Healthcare in Portugal
A World Health Organization (WHO) ranking of global healthcare systems places Portugal’s at number 12. That’s below France (one), Italy (two), and Spain (seven), yet above the U.K., Ireland, and Switzerland, which are rated 18, 19, and 20, respectively. Canada receives 30th place, with the United States at number 37 on a scale that evaluates 191 countries.
Portugal has some of the finest doctors and medical training available anywhere. Teaching facilities include the School of Health Services at the University of Minho in the north, the Faculty of Medicine at the University of Coimbra in the center—renowned for its expansive research fields and Ph.D. programs—and the Faculty of Medical Sciences of the New University of Lisbon in the south. Many if not most doctors who graduate from these fine universities do studies and residencies in the U.K. and other European countries. Additionally, many of their upper-level courses use English language texts and are taught in English. This results in most medical professionals having some level of fluency in the lingua franca of the 21st century.
In big cities and tourist areas you are likely to find as good or better medical treatment as you have experienced in your home country. Even in a small town you can find excellent care. We know of an example in which an individual inhaled a cleaning vapor, temporarily closing down his lungs. Once able to breathe again, he left the tiny aldeia (village) where he lived and drove five minutes to the clinic in town. There the doctor on call recommended the person immediately drive to the hospital in Coimbra, 30 minutes away, to seek further consultation with another professional. Cost of the visit: €5 ($6.17).
After a 15-minute wait at the hospital, the person met with a doctor who ordered chest X-rays and some blood tests. They were taken and read within moments. Total time: 45 minutes. Cost, including consultation, tests, and X-rays: €7.50 ($9.10).
Like many other European countries, Portugal offers both public and private healthcare.
Public Healthcare in Portugal
The National Health Service of Portugal (Serviço Nacional de Saúde) is available to citizens as well as both temporary and permanent residents. As an expat, you must arrange for a Portuguese número de contribuinte, the equivalent of a Social Security Number, at your local Finanças office.
Once you have your Portuguese ID number and residence permit, head to your nearest Health Center to receive a User’s Card with a Número Utente. This allows unquestioned access to the state medical system.
One fact to note: To get a residence visa the first time, you must show proof of medical insurance for the duration of the visa period. Upon renewal, however, you will not be asked for this again. Our experience is that the system is available to all residents and citizens, as described in this chapter.
If you are a citizen of a European Union country, your ID from that country is honored in Portugal as well, entitling you to the same medical care available to Portuguese residents. You must have a European Health Insurance Card to receive care, though. This card can be applied for through your home country health service for those who are residents of an EU country. It is also known as the Blue Card or the Carte Azul. It allows for treatment of health conditions arising while traveling in countries in the European Union other than the one in which you have residency. In Portugal it is applied for through the Segurança Social web portal. You must have applied for a Número de Segurança Social before you can request it. This is different from the Número de Contribuinte mentioned above. It is important for non-EU immigrants to obtain as it allows travel throughout the EU, Switzerland, Norway, Iceland, and Liechtenstein without concern about a medical emergency.
The tax system collects contributions from all taxpayers toward the social services network. When services are rendered, the user will be charged a few euros, depending on the nature of the visit. Depending on your situation, the fees paid may be more or less than someone else’s. They are always low, as noted in the example of the friend above.
Portugal has an Integrated Medical Emergency System (IMES), which is highly respected and works quite well. It is accessed by calling 112, the European emergency number. You will see the system’s yellow cars speeding to emergencies in big cities on a regular basis.
Even some of the smallest towns have volunteer fire departments and medical services, engendering great pride among community members.
Private Healthcare in Portugal
There are many private clinics and hospitals available throughout Portugal, and the number is growing daily. You will find health services readily available in all but the smallest towns. Even then, since Portugal is not a large country, the nearest big town is never very far away.
The hospital network is somewhat more limited; most facilities are centered in larger, more populated areas. Every major municipality has access, though, to a hospital. Some hospitals operate on both a private and a public basis, making it important for the patient to request the service that he or she prefers.
Some of the larger private health networks are listed below.
- CUF is a hospital/clinic network in Central and Northern Portugal.
