policies that guarantee good reimbursement cover, more and more people are turning to private medical consultations in order to freely choose their own doctors and avoid penalizing waiting times.

 

What are the covers?

Private health insurance in Portugal not only allows access to hospitalisation but also a network of generalist doctors and specialists approved by the insurance company for consultations without any advance fees. Depending on the chosen option, you may have access to “convenience” consultations like acupuncture, podiatry and some dental care.

And for those who still aren’t very proficient in Portuguese: insurance companies can suggest English-speaking doctors. Upon taking out a private health insurance policy, you will not only have a Portuguese social security card but also a private health insurance card for the insured and all beneficiaries.

 

What are the different private healthcare insurance options?

Before taking out a health insurance policy, you must ask yourself a few good questions to properly identify your and your family’s needs. Insurance companies offer different insurance formulas that can adapt to each one’s needs and financial situation… there are 3 major categories:

Partial Cover

This is the basic formula which allows access to an insurance company-approved network of doctors with a small payment per service (deductible) for:

• general medicine or specialist consultations,
• hospital care,
• healthcare when traveling abroad.

Full Cover

With this formula, patients have access to the company’s medical network without any payments per service as consultations are 100% covered by the company and the insured benefits from travel insurance.

Total Cover

With this “premium” cover, the insured always have access to the company’s medical network and benefit from 100% cover without any advance payments using the insurance card. However, if someone with “total cover” wishes to consult a practitioner, generalist doctor or specialist outside the company’s network either in Portugal or abroad, 80% of the advance fees will be covered by the company.

 

How do you get a health insurance policy?

You may sign a health insurance policy in just 24 hours. It is absolutely necessary to identify your needs well and compare the different quotes to move on to the medical questionnaire phase (on paper or by phone). Whenever you take out health insurance in Portugal, you must provide identification (passport or residence card), a mailing address and a Portuguese bank account number.

Any new health insurance policy taken out in Portugal imposes a waiting period before the cover can be applied (except life-threatening emergencies which are never subject to waiting periods).

-6 to 8 months for surgeries and hospitalisation

-8 months for childbirth

Except for childbirth, most of these waiting periods can be decreased or even waived if you were already covered by health insurance before signing the new policy. You simply need to provide your broker with a copy of your old contract and proof of the most recent payment. Please note that the period between cancellation of the old policy and signing the new health insurance policy in Portugal must be exceed 30 days.

 

Practical info

For a better understanding and more information on all the health insurance possibilities for expatriates in Portugal, you may contact the INOV Expat specialists. It is an insurance brokerage firm that was founded in 2004 by insurance professionals exclusively dedicated to French or English-speaking expatriates. INOV Expat adapts to your needs and can suggest insurance products for individuals and companies.

 

> Ask for your quote and a comparison of health insurance policies for free online HERE.

 

If you prefer, you may directly contact our health insurance specialist Benjamin Retali: [email protected]

Ask for your free online quote: automobile, health, home, business, travel, or other insurance or contact us by email at [email protected].