Health Insurance in Portugal: Complete Guide for Expats and Foreigners
Health insurance is often the first insurance concern for foreigners moving to Portugal. Whether you’re applying for a D7 visa, establishing residency, or already living in Portugal, understanding your health coverage options is crucial for both legal compliance and personal well-being.
Public vs Private Healthcare in Portugal
The National Health Service (SNS)
Portugal’s Serviço Nacional de Saúde (SNS) provides healthcare to all legal residents, including expats who contribute to social security. The public system offers:
- Essential medical care with small copayments (taxas moderadoras)
- Hospital services and emergency treatment
- Primary care through local health centers
- Limited dental and vision coverage
To access SNS, you’ll need:
- Legal residency status
- Social security contributions
- SNS user number (número de utente)
- Registration at a local health center
Private Health Insurance Requirements
Non-EU foreigners must initially have private health insurance when applying for residency visas. Even after gaining access to SNS, many expats maintain private coverage for:
- Faster access to specialists
- Broader dental and vision coverage
- Private hospital networks
- Services not covered by SNS
Types of Health Insurance Coverage
Comprehensive Health Insurance
Full health insurance policies (Seguro de Saúde) typically include:
- Outpatient care: Consultations, exams, diagnostics
- Hospitalization: Surgery, room costs, treatments
- Serious illness coverage: Oncology, chronic conditions
- Maternity benefits: Prenatal care, delivery, postnatal
- Dental care: Basic to comprehensive coverage
- Wellness benefits: Preventive care, check-ups
Health Plans vs Insurance
Be aware of the distinction:
- True insurance covers major medical expenses
- Health plans (planos de saúde) offer discounted services
- Plans cost €10-15/month but don’t cover surgery or hospitalization
- Always verify you’re buying actual insurance, not just a discount plan
Costs and Pricing Structure
Health insurance premiums vary significantly based on age, coverage, and health status:
Basic Coverage
- Entry-level plans: €6-10/month
- Limited services: Often dental or ambulatory only
- Network restrictions: Specific providers only
Comprehensive Coverage
- Adults 30-40: €20-50/month
- Adults 50+: €50-100+/month
- Family plans: €100-250/month
- Premium coverage: €100-200+/month
Factors Affecting Cost
- Age (premiums increase with age)
- Pre-existing conditions
- Coverage limits and deductibles
- Network vs. non-network providers
- Optional add-ons (dental, vision, wellness)
Major Health Insurance Providers
Portuguese Insurance Companies
Médis (Ageas)
- Part of Ageas Seguros
- Extensive provider network
- Plans from €9.70/month
- English-speaking support available
Multicare (Fidelidade)
- Portugal’s largest insurer
- Comprehensive coverage options
- Starting at €6.50/month
- Wide hospital network
AdvanceCare
- Network used by multiple insurers
- Focus on preventive care
- Competitive pricing
- Good coverage nationwide
International Providers
Cigna Global
- Worldwide coverage
- English-language support
- Higher premiums
- Ideal for frequent travelers
Allianz Care
- International plans
- Direct billing networks
- Comprehensive coverage
- Multi-country options
Waiting Periods and Exclusions
Standard Waiting Periods (Períodos de Carência)
- Ambulatory care: 30-60 days
- Non-urgent surgery: 3-6 months
- Maternity services: 10-12 months
- Dental procedures: 6 months
- Accidents: Usually no waiting period
Common Exclusions
- Pre-existing conditions (initially)
- Cosmetic procedures
- Fertility treatments (IVF)
- Substance abuse treatment
- Experimental treatments
Health Insurance for Visa Applications
Different visa types have specific health insurance requirements:
D7 Visa (Passive Income)
- Comprehensive health coverage required
- Must be valid for initial visa period
- Portuguese or international insurers accepted
- No specific minimum coverage amount
Golden Visa
- Private health insurance mandatory
- Coverage for entire family
- Must demonstrate adequate coverage
- Can transition to SNS after residency
Digital Nomad Visa
- Travel insurance or health insurance required
- Must cover entire stay period
- International policies often preferred
Choosing Between Local and International Coverage
Local Portuguese Insurance
Advantages:
- Lower premiums for Portugal-only coverage
- Direct billing with local providers
- Designed for Portuguese healthcare system
- Meets all visa requirements
- Portuguese and English support
Disadvantages:
- Limited coverage outside Portugal
- Documentation primarily in Portuguese
- May require Portuguese bank account
International Health Insurance
Advantages:
- Worldwide coverage
- English-language support
- Portable if you relocate
- Higher coverage limits
- Direct billing globally
Disadvantages:
- Significantly higher premiums
- May require reimbursement claims
- Less familiar to local providers
Tips for Expats
Getting Started
- Compare multiple quotes using platforms like ComparaJá
- Read the fine print especially exclusions and limits
- Consider your needs – don’t over or under-insure
- Check employer benefits – many companies offer group plans
- Keep your EHIC if from an EU country for travel
After Moving to Portugal
- Register for SNS once eligible
- Maintain private insurance for better access
- Use network providers for maximum coverage
- Keep all receipts for reimbursement claims
- Review annually as needs change
Money-Saving Strategies
- Bundle with other insurance types
- Pay annually vs. monthly
- Choose higher deductibles for lower premiums
- Use in-network providers
- Take advantage of wellness benefits
Special Considerations
For Families
- Children often covered free or at reduced rates
- Maternity coverage requires advance planning
- Pediatric networks vary by insurer
- School insurance may supplement coverage
For Seniors
- Premiums increase significantly after 55
- Some insurers have age limits (65-70)
- Pre-existing condition coverage crucial
- Consider supplementing SNS with basic private
For Self-Employed
- No employer coverage means full cost
- Tax deductions may apply
- Consider business insurance packages
- Professional associations may offer group rates
Making a Claim
Process Overview
- In-network: Direct billing, show your card
- Out-of-network: Pay and claim reimbursement
- Emergency: Go to any hospital, notify insurer within 48 hours
- Pre-authorization: Required for major procedures
Documentation Needed
- Medical reports in Portuguese
- Itemized bills (faturas)
- Prescription copies
- Claim forms (provided by insurer)
Transitioning from International to Local Coverage
Many expats start with international insurance for visa applications then switch to local coverage:
- Maintain overlap during transition
- Register for SNS as soon as eligible
- Compare local options after settling
- Consider keeping international for travel
- Update visa requirements if applicable
Dental and Vision Coverage
Most health insurance policies offer limited dental and vision benefits:
Dental Coverage Options
- Basic plans: Cleanings and check-ups only
- Comprehensive: Includes major work
- Annual limits: Usually €500-2000
- Network dentists offer better rates
Vision Coverage
- Eye exams typically covered
- Glasses/contacts have limits
- Surgery (LASIK) usually excluded
- Check if included or separate rider
Complementary Insurance Options
Consider these additional protections:
- Travel insurance for trips outside Portugal
- Life insurance for family protection
- Legal protection for healthcare disputes
- Accident insurance for additional coverage
Next Steps
Ready to secure health insurance in Portugal?
- Determine your status: Visa applicant, resident, or citizen
- Assess your needs: Basic SNS supplement or comprehensive coverage
- Get quotes: Compare at least 3 providers
- Read carefully: Understand exclusions and waiting periods
- Apply early: Allow time for visa applications
For other insurance needs in Portugal, explore our guides on auto insurance, home insurance, and business insurance.
