# Comprehensive health insurance?



## geological

I realise Portuguese law and practice might diverge. Maybe few cameras insist on comprehensive health insurance. But it strikes me that at least migrants who retire early might in principle be required to swear that they have CHI in order to get their 'residencia'. (And maybe there will be a problem post a non-deal Brexit for pensioners when the S1 might not be available?) So my 2 questions are
1. In Portugal what constitutes 'comprehensive'? I read that in Spain this means zero deductibles. The same in Portugal?
2. What form a sworn statement should best take? I guess it should be in Portuguese. Or maybe also in English if the person swearing does not understand Portuguese? And witnessed by a Portuguese lawyer?


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## travelling-man

You don't say what passport you have but assuming a UK one & assuming pre Brexit then there is no requirement for you to have any health insurance to get residency. 

Before you have residency you should have an EHIC card from the UK & once resident you're entitled to the same more or less free NHS care as any Portuguese person. 

The S1 only refers to which country eventually pays the bill. 

If you've been asked to prove medical insurance you've been a victim of the variable bureaucracy syndrome that Portugal is famous for & the easiest way to get that sorted out is to contact the UK Embassy via their Facebook page which is called 'Brits In Portugal'


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## geological

Thank you very much. That is encouraging. The passport situation is:
A. British by birth and career. Irish passport. (Not aware of any way to prove British to Portuguese.)
B. As above but with British passport.
C. As above, with British passport but proof of Irish citizenship.
Reading the Portuguese law a lot seems to depend on the treatment of Portuguese by UK/ Ireland. As I understand it, in certain circumstances the UK insisted on CHI but this was contested by European Commission but now with the settled status regime CHI is not being insisted upon. Unclear what the situation in Ireland in practice is. By any chance do you know whether the Portuguese treat the Irish differently at the moment?

Also do you know about the form the sworn statements should take? This goes beyond the CHI issue as they would also be needed re self-employment, according to the relevant law.


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## travelling-man

I'm guessing but think either you or a Portuguese civil servant is reading the rules for holders of non EU member state passports instead EU member state passports. 

The correct process is: 

As you have a passport from an EU member state, you have the right to enter & reside. 

Once here, you need to go to a Fiscal Office (usually in the Camara/Town Hall) and get a Fiscal number/document & to do that you need to provide your passport, some kind of ID to show your address & a few Euros........ this should take about 20 minutes. 

After you've been here 3 months & before 4 months, (it can be before 3 months if you wish) you go to your local Camara & register your residency status with them. This document is called a Residencia & is valid for 5 years. You need to provide your passport, Fiscal Document (AKA NIF) address in Portugal & a few Euros.

Then you go to your local Junta/Council & get your Attestado and for that you need passport, NIF & Residencia. 

NOTE: 
Some Camaras require the applicant to get their Attestado before they’ll issue the Residencia but the Attestado attests that you are a resident & if you’re not yet resident how can it attest to that? However the easy answer to that is just to go with the flow & give them what they want. - If the person issuing the Attestado refuses to issue it before you have the Residencia just have one call the other & sort it out amongst themselves. 

As Portuguese NHS entitlement is now SOLELY based on residency, you're then entitled to register with a Doctor & get the same care as any Portuguese person. 

Now the variables........ Portugal sometimes suffers from variable bureaucracy where individual civil servants misinterpret the rules. 

A couple of examples are some Doctor's surgeries ask you to provide a social security number before you can register but this is no longer required.......... but if you're going to work, you need one anyway so easier to go with the flow & just get one from the SS office. 

If your not going to work then just tell the person at the Doctor's office to call the SS office & let them sort it out between them. 

Some Camaras (notably Penela) try to ask EU passport holders (sic) to provide proof of income or financial security but this should only apply to non EU passports & they have no right to ask for that. 

Some EU legislation does suggest that holders of EU member state passports do need 'sufficient funds' to gain residency but I can find no mention of having to actually prove 'sufficient funds' or what amount of funds is sufficient therefore assume that if the individual says he/she has sufficient funds then the funds they say they have are sufficient. 


