Healthcare in Portugal for foreigners: everything you need to know

Portugal offers a high-quality healthcare system that combines public and private services, making it accessible to residents and expats alike. This guide covers everything you need to know about public and private healthcare options, insurance, medical costs, and patient rights in Portugal.

Portugal may not be the first country that comes to mind for having an excellent healthcare system — nations like Switzerland, France, or Singapore often top that list. However, Portugal has invested heavily in its National Health Service (Serviço Nacional de Saúde, SNS) over the past decade. According to the World Health Organization's UHC Service Coverage Index, Portugal ranks among the top five countries globally, reflecting its commitment to accessible and comprehensive healthcare.

This investment has increased the number of clinics and hospitals, placing several Portuguese institutions among Europe's leaders in specialties like oncology. Life expectancy has steadily risen, reaching 82.80 years in 2024,while the infant mortality rate has declined to 2.25 deaths per 1,000 live births as of 2024. A robust vaccination program has eradicated polio and significantly reduced other infectious diseases. Coupled with a healthy Mediterranean diet, Portugal is indeed a healthy place to live.

Serviço Nacional de Saúde (National Healthcare System)

While the backbone of healthcare in Portugal is the Serviço Nacional de Saúde (SNS), the country operates a mixed system that includes both public and private hospitals, with some doctors working in both sectors. The SNS provides universal coverage to all legal residents, ensuring access to comprehensive healthcare services.

In addition to the public system, about 25% of the population opts for private health insurance, either through voluntary schemes or employer-provided plans. It's also important to note that the SNS covers mainland Portugal, while the Azores and Madeira have their own regional healthcare systems.

A significant advantage for individuals moving to Portugal is that many medical professionals, especially in major cities and at senior levels, speak English. Many have studied or worked abroad, so language barriers are minimal. However, knowing basic Portuguese phrases like "That hurts" or "I need the toilet" can still be helpful.

Non-resident rights

Non-residents using a holiday home in Portugal for less than 90 days at a time have different healthcare coverage options based on their nationality:

  • EU, EEA, or Swiss citizens: You can rely on the European Health Insurance Card (EHIC), which should be obtained in your home country before traveling. This card grants access to necessary medical care in Portuguese healthcare facilities under the same conditions as residents.

  • UK citizens: Following Brexit, the Global Health Insurance Card (GHIC) has replaced the EHIC for UK residents. The GHIC provides similar coverage within EU countries, including Portugal. It's advisable to obtain this card prior to your trip.

  • Non-EU citizens: You are required to have travel insurance that covers medical emergencies during your stay, as Portugal's healthcare system does not offer free medical treatment for tourists and visitors.

Once you become a resident in Portugal, if you're working — whether employed or self-employed — your contributions to the Segurança Social (social security) will make you eligible for public healthcare coverage. Unlike countries with multiple health insurance funds, Portugal's single scheme covers all workers for basic healthcare services.

Retired EU citizens are covered through reciprocal arrangements with their countries of citizenship. To register in the Portuguese healthcare system, you'll need to follow these steps:

  1. Obtain the S1 form: Before moving, request the S1 form (formerly E121) from your health insurance institution in the country that pays your pension. This form certifies your entitlement to healthcare in another EU country.

  2. Register with Portuguese authorities: Upon arrival in Portugal, present the S1 form to the District Centre of the Social Security Institute in your area of residence. They will validate the form and inform you of the local health center where you should register.

  3. Enroll at your local health center: With the validated S1 form, register at your designated health center to obtain your Portuguese health card. This card grants you access to the public healthcare system under the same conditions as Portuguese citizens.

Dependents are typically covered through the head of household or wage-earner. Ensure that all family members are registered to receive healthcare services.

Free vs paid healthcare

If you're not employed and don't qualify for public healthcare coverage through other means, you'll need to obtain private health insurance. Even if you are eligible for public healthcare, having private insurance can expedite access to specialist services. The cost varies based on factors like age and coverage level, typically ranging from €30 to €150 per month.

While most healthcare services under the Serviço Nacional de Saúde (SNS) are free or require minimal co-payments, certain services incur higher fees. For instance, there's an emergency room fee of approximately €20 for direct hospital visits. Additionally, some specialized care may only be available in the private sector, making private insurance beneficial.

Dental care is generally not covered by the SNS, except for specific groups such as children up to 18 years old. For others, dental services can be costly, with prices varying between clinics. For example, a dental checkup ranges from €20 to €40, and teeth cleaning starts at €25. Complementary health insurance can help offset these expenses.

Maternity care in Portugal is free under the SNS, though services like prenatal classes may not be covered. The system is generally traditional, with most births occurring in hospitals. Postnatal support services, such as those provided by doulas, may not be as prevalent as in other countries. Children benefit from ongoing care and a national vaccination program that provides immunizations and boosters up to the age of 13.

Healthcare system peculiarities

While the Serviço Nacional de Saúde (SNS) provides comprehensive healthcare services, some specialties, such as ophthalmology and pulmonology, often have extended waiting lists due to high demand. A study released in May 2022 indicated that 48.7% of respondents experienced difficulty accessing specialist consultations, with 30.2% waiting more than three months for an appointment.

To expedite access to medical treatment, approximately 2.34 million Portuguese residents utilize private healthcare services.

Health centers (Centros de Saúde) are typically the first point of contact for non-emergency medical needs and serve as the registration point for the SNS. These centers house a team of healthcare professionals and may offer services such as dental care and childcare. A referral from a general practitioner is usually required to see a specialist, and a nominal fee of around €5 is typically charged for consultations. Pharmacies can provide free advice for minor ailments; however, medications are often more affordable when prescribed by a doctor, so consulting a physician can be more cost-effective.

Given the mixed nature of Portugal's healthcare system, it's essential to confirm with healthcare providers whether services are public or private and to inquire about any potential out-of-pocket costs. Patients accustomed to being actively involved in their healthcare decisions may need to proactively seek detailed information about their treatment plans, as the Portuguese system has traditionally been practitioner-focused. However, this is gradually changing, partly due to healthcare professionals with international training introducing new perspectives on the doctor-patient relationship.