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Public health in Portugal for tourists

15
Oct
2021
One of the most frequent doubts of those who come to live in Portugal has to do with public health. As it is one of the main problems in several countries, this concern is common.
The public health system in Portugal exists and is of quality, however, it is necessary to know that it is not free.
We will understand how health works here, how tourists can access public health care, costs and how to apply.
At the end, you can leave comments on the post. We are curious to know. What do you like most about Portugal, in terms of public health? Share your experience with us.
 
Do you have public health in Portugal?
Yes, there is public health with universal access in Portugal, the NHS – National Health System. However, despite being public, it is not completely free, but the amount paid for medical care, in some situations, may be free.
In general, when it is paid, the amount is low and affordable, whether for consultations, medical procedures, medication or exams. If you want to live in Portugal, know that the public service is of quality and you can access it on an equal basis, as long as you meet the requirements that we will mention later on.
 
How does public health work in Portugal?
Public health in Portugal is based on primary care, the family doctor is responsible for the first contacts between users and specialists. Basically, it is at the health center that the first visits and routine consultations take place. He is responsible for welcoming users.
But in the health centers there are also some emergency care services, users, as patients are called, can seek care in simpler cases in these places. In some specific situations, they can be referred to specialists as needed.
 
How much does healthcare cost in Portugal?
The health system in Portugal, despite being universal, is not free. It features user fees, a way found to avoid unnecessary access to medical appointments and care. Thus, you have to pay to be assisted in the health system.

User fees for public service
The value of user fees is almost symbolic. A general and family medicine consultation costs €4.5, while a specialist consultation costs €7. In hospitals, the values ??are higher, for example, a basic emergency costs €14, while a medical-surgical emergency costs 16€.
Since 2020, primary health care consultations in health centers are no longer paid, as well as complementary diagnostic tests prescribed in these consultations and carried out in public health institutions. As of 2021, all exams prescribed in health centers are no longer paid for.
 
Who is exempt from user fees?
But not all residents in Portugal need to pay for care in the public health service, there are some situations in which care is free. Are they:
 
- Pregnant;
- Children and young people up to 17 years and 364 days;
- Users who have a degree of disability equal to or greater than 60%;
- Blood donors;
- Cell, tissue and organ donors;
- Firefighters;
- Transplant patients;
- Military and ex-military members of the Armed Forces who are permanently disabled due to military service;
- Unemployed persons registered at the employment center with a subsidy less than or equal to 1.5 x IAS (€653.64), provided that they cannot prove the condition of economic insufficiency as provided for. The payment exemption is extended to the spouse and their dependents;
- Asylum seekers and refugees, as well as their spouses or equivalent and direct descendants;
- Users in a situation of economic insufficiency and their dependents (who have an income equal to or less than €653.64).
 
Average values for private service
Private services have a much higher value. An appointment with a specialist can reach €80. While an emergency service reaches €100.An echocardiogram can cost between €131 and €252, an X-ray can range from €30 to €212. For users of this service, a normal delivery can cost between €2,160 to €3,583, if a cesarean is needed, the values ??can reach €5,075.
Values ??may vary from one hospital to another, these were identified at the CUF Hospital in Porto.

Are all citizens of the world able to have a family doctor in Portugal?
No. Especially in big cities and health centers that have a higher population density, getting a family doctor is very difficult. About 700,000 residents still do not have a family doctor assigned, which corresponds to less than 10% of the population. However, all children born in the country are automatically assigned a GP in the area in which they reside.
 
Do you need to have health insurance in Portugal?
Not necessarily. The public health service is of quality and serves the entire population well. However, you must consider that in the public system the family doctor will be the first contact with medical care and, only if necessary, will you be referred to a specialist.
Health insurance, as the health plan in Portugal is called, is cheap, around €39 per month. However, in general, the plans work in the co-participation system, that is, at each consultation or exam, you have to pay partially for the service, not being fully included in the monthly fee, which can end up having an influence on the budget.
If you are the type of person who prefers to go straight to the specialist, health insurance can be a viable option, so you do not need to go to the family doctor when you need specific care and you will have greater speed in solving health problems.

How care works at the Health Center
The service in health centers works initially with consultations with the family doctor, it is the first step in the service. In general, the health center offers scheduled care, when an appointment with the doctor is scheduled in advance, and also emergency care, when it results from an acute illness.
And in hospitals?
Hospitals in Portugal operate in an integrated manner, in general, there is public management that administers several hospitals in the same location. This model facilitates integration between health facilities and distribution.
 
What about medications?
Public health in Portugal goes beyond medical care, there are also drug subsidy programs. This is the case of reimbursed medicines, on which the government pays part of the value and the user pays the rest.
There are 4 reimbursement levels, ranging from 90% to 15% of the drug's value. In tier A, in which the discount is 90%, there are hormonal and immuno-modulating drugs, for example. On the B side, there are cardiovascular and anti-infective drugs, a category in which discounts are 69%.
Steps are defined according to the pathology. There is also a special co-payment scheme, aimed at pensioners, in this category the discount is 95% level A and 15% higher in the others, thus, the discounts are accumulated.
 
And the coronavirus pandemic, has public health in Portugal dealt with?
Portugal was highlighted in the fight against coronavirus internationally. While many European countries suffered from overcrowded hospitals, the country set up field hospitals that were never needed. There were many preparations to attend to the sick, from the postponement of appointments and non-urgent surgeries, to the definition of referral hospitals in the first moments.
The public health system in Portugal was able to withstand the first wave of the disease well, at the peak of the disease in the country, in April, about 54% of the places in intensive care were occupied, which left the system far from saturation.


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