Portugal Public Healthcare System

All About Portugal’s Healthcare System
Planning to move to Portugal? Understanding how healthcare works should be a top priority. There’s a lot of conflicting information out there about medical care in Portugal. Should you rely on the public system, or opt for private care? What are the pros and cons of each? And how do you register with Social Security?
Below, you’ll find all you need to know about Portugal’s healthcare system—costs, waiting times, and key considerations to guide your decisions.

The Public Healthcare System

How Do You Get Medical Care in Portugal?

Portugal’s public system is provided by the government through the Serviço Nacional de Saúde (SNS)—equivalent to Social Security. Everyone can access it, with no distinction based on residency or employment status.

Whether you’re Portuguese, born in Portugal, or a foreign resident, the constitution guarantees access to public healthcare for every kind of treatment.

A Dual System: Public and Private Care

When seeking medical attention in Portugal, you essentially have two options:

Public Healthcare
Private Healthcare

Public Sector Costs are largely covered by Social Security.
Private Sector Costs are handled through health insurance.

Important: Unlike in some countries (e.g., France), these two branches are completely independent. Public healthcare won’t reimburse you for services performed in private clinics (unless you started through public care and were referred). Conversely, your private insurance only applies to care in the private sector.

Health Centers for General Medicine

To receive public healthcare, you usually start at the health center (centro de saúde) in your area.

Registration: You’ll be assigned a family doctor (similar to a general practitioner) who’s your first point of contact.
Specialist Referrals: If you need to see a specialist, your family doctor arranges the referral.
Vaccinations: Typically administered at the health center, which supplies the vaccines directly—no need to purchase them at a pharmacy.

Emergency Services

For emergencies, you can go to a public hospital. On arrival, nurses give you a color-coded bracelet indicating urgency (triage system):

Red: Immediate care
Orange: Seen within 10 minutes
Yellow: Seen within 1 hour
Green: Seen within 2 hours
Blue: Seen within 4 hours

These times reflect how long before you see a doctor, not necessarily how soon your full treatment ends (especially if tests are needed).

Advantages of the Public System

Consolidated Medical Records
All your health data is computerized and stored in the RNU (Registo Nacional de Utentes). Any public healthcare professional treating you can access this record.
Nearly Free Care
You usually pay only a symbolic fee of a few euros for consultations and services.

Drawbacks of the Public System

Despite its benefits, the public system has some inefficiencies:

Shortage of Family Doctors
Over a million Portuguese citizens can’t be assigned a family doctor due to staffing shortages. If that happens in your area, you’ll be placed on a waiting list.
- Even without a family doctor, you can still see a GP in “consultas abertas” (open consultations), where a duty doctor handles daily urgent issues. However, you must visit the health center the same morning to get a slot.
Long Wait Times
The biggest downside is often the waiting period for appointments or routine exams—potentially months or even years. This is a primary reason many people also consider private insurance.
Severe Cases
If you have a serious illness like cancer, Social Security may authorize private treatment if public-sector delays are too long.

The National Users’ Registry (RNU): Your Digital Health Record

The RNU (Registo Nacional de Utentes) is part of the national health information system (SIS)—essentially your computerized medical file.

Public Only: It includes only your public healthcare history.
SNS Portal & Mobile App: You can access your record on the SNS Portal, created in 2016. Through this portal, you’re listed under a National User Number (NNU), also called “número de utente,” which works like a social security number.
Data Included: Personal details, health center info, your family doctor’s name, possible fee exemptions, medication and exam history, and vaccine records.
Identity Cards:
- If you have a Portuguese ID card, you present it at any health facility. The card is scanned to pull up your medical details.
- If you’re not Portuguese, you provide the “número de utente” you received at registration.

Registering with Portuguese Social Security (SNS)

To join Portugal’s public healthcare, register at the health center for your area:

They’ll issue you two numbers:
1. NISS (Social Security Number, 11 digits)
2. Número de utente (9 digits)

If you’re Portuguese, these IDs are already on your national ID card.

Getting a NISS

Working in Portugal: Your employer typically handles registration.
Family Registration: You may need to request NISS for your spouse or children.
Options:
1. In Person: Visit a Social Security office or health center.
2. Online: Fill out the official NISS request form.

Required Documents:

ID (Passport or national ID)
NIF (Tax ID Number)
Proof of residence (from the town hall if you’re not Portuguese)

Transferring Rights from Another Country

If you’re employed by a French company, for instance, you’d transfer your French coverage to Portugal via:

Requesting an S1 form from French Social Security.
Submitting that form to Portuguese Social Security.

This is mandatory when you contribute to a foreign system, so the two countries can decide how to coordinate coverage and reimbursements.

Getting a Número de utente

At the health center, you can obtain your “número de utente” with:

ID (Passport or national ID)
NIF (Tax ID Number)
Residence certificate

If you’ve been in Portugal less than 90 days and don’t have a permanent address, you can request a temporary número de utente. Call “Linha Saúde 2424” (+351 808 24 24 24) for instructions.

Public Healthcare Costs

Approximate fees in the public sector:

Under €5 for a family doctor visit
€7 for a specialist visit
€18 for adult hospital emergencies (free for children)

These rates vary depending on individual circumstances (e.g., minors, unemployed, or disabled may be exempt).

The Private Healthcare System

Private Health Insurance in Portugal

Portugal’s private healthcare system is entirely separate from the public SNS. Anyone can use it, but services cost more.

Insurance Recommended: Many Portuguese who rely on the private system pay for a private health insurance plan (akin to a “mutuelle” in France, but valid only for private facilities).

Monthly Premiums

Premiums depend on age, coverage levels, and medical history.
Rates typically fall between €15 and €30 per month, per person.

Understanding Co-Payment

A key concept is co-pagamento (co-payment)—the out-of-pocket amount you’ll pay for certain services.

Example: If your plan sets a co-pay of €15 for a specialist appointment, you always pay €15, and the insurance covers the remainder. Without insurance, the same visit might cost €80–€120.

Choosing Health Insurance

Provider Networks: Each insurance has a specific network of private clinics and specialists. Ensure the facilities near you accept that insurer.
Major Networks: Médis, Multicare, Saúde Prime, Allianz, AdvanceCare, Mapfre. You can request quotes on each provider’s website.

What Private Plans Often Don’t Cover

Many plans exclude:

Preexisting conditions (diagnosed before policy start)
Nervous or psychiatric disorders
Work accidents
Issues due to alcohol or drug abuse
Cosmetic procedures or plastic surgery
Transplants
Artificial insemination and infertility treatments
Obesity treatments
Alternative medicine

You’ll also want to watch out for waiting periods (sometimes up to six months) before coverage starts for specific treatments.

Portugal’s healthcare system offers two distinct pathways—public and private—each with its own pros and cons.

Public SNS: Generally low costs, centralized records, but potential wait times for specialists and a shortage of family doctors.
Private Clinics & Insurance: Faster appointments, higher costs, and monthly premiums.

By understanding registration steps (NISS and número de utente), typical fees, and how insurance works, you’ll be well-prepared to navigate medical care for you and your family in Portugal. Whether you choose public, private, or a mix of both, having the right info—and coverage—can make all the difference in ensuring you have the healthcare support you need.