European Health Insurance Card (EHIC)

What is the European Health Insurance card?

It is a free card that gives you access to medically necessary state provided health care during a temporary stay in EU member countries and certain other European countries. In Portugal this card can only be used for public services and not private clinics like ours.

Our clinic is based in Albufeira Council area and the only place this can be used is Centro de Saude, Albufeira. You have to register at the casualty department and wait to be seen. This is arranged through their triage system. Treatment is still not free however, and you have to pay the fee they ask at the time of registering. No appointments can be booked; you have to sit and wait to be seen.

The card is not an alternative to travel insurance, does not cover any private healthcare costs, will not cover anyone travelling for the express purpose of obtaining medicial treatment.

When you move your habitual residence to another country, you should register with the S1 form instead of using the EHIC to receive medical care in your new country of habitual residence.

How to get medical care in Portugal?

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What to do first?

In Portugal, healthcare needs are met by the National Health Service (Serviço Nacional de Saúde). The service provides healthcare through health centres and public hospitals.

To register with the SNS you should stop by the health centre in your area of residence once you have moved to Portugal. You should bring with you a valid identity document, a Portuguese social security beneficiary letter and a residence permit. The health centre will give you a SNS card under your name and assign you to a family doctor.

Those that have contributed to the Portuguese social security system may also register with the SNS. For those over the age of 65, there are also subsidized prescriptions available.

Public Health Centres (Centro Saude), provides family medicine, public healthcare, nursing, vaccinations and several diagnostic tests. Hospitals will provide specialised consultations and emergency care.

Once registered with the SNS, you will pay a small charge for each appointment or treatment you receive. A regular appointment at a health centre costs around EUR 5 and an emergency consultation in a hospital costs around EUR 20. If you do not qualify to register with the SNS, then you will have to use a private clinic.

The cost of medicine in most cases is partly subsidized by the state. Medicines which are vital for treating specific illnesses are usually covered. Prescription medicine is mostly sold at pharmacies which can be recognised by the green cross. Pharmacies can be found throughout the country and are usually open Monday to Friday from 9am to 1pm and then again from 3pm to 7pm. On Saturdays they are only open in the morning.

In case of an emergency, remember that the number to dial is 112. Police, Fire Brigade, Ambulance.

Usefull information for expats

Expats looking to spend an extended amount of time in Portugal or move there permanently might find that the country’s healthcare system poses a number of significant challenges.

Both public and private healthcare options are available in Portugal. Private healthcare in Portugal is steadily gaining popularity among expats and becoming more readily available. The public healthcare system in Portugal continues to frustrate and disappoint locals and expats alike. Public hospitals in Portugal and clinics are frequently understaffed and overcrowded. The shortage of physicians has caused longer than necessary waiting lists for non-life threatening surgeries and a greater strain on the system as a whole, which often forces Portuguese nationals and expats alike to use the emergency room services as a general practitioner. At the public level, technology is often lacking and it can be difficult to arrange an appointment with a specialist.

Expats moving to Portugal will find it reassuring that many doctors are conversant in English. This is true of both public and private healthcare facilities in Portugal.

Whether other employees in the health sector, such as nurses and technicians, speak English will depend on the location of the facilities. Areas with a larger expat population, such as Lisbon and the Algarve, will naturally have more bilingual employees. Expats living in rural parts of Portugal should not rely on healthcare professionals to speak English and should ensure they can speak an adequate amount of Portuguese in order to communicate at the local hospital or clinic.

Private healthcare is the best option for those who can afford a relatively low-cost health insurance policy.

Long queues and crowded waiting rooms are almost never seen in private health clinics or hospitals in Portugal. Doctors at private establishments in Portugal are generally skilful and more attentive.

The popularity of private medical care is growing amongst expats and locals in Portugal. Private facilities are also becoming more readily available in urban areas, which are just a short drive away from most rural zones.

Most banks in Portugal now offer information on their choice of private health insurance provider. While some larger corporations and government bodies offer private health insurance to their employees; this is not the norm, nor is it required by law. Therefore expats should be prepared to pay for their own healthcare expenses whilst living in Portugal.

Pharmacies and medicines in Portugal

Pharmacies in Portugal are widely available and easily accessible. They can be found in most town centres and shopping malls.

Since many medications are subsidised, with the proper prescription from a general practitioner or specialist, medication can be obtained for a very low cost. The subsidy depends on the type of medication and its requirement, and the residential status of the patient. You can only obtain subsidised medication if you are registered on the Portuguese national health prescription data base.

Emergency services in Portugal

Emergency services in Portugal can be reached by dialling 112.

Paramedics who respond during emergency situations are adequately trained, generally proficient and considerate.

In serious emergency situations, it is not unusual for patients to be quickly transferred from a less well-equipped hospital to a more specialised care unit in the closest large city.

Having a baby in Portugal

Maternity care is covered by the national health system, and an expectant mother receives care at the public hospital in her area, unless otherwise requested by her practitioner. A woman may also choose to receive private care if she is insured.

Prenatal care also takes place at the hospital.During the first appointment, the mother-to-be will receive a Pregnancy Booklet (Boletim de Saúde da Grávida) in which her doctor will record ongoing medical information as the pregnancy progresses.

The birth itself will also take place in the maternity ward of the hospital. Home births are very rare in Portugal. A woman can choose to have a midwife (parteira) present to help with delivery and is allowed one other person, usually a partner or friend, in the room during labour.

Maternity benefits in Portugal

In Portugal the maternity leave is paid at 100 percent salary rate for 120 consecutive days or in two separate periods of leave: 30 days before the birth of the child and 90 days after that. If the mother would like to extend her maternity leave up to 150 days, then the extra leave is paid at 80 percent rate of her salary.

Paternity leave is allowed for working fathers for five days after the birth of the baby. These days do not have to be consecutive. However, a new father may have the same leave rights as a new mother in certain cases: death of the mother, physical or psychological incapability of the mother, shared decision by both partners to switch roles in taking care of the baby.

Dental care in Portugal

You and your dependents are entitled to receive dental care, once you are paying into your social security. The treatment is either free or subsidized. You will need to bring your Cartão de Utente (the document showing you are part of the NHS system) when visiting your dentist. This will ensure that you do not pay the full amount for the consultation. Children between 3 and 16 years of age, pregnant women and pensioners have the right to receive dental care for free. Please note however, that it is not easy to register with a dentist who will only offer state subsidised treatment, so please check carefully what when you register with a dentist. State healthcare is provided without charge, although state-funded dental care may not be available in your area.

You should be particularly careful if healthcare arrangements are made by a hotel or travel representative. They might reassure visitors that they can claim back whatever is paid out, but they are referring to private insurance and not the treatment given under the EHIC.

Always get adequate travel health insurance before you travel, and make sure you can access funds to cover the cost of any medical treatment abroad and repatriation. Repatriation for medical treatment can be very expensive and is not covered by the EHIC.

Remember to keep all receipts and any paperwork (make copies if necessary) as they might be needed by you or your insurance company to apply for any refund or reimbursement.