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Portugal - Health Service
The standard of healthcare is generally high in Portugal with more limited resources in rural areas. For the most part hospitals are large, clean and equipped with state of the art equipment and facilities. In both private and public institutions English is spoken by doctors and nurses. Healthcare is divided into the state funded Portuguese Serviço Nacional de Saúde (SNS) hospitals plus health centres and and privately run hospitals.
State healthcare (Serviço Nacional de Saúde) in Portugal is paid for by social security contributions (segurança social) of those living and working in Portugal. Both employees and employers plus those who are self-employed contribute through their taxes with such payments covering pensions, disabilities and maternity whilst the Portuguese government pays for healthcare coverage. Old age pensioners receive subsidised prescriptions and those who have certain classifications do need to pay for non-essential medicines, other members of the public do. Dental treatment is provided by the SNS as well as treatment by GPs and consultants. The SNS is managed by the Ministry of Health who also develops health policies.
Public hospitals provide emergency medical care and specialised consultations. For further care there are local family units as well as long-term care units which may be separate or attached to the main hospital. Secondary and consequently tertiary care is mostly provided in hospitals. There are limited resources for full care such as post-operative care, terminal illness or psychiatric treatment. Individuals will most probably be transferred to a more suitable unit. Public hospital treatment is useable by anyone in Portugal wherever they are from, but if without the SNS or medical insurance full payment will be necessary. Some consultations and vaccinations are free but others are not.
Private hospitals have higher standards of facilities, faster appointment and consultancy times and almost no waiting. They have skilled and English speaking staff and local specialists. Private healthcare will see those who have it still pay for prescriptions as they pay annual or monthly healthcare fees to their healthcare providers but for emergency and non emergency hospital treatment and specialists, private healthcare covers the costs. There are also private GP practices which are funded mostly by private insurance contributions. Those with the appropriate private healthcare can see such independant practices for consultations and references to specialists.
Health centres (centros de saúde)
Health centres are the most accessible places for healthcare all over the country. They provide outpatient care, specialist services, general practice care, care for children and maternity care and medical aid. Qualified nurses and doctors work within health centres. Locals and foreigners register here to be assigned their doctor with it being the go to place for doctors appointments and referrals to hospital if necessary.
The Portuguese Constitution states that all citizens are privy to receive global health care. Those able to access the SNS are stateless persons residing in Portugal, asylum seekers, foreign citizens residing in Portugal with regards to reciprocity, Portuguese citizens, EU member citizens. The unemployed, those with long term sickness, those on maternity leave and old age pensioners do not have to pay healthcare contributions and are able to access the SNS. A small charge is paid per appointment or treatment. Those who are relatives of people who have contributed to the Portuguese social security system can also register with the SNS.
To access the SNS both Non EU and EU individuals need a valid Portuguese residence permit. By visiting your local health centre and bringing a valid identity document, residence permit and social security beneficiary’s card you will be given an SNS card, with a doctor assigned to you.
EHIC (The European Health Insurance Card (Cartão Europeu de Seguro de Doença – CESD)
If you are an EU citizen make sure you have your EHIC with you so that any emergency treatment you need costs the same as that of a local person. Maternity care will be covered with this card plus ongoing treatment of a medical condition. If you’ve paid for treatments it may be that you can get reimbursed if you claim the costs to the Administracão Regional de Saúde where there are offices throughout the Azores, Madeira and Continental Portugal.
If you are a non EU citizen health insurance/private health care is necessary whilst you reside in Portugal. Once you begin employment and start paying social security contributions and become a Portuguese resident then you can use the permit to gain access to the SNS.
Any foreign visitor will be treated for emergency medical treatment. The costs will not be free- though private medical insurance for non EU members will cover the costs if they have it or holders of the EHIC will have discounted rates and perhaps some treatments for no cost. Other EU citizens who have an E111 document from their birth country can use this to cover their costs from their insurance company in their home residence.
Gostaria de ver um medico - I would like to see a doctor
Chame uma ambulância - Call an ambulance
Gostaria de marcar uma consulta - I’d like to make an appointment
Estou doente - I don’t feel well/ feel ill
An individual must be 18 to buy or smoke tobacco products in Portugal with a ban on vending machine distributions. As of 2015 it is prohibited to use electronic cigarettes containing nicotine or smoking of any kind to occur in closed public spaces. It is not permitted for anyone to smoke in public places as listed on the Protection of Minors webpage under Portugal. Having previously been allowed to smoke in closed public spaces with adequate air extraction fitted, those who want to smoke have to redirect themselves to establishments such as bars or restaurants with blue stickers (smoking allowed). There are also red sticker (non-smoking) establishments. In restaurants there is usually a separate smoking room if they have a blue sticker so meals can be eaten in separate rooms. In bars, you can experience a fair amount of smokers inside particularly in places like Lisbon in the colder months, though they’ll head outside in the warming months.
As of 2016 the World Health Organisation released data representing the percentage of smokers aged over 15 in the country at 22.2%. Attitudes to smoking vary though due to the choice of blue and red sticker establishments, there is the choice to live life how you choose. Local smokers and some establishments are positively casual about the laws and have barely changed their approach. It depends where you visit, Oporto and Lisbon may appear to have a higher prevalence of smokers. The overall aim is to entirely restrict smoking in public places by 2020.
According to the 2015 figures from the Institute for Health Metrics and Evaluation the life expectancy of a Portuguese male is nearly 78 years and for women it is nearly 84 years. The top causes of death in the Portuguese population are strokes, coronary heart disease and Influenza and pneumonia plus cancers. Common serious health issues are lung disease, heart disease and diabetes. As of 2014 a Eurostat survey on obesity found 16.6% of total adults in the population were categorised as obese though this figure is within the lower 50% of countries in the EU.
The following link from the Centre for Disease Control (U.S) is useful in highlighting potential vaccinations/immunisations before heading to Portugal or if you are coming from a country where Zika may be present.
There are a number of English speaking counselling services available:
Alcoholics Anonymous: (Alcoólicos Anónimos)
Tel: 217 162 969
Cancer Help Line: (Linha Contra o Cancro)
Tel: 808 255 255
Portuguese Anti-Alcohol Society: (Sociedade Anti-Alcoólica Portuguesa)
Tel: 213 571 483
Phone service- HIV/AIDS (Linha SIDA)
Tel: 800 266 666
Suicide/Crisis Line (SOS Vos Amiga)
Tel: 800 202 669
Befrienders worldwide hotline for suicide prevention (Voz De Apoio)
Tel: AM 351 966452204 // PM 351 225 50 60 70
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