Right to reside EU PPT holders & partners

http://www.sef.pt/portal/v10/en/aspx/apoiocliente/detalheApoio.aspx?fromIndex=0&id_Linha=4351 

UK entitlement to PT NHS with/without SS number 
https://www.nhs.uk/using-the-nhs/he...MWvk1kNlKOpch5hQuRUxLq3oSeUr58l1xz_CT1dH-V5jY 


How to register on the PT NHS in Portuguese & English

https://www.ers.pt/pages/438?news_id=1203 

If you need to complain about not getting registered on the PT NHS system: https://www.ers.pt/pages/356 

You can apply for your Portuguese EHIC card here: https://www.portaldocidadao.pt/en/w...eguro-de-doenca-da-seguranca-social-renovacao 

This link from SEF refers to “sufficient means” but fails to quote a figure of what constitutes ‘sufficient means’ & as SEF only deal with renewals for EU member state passport holders & all applications & renewals of non EU member state passport holders I’m not sure it’ll be of much help in many cases: 
https://imigrante.sef.pt/en/renovar...dbZLeUgGxW9PUPBA2bom4fOKZ-gopAA-R75LuBquGFrzw


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## geological

travelling-man said:


> I'm guessing but think either you or a Portuguese civil servant is reading the rules for holders of non EU member state passports instead EU member state passports.


Actually, I found we were referring to the same site your. Your link to the SEF site eventually led me here: https://www.sef.pt/en/Pages/conteudo-detalhe.aspx?nID=22

The relevant text is:
What do I need to apply?
Documents and Requirements:

1. A valid Identity Card / Passport; 

2. A written Affidavit declaring that you have a Professional activity as a worker or as self-employed in Portugal; or An Affidavit, declaring that you have sufficient funds for you and for your family, and that you are covered by health insurance when the same applies to Portuguese citizens in your country of origin; 

The law (Lei n.o 37/2006 de 9 de Agosto) mandates in the case of non-workers:
b) Disponha de recursos suficientes para si próprio
e para os seus familiares, bem como um seguro de saúde,
desde que tal seja exigido no Estado membro da sua
nacionalidade aos cidadãos portugueses;

Helpfully, the Lisbon Council website has the form they use: 
http://www.cm-lisboa.pt/fileadmin/D...o/Registo_cidadao_comunitario/SOCIAL_Mod2.pdf

I am not doubting that your advice might better capture the bureaucratic reality. But I guess it is best to be prepared for the worst case scenario.


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## travelling-man

Note the words "when the same applies to Portuguese citizens in your country of origin; "

As the UK doesn't require Portuguese people residing in the UK to have health insurance there is no requirement here.


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## geological

Are you inferring that or do you know? The situation is a bit nore complex than you claim if this is anything to go by (even leaving adide the Irish aspect):https://www.freemovement.org.uk/comprehensive-sickness-insurance-what-is-it-and-who-needs-it/


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## RichardHenshall

https://www.gov.uk/guidance/nhs-entitlements-migrant-health-guide


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## travelling-man

geological said:


> Are you inferring that or do you know? The situation is a bit nore complex than you claim if this is anything to go by (even leaving adide the Irish aspect):https://www.freemovement.org.uk/comprehensive-sickness-insurance-what-is-it-and-who-needs-it/


I guess it'd be more accurate to say that I've helped a fairish number of people who hold passports (mostly Brits) from EU member states countries to get everything from NIF to NHS registration & everything in between & not one of them have needed medical insurance if they have residency. 

It's a different situation with people on visas such as Type D but they're on visas not residency so their case is obviously & understandably different.


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## geological

travelling-man said:


> I've helped .... people who hold passports (mostly Brits) from EU member states ....& not one of them have needed medical insurance if they have residency.


That was never the issue for us. It was about getting residency without having to swear that you have insurance, but I think you know that! 

Can we agree that the procedures (as practised in Lisbon at least) can put people wanting to register their residency in an awkward position - effectively relying on knowledge that neither you nor I would seem to have been able to find about how the Portuguese government regards the position of Portuguese in the UK/(/Ireland)?


