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National Health System for Expats in Portugal

Submitted: August 2014

The right to health is recognised by the Portuguese Constitution of 1976. Consequently, Portugal has a comprehensive national health system, called National Health Service (Serviço Nacional de Saúde – SNS). The SNS ensures universal access to subsidised healthcare for all residents.

Entitlement is based on:

Social security contributions have to be paid by those currently in work, i.e. employees and the self-employed. This should extend to their dependants and the retirees receiving a pension from the Portuguese Social Security (Segurança Social).

All those who do not pay social security contributions, e.g. the unemployed, are still entitled to subsidised healthcare services, but they would need to prove they have resided in Portugal for at least three months. In this case, funding comes from general tax revenue.



If you have come to Portugal as an employee, and Portuguese social security contributions are deducted from your pay, you should have been automatically by your employer. If you are self-employed, you must register with the Social Security Institute if your annual profit exceeds 6 times the social support index (Indexante dos apoios sociais – IAS), i.e. €2,515.32.

You then have to get to your Local Health Centre to register and be assigned a doctor there. You should bring:

A healthcare card (Cartão do Utente) should then be issued by the Local Health Centre. This process can take up to several months, but a temporary certificate of registration may be issued immediately. You should carry your healthcare card with you at all times.



The Portuguese healthcare system has a co-payment mechanism (Taxa moderatora). This means that healthcare services are strongly subsidised without being totally free. The purpose is to ensure that you get an incentive not to overuse health services.

There are exemptions or reductions for those seen as the most vulnerable groups, such as:


Excluded services

Certain important services are generally excluded from SNS coverage. This can be, for example:



The Portuguese economy has been particularly hit by the Eurozone crisis, with the public finances under severe pressure. Accordingly, Portuguese policymakers are strongly committed to delivering better services with less.


European Health Insurance Card (EHIC)

If you come from another EEA country or Switzerland, the EHIC normally grants you access to public healthcare on the same conditions as Portugal residents while you are temporarily visiting Portugal, unless you specifically come to Portugal to seek treatment. However, your EHIC may be invalidated by your country of origin if you are no longer residing there.

It is generally advised not to rely solely on your EHIC. European expats should therefore seek health or travel insurance to supplement their EHIC.


Expats insured by an overseas social security scheme

If you have come to Portugal as an expat and you are in fact still covered by the social security scheme of your home country, you may get subsidised healthcare in Portugal on the same basis as the other Portuguese residents. However, the bill will eventually be paid by the social security scheme of your home country.

Should you come from an EEA country or Switzerland, you would need to get a portable document S1 from your home country, and then register your portable document S1 with the Portuguese authorities. This may have to come with a portable document A1 in order to ensure you pay social security contributions in your home country only.

Similar arrangements may apply if you do not come from an EEA country or Switzerland, but this will depend on the terms of the bilateral social security agreement between Portugal and your home country, if there is any.

To date, Portugal has entered into social security agreements covering sickness and maternity with: Andorra; Brazil; Cape Verde; Channel Islands; Isle of Man; and Morocco.


Medical expense tax credit

Medical expenses incurred by Portuguese residents or their dependants attract a 10% tax credit up to €838.44, i.e. 2 IAS. This cap is increased by €125.77 for each dependant for families with at least 3 dependants.

Private health insurance premiums are eligible for a 10% tax credit up to €50 for single individuals (€100 for married couples). This cap is increased by €25 per dependant.

The medical expense tax credit is part of a number of tax credits under the Portuguese tax system (e.g. educational expenses, alimony payments, mortgage interest, rental costs). These expenditures are subject to an overall tax credit cap which starts for individuals whose income exceeds €7,000. Those earning more than €80,000 per year are not eligible for tax relief whatsoever.



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