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Portugal offers a comprehensive health system to both its citizens and foreign residents. However, the limits of coverage, the overcrowding of certain public hospitals, and the waiting times for access to care lead many insured persons to turn to the private health sector. In order to benefit from better reimbursement, it is essential to take out complementary health insurance.
The Portuguese National Health System (Serviço Nacional de Saúde or SNS) is available to all residents of the country regardless of nationality.
Insured persons are registered with their local health centre (centro de saúde) and must choose a general practitioner. After that, they receive all primary services almost free of charge (sometimes with a small out-of-pocket expense), in particular:
Consultations with their general practitioner
Specialist consultations, in private practice or in hospital, on referral from the GP
Hospitalisation in a public facility on the referral of the GP (except in case of emergencies)
Medicines (the reimbursement rate varies between 15 and 90%)
Dental care is also rarely covered (except for certain categories of insured persons such as the under-16s and pregnant women), as are optical aids.
As for care provided in private health establishments, it is covered according to the same basic rates as those applied to private establishments. All excess fees are excluded from SNS coverage.
The use of the Portuguese health system, therefore, generally leads to out-of-pocket expenses―sometimes substantial―for the insured, many of whom take out complementary health insurance.
Portuguese mutual insurance companies are relatively expensive and usually limit their coverage to care provided in the establishments in their network. Services provided in other countries during a stay abroad are also excluded from their coverage.
With international health insurance, expats in Portugal can benefit from tailor-made protection, thanks to guarantees and reimbursement levels adapted to their needs and situation as a foreign resident.
Examples of reimbursements with MyHealth International COMFORT in relation to the cost of care in Portugal in the private sector*.
*Reasonable costs in the private sector, APRIL International data 01/2022
In case of emergency, patients have the option of going to the public hospital of their choice, or a centro de saúde, which are listed by location on an official website.
In non-emergency cases, any hospitalisation must be prescribed by the patient's GP if they wish to benefit from the SNS. This obligation of prior referral, combined with the lack of staff and resources in some regions, particularly rural ones, contributes to longer waiting times and saturation of many public hospitals.
To compensate for these disadvantages, private hospitalisation is an alternative chosen by insured persons, who thus benefit from faster treatment and sometimes a better quality of care.
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