Benefits include general and specialist care, hospitalisation, laboratory services, discounted drugs and medicines, basic dental care, maternity care, appliances and transportation.
Most Portuguese are covered by Portugal’s public health scheme, including retired EU residents (with a residence card) receiving a state pension. If you aren’t entitled to public health benefits through payment of Portuguese social security ( segurança social) or receiving a state pension from another EU country, you must usually have private health insurance and must present proof of your insurance when applying for a residence card. If you’re an EU national of retirement age, who isn’t in receipt of a pension, you may be entitled to public health benefits if you can show that you cannot afford private health insurance.
Anyone who has paid regular social security contributions in another EU country for two full years prior to coming to Portugal (e.g. to look for a job) is entitled to public health cover for a limited period from the date of the last social security contribution made in their home country. Social security form E106 must be obtained from the social security authorities in your home country and given to your local social security office in Portugal. Similarly, pensioners and those in receipt of invalidity benefits must obtain form E121 from their home country’s social security administration.
You will be registered as a member of social security and will be given a social security card, a list of local medical practitioners and hospitals, and general information about services and charges. If you’re receiving an invalidity pension or other social security benefits on the grounds of ill-health, you should establish exactly how living in Portugal will affect those benefits. In some countries there are reciprocal agreements regarding invalidity rights, but you must confirm that they apply in your case.
Citizens of EU countries and European Economic Area (EEA) countries (Iceland, Liechtenstein and Norway) are able to make payments in their home country entitling them to use public health services in Portugal and other EU and EEA countries.
The Portuguese health system places the emphasis on cure rather than prevention and treats sickness rather than promoting good health. There’s little preventive medicine, although this has changed in recent years and there are now regular health checks for children and older people, and a full immunisation programme for children.
The public health service has limited resources for out-patient treatment, nursing and post-operative care, geriatric assistance, terminal illnesses and psychiatric treatment.
In the past the Portuguese health system was criticised mainly for perfunctory treatment due to staff shortages, long waiting lists as a result of a shortage of hospital facilities, and a general dehumanisation of patients. Many of these problems were related to crippling bureaucracy and bad management.
Although many of these problems still exist, the situation has generally improved greatly in recent years and the health system has become much more ‘transparent’. Among other things, patients now have a list of rights they can expect from the health service. However, it’s generally considered that the Portuguese health system is badly in need of a general over-haul (which has been promised by successive governments but has yet to materialise).
The department of social security in Portugal has a free telephone hotline ( linha verde) for information and enquiries operating Monday to Friday from 9am to 7pm (Tel. 800-290 029) and a comprehensive website (in Portuguese only), which includes downloadable documents and forms (www.seg-social.pt).
Reciprocal Health Agreements
If you’re entitled to social security health benefits in another EU country or in a country with a reciprocal health agreement with Portugal, you will receive free or reduced cost medical treatment in Portugal. EU residents should apply for a certificate of entitlement to treatment (form E111) from their local social security office at least three weeks before they plan to travel to Portugal.
The form E111 can be used for a stay of three months’ duration only. If you use the E111 in Portugal, you must apply for reimbursement to Portuguese social security (instructions are provided with the form), which can take a number of months. However, you can still receive a large bill from a Portuguese hospital, as your local health authority assumes a percentage of the cost only. Note that a form E111 issued abroad (i.e. not in Portugal) isn’t valid in Portugal if you’re a Portuguese resident.
Participating countries include all EU member states and most other European countries, excluding Albania, Switzerland and Turkey. The USA doesn’t have a reciprocal health agreement with Portugal and therefore Americans who aren’t covered by Portuguese social security must have private health insurance in Portugal. British visitors and those planning to live in Portugal can obtain information about reciprocal health treatment from the Department of Social Security, Overseas Branch, Newcastle-upon-Tyne, NE98 1YX, UK.