Private Health Insurance

Private health care in Portugal

Private Health Insurance

If you aren’t covered by Portuguese social security you should take out private health insurance.

It’s advantageous to be insured with a company that will pay large medical bills directly. Most private health insurance policies don’t pay family doctors’ fees or pay for medication that isn’t provided in a hospital or there’s an ‘excess’, e.g. the equivalent of around €75, which often exceeds the cost of treatment. Most will, however, pay for 100 per cent of specialists’ fees and hospital treatment in the best Portuguese hospitals.

The cost of comprehensive private insurance with a Portuguese company varies considerably and can be very expensive, although young families generally get comprehensive coverage at very competitive rates.

Note that Portuguese companies usually only provide health insurance for those under 55. If you are older you will have to consider health insurance from a foreign company. Generally, the higher the premium, the more choice you have regarding doctors, specialists and hospitals.

You should avoid a company that reserves the right to cancel a policy when you reach a certain age, e.g. 65 or 70, or which increases premiums sharply as you get older, as to take out a new policy at the age of 65 or older at a reasonable premium is difficult. If you already have private health insurance in another country, you may be able to extend it to cover you in Portugal.

Changing Employers or Insurance Companies

When changing employers or leaving Portugal, you should ensure that you have continuous health insurance. If you and your family are covered by a company health plan, your insurance will probably cease after your last official day of employment. If you’re planning to change your health insurance company, you should ensure that important benefits aren’t lost, e.g. existing medical conditions won’t usually be covered by a new insurer. When changing health insurance companies, it’s wise to inform your old company if you have any outstanding bills for which they’re liable.

Health Insurance for Visitors

Visitors spending short periods in Portugal (e.g. up to a month) should have a travel health insurance policy, unless they’re covered by an international health policy. If you plan to spend up to six months a year in Portugal you should take out either a travel, special long stay or international health policy, which should cover you in your home country and when travelling in other countries.

Note that premiums vary considerably and it’s important to shop around. Most international health policies include repatriation or evacuation (although it may be optional), which may also include shipment (by air) of the body of a person who dies abroad to his home country for burial. Note that an international policy also usually allows you to choose to have non-urgent medical treatment in the country of your choice.

Most international insurance companies offer health policies for different areas, e.g. Europe, world-wide excluding North America, and world-wide including North America. Most companies also offer different levels of cover, for example basic, standard, comprehensive and prestige.

There’s always an annual limit on the total medical costs, which should be at least €350,000 (although many provide cover of up to €1.1m or more) and some companies also limit the charges for specific treatment or care such as specialists’ fees, operations and hospital accommodation. A medical examination isn’t usually required for international health policies, although pre-existing health problems are excluded for a period, e.g. one or two years.

Claims are usually settled in all major currencies and large claims are usually settled directly by insurance companies (although your choice of hospitals may be limited). Check whether an insurance company will settle large medical bills directly, as if you’re required to pay bills and claim reimbursement from an insurance company it can take several months before you receive your money (some companies are slow to pay).

It isn’t usually necessary to translate bills into English or another language, although you should check a company’s policy. Most international health insurance companies provide emergency telephone assistance.

The cost of international health insurance varies considerably with your age and the extent of cover. Note that with most international insurance policies, you must enrol before you reach a certain age, e.g. between 60 and 80 depending on the company, to be guaranteed continuous cover in your old age.

Premiums can sometimes be paid monthly, quarterly or annually, although some companies insist on payment annually in advance. When comparing policies, carefully check the extent of cover and exactly what’s included and excluded from a policy (often indicated only in the very small print), in addition to premiums and excess charges.

In some countries, premium increases are limited by law, although this may apply only to residents in the country where a company is registered and not to overseas policy holders. Although there may be significant differences in premiums, generally you get what you pay for and can tailor premiums to your requirements.

The most important questions to ask yourself are: does the policy provide the cover required and is it good value for money? If you’re in good health and are able to pay for your own out-patient treatment, such as visits to a family doctor and prescriptions, then the best value is a policy covering specialist and hospital treatment only.

Further reading

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