The healthcare system in Portugal takes a three-tiered approach. If you are a member of a relevant profession, for example if you are a civil servant or working in the armed forces, then your healthcare will be covered by the state through your professional body. If you are living in Portugal but are not in one of the registered professions, then you will be covered by state healthcare. There will still be a small amount to pay for most of your health appointments and prescriptions, unless you are retired or on a very low income.Private healthcare is also available in Portugal. The state system offers a very high standard of healthcare, so private cover is optional and not everyone chooses to take out a policy. However, some who choose this option do so because they want to guarantee that their doctor will speak fluent English; because they want to see a particular specialist; or simply for peace of mind.
Most of the big international insurance companies, such as BUPA and Cigna, will cover you for healthcare in Portugal. You might also be able to find cover through a smaller local insurer.
Pre-Existing Conditions
If you have a pre-existing medical condition, then getting full health insurance cover can be difficult. Some insurers will completely refuse to cover you at all if you have a pre-existing condition, whilst others will offer you insurance but set your premiums higher. You might also be asked whether you would be willing to take out cover for everything except your pre-existing medical condition.
This may seem like it would defeat the object of taking out private health cover in the first place: what is the point of having cover if you can’t use it for the thing you visit the doctor about the most frequently?
However, Portugal has a high standard of general healthcare, so unless your condition is something for which you want to see a particular specialist — for example, someone who works in the British Hospital in Lisbon which has an excellent specialist department for joint surgery — then you can simply visit your normal doctor and be referred to other health professionals who will be able to help you.
Often, people with one medical condition, particularly chronic illnesses, find that over time they end up with other health conditions linked to the first one. This is known as co-morbidity and it is one reason why it might be worth taking out health insurance even if it does not cover your original condition.
Some insurers will refuse to cover anything relating to a body part that has been affected by a condition already; for example, if you have had asthma they might refuse to cover you for lung cancer, since both conditions affect the lungs. However, other insurers will not have such a strict policy, and in these cases you might be able to find a good private specialist who can work with you if anything else goes wrong in an area of your body that has been weakened by chronic illness.
Some comorbid conditions will affect different areas of the body and have no known medical reasons for being linked, even though they often show up together. A lot of people with irritable bowel syndrome (IBS), for example, also have fibromyalgia, and vice versa. Since there is no currently known causal link between the two, you might find that you are insured for everything except your IBS, but then in the future if you develop fibromyalgia, your insurance might still be able to cover this.
Look into the options offered by different private health insurers to see what they can do for your circumstances.
Maternity Care
Childbirth and maternity care are of an excellent standard in Portugal, and this is often an expensive part of an insurance plan, so you might want to consider removing it from your policy if you want to keep your premiums low.
Portugal does have quite an old-fashioned view of childbirth, though, which means that if you go to a public doctor you might find that your options are restricted. For example, they might not have provisions for giving birth in a birthing pool or at home; and they might not be able to offer you the pain medication you would have been offered back home.
Having a baby in a private hospital will set you back a few thousand euros if you pay for it yourself, even if there are no complications during the delivery. However, some people still choose to do this rather than adding it onto their health insurance policies.
This decision will largely be based on cost: depending on how long you are spending in Portugal and how many babies you plan to have while you are living there, you might find that paying for a one-off birth in a hospital will be cheaper in the long run than paying the increased premium over the course of several years.
Optional Extras
Other optional extras should be carefully considered when you are looking at quotes from different insurers. Bear in mind that some of these might be included by default; you may need to speak to an insurance agent directly to find out whether or not they can be removed.
Things like repatriation and medical evacuation are touchy subjects, but it is worth thinking about how likely you are to require them and what you would want to do in the event of a serious emergency.
Medical evacuation to another country is normally a popular option in places where the local health system is understaffed or otherwise inadequately equipped to deal with serious cases, but this is not the case in Portugal, so you might be happy being treated at a hospital in the country.
Repatriation of remains is a very popular option with expats. Although it is tempting not to think about what will happen in the event of your death, it is important to make these kinds of decisions to prevent your loved ones from having to make difficult choices and sort out extra cover in the event that the worst happens.
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