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## Ukkram

My wife has a South African passport and I have a Finnish one. Neither of us were asked for our financial position or health insurance even though we had private comprehensive health insurance. 

SEF sent my wife to the local health center to register for a SNS number and to be signed a house doctor. They in turn sent her to the local parish Junta for an Attestado to prove we live in the parish.

With the Attestado she was able to get her SNS number without any problems at all.

State health care became open to all residents regardless of where they come from. All residents are treated equally. Portuguese or not.


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## geological

Ukkram said:


> State health care became open to all residents regardless of where they come from. All residents are treated equally. Portuguese or not.


I am aware that SNS depends on residence. The issue is therefore just about acquiring resident status. Seems clear to me that if camaras were doing their job properly they would require people seeking residence to sign a form like the Lisbon one I linked to. Even if they did that anyone signing that (and is not employed/ self-employed) would be duty-bound to ascertain whether in their country of nationality Portuguese immigrants in an analogous position are required to have CHI. It would be nice if the Portuguese government laid out clearly which of the countries had that requirement. Otherwise it would be easy for those applying for residence to commit perjury. 

Happily we are in no such danger (being self-employed) but as some of the procedure is relevant to us (e.g. same form used in Lisbon) I thought it was worth raising. I am, of course, happy that the attitude seems to be "relax, everything is easy". This accords with my experience of Portugal so far. But what also accords with my experience so far is the tendency to make claims which ignore what the law clearly states.


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## Naaling

geological said:


> But what also accords with my experience so far is the tendency to make claims which ignore what the law clearly states.


That is not the case here!

In this situation the law is very straigtforward, and all of the claims made, by people who have responded, in this thread are consistent with that law.


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## Ukkram

This topic has been debated and all had the same experience as I had. There was no mention of that form in the link that must be signed.


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## geological

Naaling said:


> ...the law is very straigtforward, and all of the claims made, by people who have responded, in this thread are consistent with that law.


That seems, to this newbie, quite a bold claim. While I would not want to put the British embassy in Lisbon on a pedestal it is clear that
1. Their video on getting residency links to the gov.uk advice on living in Portugal
2. This refers to the following https://europa.eu/youreurope/citize...s/registering-residence/portugal/index_en.htm

This, I think you will find, is consistent with my posts. What i have learnt is that practice is variable and quite loosely related to the law. You seem to me to be arguing that everything is clear. Like I wrote, that is bold.


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## Ukkram

I stopped referring to the "youreurope" website some years ago as it conflicts with other websites and it does not get updated.

In fact that page was last checked almost 2 years ago (April 2017) and the new state health regulations came into force well after that date.


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## geological

Ukkram said:


> I stopped referring to the "youreurope" website some years ago as it conflicts with other websites and it does not get updated.
> 
> In fact that page was last checked almost 2 years ago (April 2017) and the new state health regulations came into force well after that date.


Not sure how new health regulations alter the directives/ Portuguese laws implementing them. Please remember I was not asking about getting SNS cover but getting the residency which is a precondition. 

As for being up to date or not "your Europe" referred me to the SEF site, on which I found this:https://www.sef.pt/pt/Pages/conteudo-detalhe.aspx?nID=63#p_id2

Is this out of date? This is a genuine question. I don't know how to check.


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## Ukkram

This same question was discussed by many of us and it was agreed that SEF officials do not always follow the correct procedures and also tend to make their own rules as they go along. 

We all had different experiences at SEF in the north central and southern Portugal.

My personal experience was totally different to both links you supplied. Both at SEF for my wife and me at the Camara.


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## geological

Ukkram said:


> This same question was discussed by many of us and it was agreed that SEF officials do not always follow the correct procedures and also tend to make their own rules as they go along.


I have never disputed that and I am only grateful to you and others on here who have shared their experience. What has the potential to confuse is 
1. Mixing up issues re getting residency certificate with those getting SNS cover. They are legally, logically and temporally distinct.
2. Posts asserting (without evidence) that the relationship between the law and practice is clear. Even as a newbie, I think I have the right to point to evidence that this might not be the case.


