The Portuguese health system works on a three-tiered basis. Most people living in Portugal, regardless of whether they are in full-time employment, will be covered by the state health system, which is generally free at the point of service with a few small exceptions. If you work in a profession which is covered by its own health insurance — for example, if you are a civil servant — then your healthcare will be funded by the state through the professional body that deals with your employment.There is also the option to take out private health insurance in Portugal. Some expats choose to do this even though they ultimately plan to become residents, since it can help to have some insurance in place until your residency has come through, and until your state healthcare has been set up.
In order to register with the public health system and find a doctor, you will first of all need to have legal residency. You can apply for this through your job if you are employed by a company in Portugal; otherwise, you will have to set it up for yourself. Once you have residency, you will be sent a social security number. If you apply for, and are granted, Portuguese citizenship, you will also receive a citizen card.
Once you have either a social security number, or a citizen card, or both, you can register with the health system. All you need to do is take these along to your local health centre and ask for the required forms to fill in. They will need to take certain details from you and then you will receive a health card (cartao do utente), which you will need to take with you to any health appointments.
If you do not have residency but you are staying in Portugal for longer than 90 days, then you should go to the local council office in your municipality and request a certificate. They will need to see proof of ID and your visa that shows you are in Portugal legally. Once they have issued you with your certificate, you can take this along to health centres like you would a health card and you will be given care under the state system.
If you are staying for less than 90 days, then you will need to either take out private health insurance, or take advantage of your home country’s reciprocal healthcare agreement with Portugal if it has one. You can use your EHIC card if you are from another EU country, although this is only meant for emergencies and should not be used in lieu of full health cover. Andorra, Brazil, Cape Verde and Morocco have separate health agreements with Portugal, so if you are from one of these countries then you might be eligible for free healthcare during your stay.
The local health centre you visit to pick up your health card should automatically assign you a doctor who works there. If you want to make sure you find a doctor who serves your specific needs — for example, if you want one who speaks fluent English — then it is a good idea to do some research beforehand and find out which health centre you should visit. You can go to any health centre as long as it is in your local area.
Once you have registered, you will be able to make an appointment to see your new doctor. Most health centres offer a walk-in service during opening hours as well, although the waiting times for this will be long.
If you are working in Portugal then you will be charged a small fee to see the doctor, usually just under €5. If you need the doctor to visit you at home then the charge will be around €10, and if you need to stay in hospital then you will be charged around €25 per night. You will be exempt from these fees if you are retired, and any children will not need to pay anything. If you are on a very low income, you might also be exempt; check with your local health centre when you register for your health card to see what the threshholds are.
If you are in Portugal for a short period of time, or if you are not a resident there, then you will probably need to take out health insurance. Even those who plan to stay in Portugal for the long term often choose to take out insurance to cover their needs until they have registered with a local doctor.
The best way to find the right insurer for you is probably to look at which health centres in your local area offer private care, and which insurers they work with. Once you have narrowed down your options in this way, you can check online for price comparisons and get quotes from a few insurers before you make your decision.
Insurers will need to know about any pre-existing medical conditions you might have. Some of them may refuse to insure you if you have an existing condition, whilst others will insure you but the premiums will be higher. They will also ask about your residency status and the length of your stay.
You can sign up for private health insurance online, and you can then take the proof of your insurance to a local private clinic that works with your insurer and ask them to register you with a doctor. Most private practitioners in Portugal, especially in the larger cities, will speak English.
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