- Lusiadas clinics and hospitals.
- Private doctors and dentists. Some doctors work for the state and have their own private practice in addition.
- British Hospital in Lisbon.
Private Health Insurance in Portugal
Most middle- and upper-class citizens have private insurance, allowing on-demand access to a comprehensive network of private hospitals at minimal cost (in addition to public ones, of course).
Occasionally a clinic or hospital will offer both public and private care, so a patient must declare the type of service he wants when he arrives for his consultation. Depending on your age and health condition, private insurance can be had for as little as €4 ($4.93) per month, although usually it is more in the €40 ($49.33)-per-month-per-person range.
One insider tip worth noting is that ACP, the Automóvel Club de Portugal, has its own medical insurance plan available to members starting at the aforementioned four euros per month. Members with this plan can have in-home doctor visits for as little as €10 ($11.25) per visit as well as many other privileges from the private healthcare system.
Age is a limiting factor with respect to the companies that provide insurance. If you are older than 55, some companies won’t accept you into their plan, and at 65, the choices become very restricted. The Médis company offers competitive insurance up to the age of 75, and once in the plan you will not be cancelled. If you bank with Millenium BCP, you should know it is a partner with them offering certain other benefits as well.
Three dependable private health insurers are Fidelidade/Multicare (will insure over age 55), Tranquilidade (a multi-line insurance company), and Millennium Bank/Médis (insures over 65).
Sample Medical Care Costs in Portugal
Healthcare in Portugal costs a fraction of that in the U.S., and savings also exist for those from the U.K. and other countries who choose Portugal as a destination for routine and elective procedures. Some examples follow:
|Expense||U.S.||Portugal Public||Portugal Private|
|Doctor’s visit||$100||Free or €5 ($6.17)||€50 ($61.55)|
|Dental cleaning||$120||Free||€25 ($30.85)|
|Hip replacement||$40,000||Minimal Co-pay||€4,000-€20,000 ($4,924-$24,618)|
|Mammogram||$250||Minimal Co-pay||€75 ($92.32)|
Pharmacies in Portugal
Sometimes it seems there are as many pharmacies as there are cafés in Portugal. You can occasionally stand at an intersection in a small town and see the identifying flashing green neon cross on all four corners. It is important for the new arrival to distinguish between the two types of pharmacies in Portugal.
- The first is the traditional pharmacy or apothecary. It sells prescription medicines, those determined by the government to be available with a doctor’s written permission, although they are occasionally sold by the same pharmacies without a prescription, depending on the side effects. These pharmacies are part of the national health service, and if a medicine is dispensed with a doctor’s prescription, the cost is usually negligible. These pharmacies also sell over-the-counter painkillers, antacids, nutritional supplements, select body care products, etc. They can be recognized by the word Farmácia preceding the name of the pharmacy.
- The other type of pharmacy in Portugal is like the American-style drugstore but without the prescription drugs. It may look similar to the first but will not have Farmácia before the name of the business. As the cost of most patent and prescription medications is closely regulated, buying ibuprofen in one or the other will be virtually the same price.
It’s up to you which type to choose. If you need a prescription filled or want to ask a question about medication, seek out the first type. Pharmacists are professional and very well trained. Often you can avoid a trip to the doctor—and still get to see a white lab coat, because no pharmacist is without one—simply by speaking with your local person about a minor ailment. If you want to buy sunglasses, vitamins, headache medicine, or shampoo, look for the second.
Unlike some other businesses such as banks, the post office (correios), and retail stores, pharmacies here tend to stay open during the lunch hour. Even if one is closed, there will almost surely be another option, not only because of the proliferation of them, but because midday closing hours vary. Some are closed 12:30 to 14:00 (2 p.m.), others 13:00 to 14:30 (1 to 2:30 p.m.), and still others 13:00 to 15:00 (1 to 3 p.m.). They are very accommodating to emergencies as well.
There are two perks you’ll find in Portuguese pharmacies: As indicated above, some medications that are prescription-only elsewhere are available over the counter here. Also, medications are considerably less expensive than in the U.S. or other countries.