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## Naaling

geological said:


> That seems, to this newbie, quite a bold claim. While I would not want to put the British embassy in Lisbon on a pedestal it is clear that
> 1. Their video on getting residency links to the gov.uk advice on living in Portugal
> 2. This refers to the following https://europa.eu/youreurope/citize...s/registering-residence/portugal/index_en.htm
> 
> This, I think you will find, is consistent with my posts. What i have learnt is that practice is variable and quite loosely related to the law. You seem to me to be arguing that everything is clear. Like I wrote, that is bold.


I'm not saying everything is clear - that would be silly!
However, the issue of whether British citizens need private health insurance to register for residency is very clear - they don't. That fact is even implied in the form from the Camera in Lisbon that you appear to have taken issue with! A British citizen can tick the box, without having private health insurance and not "commit perjury"


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## geological

Naaling said:


> I'm not saying everything is clear


I inferred that from your post to the effect that the law was straightforward and all of the claims made are consistent with the law. You are clearly someone 'in the know' but I thought there was a danger that a not very diligent reader, new to the forum, might take the same inference as I did. 

I have never claimed that all British subjects need CHI just some of them in a certain category might (and maybe more Irish citizens) if the civil servants processing the application interpret the law in a less generous manner than is clearly the norm. 

I have no idea how you can interpret the Lisbon form as you do, but I think my query has run its course on this forum. But I will try to remember to return to it if our experience sheds any light on the issues in such a way as to be useful for others.


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## Ingenue

Hi Travelling Man,
Re NIF registration: "Once here, you need to go to a Fiscal Office (usually in the Camara/Town Hall) and get a Fiscal number/document & to do that you need to provide your passport, some kind of ID to show your address & a few Euros........ this should take about 20 minutes.:

How does one provide evidence of one's address when you are living in an apartment rented with no lease?


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## RichardHenshall

Ingenue said:


> ... How does one provide evidence of one's address when you are living in an apartment rented with no lease?


Maybe you should apply for your NIF as a non-resident, evidencing your home address, and change your status later when you're more settled?


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## Naaling

RichardHenshall said:


> Maybe you should apply for your NIF as a non-resident, evidencing your home address, and change your status later when you're more settled?


You can also get someone who is resident in Portugal to act as your Fiscal Representative.


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## Ingenue

*Evidence of Home Address*



RichardHenshall said:


> Maybe you should apply for your NIF as a non-resident, evidencing your home address, and change your status later when you're more settled?


Thanks for the suggestion Richard.
We are pretty settled here already - my wife has been here for 5 months already.
I've read of needing to get affidavits from 2 persons living in your street who vouch for one's residency, to satisfy this requirement...(?)


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## RichardHenshall

Ingenue said:


> ... I've read of needing to get affidavits from 2 persons living in your street who vouch for one's residency, to satisfy this requirement...(?)


That would be an Atestado de Residência (see https://www.economias.pt/atestado-de-residencia/) but that's more normally used as part of the process for registering (or applying for) residency in situations such as yours (where you don't have a lease or utility bills etc to prove occupancy).

I suspect that registration (or application for) residency probably should have been done a while ago and having your NIF would have been a pre-condition. The Atestado is a documented 'proof' that you live at the address you claim.


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## Ingenue

Thanks Richard. 
I've only been in Portugal for 2 months. 
I understand that the normal sequence for documenting one' residency is, as TravellingMan indicated:

"Once here, you need to go to a Fiscal Office (usually in the Camara/Town Hall) and get a Fiscal number/document & to do that you need to provide your passport, some kind of ID to show your address & a few Euros........ this should take about 20 minutes. 

After you've been here 3 months & before 4 months, (it can be before 3 months if you wish) you go to your local Camara & register your residency status with them. This document is called a Residencia & is valid for 5 years. You need to provide your passport, Fiscal Document (AKA NIF) address in Portugal & a few Euros.

Then you go to your local Junta/Council & get your Attestado and for that you need passport, NIF & Residencia." 

There seems to be a large Catch22 operating here!


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## travelling-man

Portuguese variable bureaucracy at it's best...................... The easy way to do it is go to the Camara & ask them which way they want you to do it & just go with the flow.


