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Healthcare and Health Insurance for Americans & Canadians Moving to Portugal

Americans & Canadians moving abroad should understand the medical landscape before making the move. Having a plan in place for meeting your primary care, emergency care, elective care,  and medication procurement, can give you peace of mind, and ensure that you and your loved ones are taken care of in any event.

Healthcare in Portugal

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Healthcare overview for expats in Portugal

Portuguese healthcare is generally considered very good. It was ranked #12 in healthcare efficiency by the World Health Organization (above #37 USA) and #24 in the Numbeo 2022 health care index (above #33 USA). The country has around 200 hospitals, about half of which are private facilities. The Azores and Madeira have separate public healthcare systems

 

Portugal has both a national public healthcare system (the Serviço Nacional de Saúde, or SNS) and a private system. Public healthcare is high quality, although there are often long wait times to see specialists and for scheduled procedures. Public health insurance covers most costs within this system, but there are often small fees to pay

 

Private healthcare typically allows for seeing doctors and specialists faster, private hospitals are usually more modern, and staff are more likely to speak English. Private healthcare is accessible on a pay-per-visit basis, or private health insurance may reduce your costs. Approximately 20% of Portuguese have private health insurance.

 

Private insurance is required to get a temporary stay visa (includes D7, D2, and Golden visas). This requirement is waived once permanent residency or citizenship is achieved (possible after 5 years).

 

Dental care is only covered by public healthcare insurance for "vulnerable groups" and optical care is not covered.

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Costs

This is a sample of out-of-pocket fees under Portugal’s public health system:

Portugal public healthcare costs

Private healthcare costs will be significantly higher, but still well below U.S. healthcare costs. For example, a wellness visit costs approximately €50 out of pocket in Portugal without insurance, while a dental cleaning costs about €25. 

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Expat Health Insurance in Portugal

Insurance can help reduce the cost of private healthcare. With insurance, you'll likely use private hospitals for most needs, but you will probably still use the public system from time to time (e.g. for emergencies and some referrals). Insurance costs average under $50 per person monthly (although this depends on many factors like age and pre-existing conditions).  Many insurers have age restrictions and won't cover pre-existing conditions, although this isn't always the case (look at MGEN in particular for pre-existing condition cover).

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Our Recommendation

We recommend looking into private health insurance options from the largest Portuguese providers, regardless of health status. For those with ongoing health issues or those taking expensive medications, we strongly recommend private insurance.

 

Popular health insurance providers include: 

  • Multicare 

  • Médis

  • AdvanceCare

  • Allianz

  • Medal

  • MGEN

  • Fedelidade

 

You may choose to purchase a plan from an international provider targeting expats like Cigna Global or Allianz International. These are typically more expensive and only worthwhile if you want to use your plan in multiple countries.

 

Many policies don't cover outpatient costs. Remember that outpatient fees in Portugal are typically much lower than in the US, so an inpatient-only policy may be right for you if you have no current health issues.

 

Regardless of provider, always check the fine print to be sure there are no clauses that give insurers the right to cancel your policy once you reach a certain age.

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