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## Ingenue

Thanks Travelling Man - let's grab the bull..


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## geological

geological said:


> I have never claimed that all British subjects need CHI just some of them in a certain category might (and maybe more Irish citizens) if the civil servants processing the application interpret the law in a less generous manner than is clearly the norm.
> 
> I have no idea how you can interpret the Lisbon form as you do, but I think my query has run its course on this forum. But I will try to remember to return to it if our experience sheds any light on the issues in such a way as to be useful for others.


Happily, I can now report my experience in Seixal. I swore that I was exercising a professional activity. OItherwise I would have had to claim the following: Dispor de recursos suficientes para si proprio e para os seus familiares, bem como um seguro de saude. 

This refers to health insurance irrespective of the situation in one's home country. In that respect it is worse than what is the case in Lisbon (if their form is anything to go by). 

Probably best if people posting on this forum do not encourage law breaking. I fear that blanket statements along the lines of 'comprehensive health insurance is not required' might effectively encourage some to commit perjury. I hope that by publicising both the law and the practice in two large municipalities, I have helped diminish that danger.


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## Denc

Ireland is in the EU, and so would fall under EU rules for health care in Portugal. The UK are still in the EU, but when Brexit happens it is my understanding that Brits wishing to move to Portugal will need some form of private health care. It is all up in the air, until we see what kind of Brexit happens.


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## Ukkram

I have just recently arrived in the UK and as a member of an EU country I was not asked at all about private medical when I registered for pre settled status. The HO website says this will not be a requirement as all residents get free state medical care regardless if they are UK citizens or not.

So it would be safe to assume that all EU countries will reciprocate. I had free state medical in Portugal and now in the UK too. I do not work.


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## Pgmills

Denc said:


> Ireland is in the EU, and so would fall under EU rules for health care in Portugal. The UK are still in the EU, but when Brexit happens it is my understanding that Brits wishing to move to Portugal will need some form of private health care. It is all up in the air, until we see what kind of Brexit happens.


Tosh mate. Healthcare in Portugal is residence based not nationality based.


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## geological

Pgmills said:


> Tosh mate. Healthcare in Portugal is residence based not nationality based.


No need to be so rude. Although I don't speak for Denc, you are missing a key point. He/she was referring to people moving to Portugal and, one should assume who do not yet have any residency rights at the moment. To tell them that healthcare is residency based is irrelevent if you don't have residency and as I have tried to demonstrate, in a number of areas, in a number of cases in order to get residency you need to swear you have health insurance. And that is in the case of EU nationals!


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## Ukkram

geological said:


> No need to be so rude. Although I don't speak for Denc, you are missing a key point. He/she was referring to people moving to Portugal and, one should assume who do not yet have any residency rights at the moment. To tell them that healthcare is residency based is irrelevent if you don't have residency and as I have tried to demonstrate, in a number of areas, in a number of cases in order to get residency you need to swear you have health insurance. And that is in the case of EU nationals!


No need for health insurance and they don't even ask for it. EU national or not. Been there and done that. It is residency based.

My wife in non EU and I am EU and neither of us were asked to show our medical insurance card. We were quite peeved off as we specifically joined Allianz medical just for residency. We quit it soon after and got our state medical SNS numbers.


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## Pgmills

geological said:


> No need to be so rude. Although I don't speak for Denc, you are missing a key point. He/she was referring to people moving to Portugal and, one should assume who do not yet have any residency rights at the moment. To tell them that healthcare is residency based is irrelevent if you don't have residency and as I have tried to demonstrate, in a number of areas, in a number of cases in order to get residency you need to swear you have health insurance. And that is in the case of EU nationals!


Total rubbish. I have no problem being blunt to remove these types of misinformation from circulation. It is a fact that once you are registered here you are entitled to healthcare on the same basis as every other resident. As an Eu citizen all you have to do to prove residence is get a certificate of registration which does not need a health care declaration.


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## travelling-man

NHS entitlement is SOLELY based on residency & even people on the 1st part of the Type D visas which only gives them 4 months & 2 visits are entitled to register & I know 2 people currently in that position who have recently done just that. 

However, some areas (notably Penela) have in the past consistently refused registration but that was corrected last year when the UK Embassy stepped in & banged a few heads together. 

Note the words "The state health system is universal and eligibility is residence-based."

https://www.nhs.uk/using-the-nhs/he...oad/healthcare-in-portugal-including-madeira/


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## geological

Pgmills said:


> Total rubbish.... It is a fact that once you are registered here you are entitled to healthcare on the same basis as every other resident. As an Eu citizen all you have to do to prove residence is get a certificate of registration which does not need a health care declaration.


It would be preferable if you paid me the courtesy of reading what I wrote. I did not contend your 'it is a fact' point. Sure, entitlement to healthcare is residency based. 

To argue, as you do, that as an EU citizen you don't need a health care declaration in order to get a residency certificate is an oversimplification. Have you read the relevant law? I have. Have you seen the forms that are required to be signed in both Lisbon and Seixal? I have. 

Please all, can we have a little less heat and a bit more light?


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## MaxAbeja

Greetings, I'm a new subscriber to Expatforum.com. I've read carefully the four pages of posts in this thread, and I thank everyone for all the detailed information about healthcare in Portugal.

I'm a UK citizen and passport holder, but I've lived as a permanent resident in the US for many years. Since leaving UK, I never paid into British National Insurance, and so I don't qualify for British NHS healthcare. As a US resident all this time, I paid into US social security, and when I retired I enrolled in US Medicare and now receive monthly SS benefits. 

I'm planning to retire to Portugal, and I need to know exactly what kind of healthcare would be available to me, its costs, and how to get private health insurance if needed. I'd greatly appreciate any information specific to my situation.

Thank you,

Max Abeja


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## travelling-man

All residents of Portugal are entitled to the same PT NHS care as any Portuguese person no matter where they come from................. & from my experience & that of my friends, it's very good


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## grammymissy

IF you are comfortable with the type of healthcare that a NHS, as in the UK provides, the NHS in Portugal is acceptable. We however are used to choosing our own doctors and hospitals, choosing when we wish to receive care, and level of care, as we were treated in the USA, so we do not find the Portugal NHS acceptable and have a private health insurance plan and use the private health system, which we find excellent. 


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## MaxAbeja

Thank you, Grammymissy. Which health insurance plan are you with?


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## grammymissy

We have Multicare.pt, they have several different plans to choose from. There is also Allianz and Medis insurance plans to choose from here, and more, but those 3 companies I am familiar with and can recommend. 


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## MaxAbeja

Outstanding help, many thanks!


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## Ukkram

Many UK expats are with Allianz Medical via Medal Insurance. This is a scheme specifically tailored for members of AFPOP which is an association that assists all foreigners in Portugal in settling down. They have negotiated a good discount for members with no age limit. Most medical insurers will not cover people over 65.


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## MaxAbeja

Thank you, Ukkram. I much appreciate your specific informative post.


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## JohnThomas0168

Ukkram said:


> Many UK expats are with Allianz Medical via Medal Insurance. This is a scheme specifically tailored for members of AFPOP which is an association that assists all foreigners in Portugal in settling down. They have negotiated a good discount for members with no age limit. Most medical insurers will not cover people over 65.


Do they, or any other company, offer health insurance that covers pre-existing conditions? or is that so impossible or so expensive that it is a non starter?


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## Ukkram

JohnThomas0168 said:


> Do they, or any other company, offer health insurance that covers pre-existing conditions? or is that so impossible or so expensive that it is a non starter?


As I am a cheap skate I always do thorough research into the best deals. Allianz is the best and the cheapest you will find in Portugal. The subscriptions for membership of AFPOP will be worth the discount you will get.

Unfortunately pre-existing conditions will not be covered by Allianz. Some other insurers will charge a premium for this.

I did however have high blood pressure before I joined and Allianz paid for my doctors visits for repeat prescriptions.

You could apply for state medical and use the state hospitals for free to treat your pre-existing conditions. Some state hospitals are better equipped with more modern equipment than the Hospital Particulars. I left Allianz for this reason but it is another long story.


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