# I'm confused about healthcare



## flashfolly (Feb 26, 2011)

I've spent quite a while now searching the net for info, including visiting the NHS site, but I'm still a bit confused about how the rules might apply in my circumstances... if anyone can help I'd be grateful ... we're hoping to move out to Portugal in the next year.

I'm 60 and very active - tennis, swimming, golf, dog-walking - but in the UK I've had to visit my GP quite often for one condition or another - the joys of getting old! I'm retired and planning to move out to the Algarve with my wife to live there permanently. Budget is tight-ish so I don't really want to have to pay for private medical insurance. But the NHS website tells me that once I move permanently I'm not entitled to NHS-funded care, but I should be entitled to Portuguese state cover. The website goes on to say that visits to doctors and dentists are free (?) but doesn't mention the cost of prescriptions. Do I have to be paying some sort of tax or stamp though to qualify for this?

So, do I pay anything to visit a local GP? What do I pay for prescriptions (at least 2 a month)? What if something major goes round?

If I HAVE to take out private insurance, how much am I likely to have to pay for the two of us?

Thanks in anticipation of a mountain of replies!

Nick


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## silvers (Sep 22, 2008)

Hi Nick,
To see a GP costs around €3 per visit, prescriptions vary, I have paid upto €21 for one item but have also paid as little as 56c.
To go to A&E costs €8 ish. 
When you arrive you need to register with your local GP, speak with the locals to find out which is the best one. You will then get your Cartao do Utente, this will entitle you to the cheaper health care.


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## flashfolly (Feb 26, 2011)

silvers said:


> Hi Nick,
> To see a GP costs around €3 per visit, prescriptions vary, I have paid upto €21 for one item but have also paid as little as 56c.
> To go to A&E costs €8 ish.
> When you arrive you need to register with your local GP, speak with the locals to find out which is the best one. You will then get your Cartao do Utente, this will entitle you to the cheaper health care.


Thanks, that's very useful. Would you say the system and standard of care is good? I've generally heard positive comments. And if you don't mind me asking, do you have private cover, and if not, why not?

Nick


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## silvers (Sep 22, 2008)

Hi Nick,
I don't have private cover as I think the NHS service here is adequate. The cover is generally good, you are often sent to private hospitals/clinics for the tests anyway. As I said previously, ask the locals in your area, who they consider to be the best GP in the area.


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## flashfolly (Feb 26, 2011)

silvers said:


> Hi Nick,
> I don't have private cover as I think the NHS service here is adequate. The cover is generally good, you are often sent to private hospitals/clinics for the tests anyway. As I said previously, ask the locals in your area, who they consider to be the best GP in the area.


Am I automatically entitled to NHS service once I'm resident in Portugal?


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## silvers (Sep 22, 2008)

And you have the Cartao do Utente, which you get by registering at the local doctors.


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## santaanita (Jan 16, 2008)

i think you will find various opions on this,my wife has had operations here and various clinic visits,and yes the treatment has been first class but the down side for us has been the officialdon side of things,also you do pay for everything even the use of a ambulance is chargeable,to say you will come across the jobsworth type that we have at the central de suade would be wrong you might get a helpful one but if you dont and your portuguese is not good then good luck


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## canoeman (Mar 3, 2011)

Health care is generally very good in Portugal, a lot depends on area. The procedure is or should be very straight forward for Registering, but again can depend on area.
Obtain a S1 from the UK NHS
Register at your Regional Social Security Office which gives you a Social Security Number.
You then Register with your local Centro de Saude and receive a Utente Number,this gives you the same access as a Portuguese Citizen to "free" healthcare anywhere within Portugal.

Free has a totally different meaning here, as unlike UK you pay
To see a Doctor or Specialist
For individual drugs, the discount is calculated against the generic cost of the drug.
Blood Tests, X-Rays etc.
You don't pay for operations or treatment in hospital, but do pay an overnight fee.

Certain things are referred to the Private sector mainly blood analysis, x-rays, mri but service here is very quick and heavily subsidized

If you are both under UK Pension age you get an EHIC from Portugal, if one or both of you receive a UK Gov. pension you get your EHIC from the UK, plus your registration with the Social Security service is done via the UK's S1 as a dependent relative.

You don't need Private Medical Insurance, and would find your age and any pre existing conditions make it an expensive insurance with very limited use.


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## canoeman (Mar 3, 2011)

If I heard UK news correctly the other date Prescription charges have gone up to £7+ per item, which makes precscriptions here quite cheap unless your on an expensive drug.
You also as a Resident can claim certain health costs against any tax liability here.


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## flashfolly (Feb 26, 2011)

Thanks very much to everyone who's replied, canoeman in particular for a detailed response. The picture is much clearer now - I'll strike private medical insurance out of my budget, but still make sure I've got a contingency to cover unexpected extras. I have friends who live there who can advise me on where to go and which doctor to sign up with.

I'm hoping that the warmth of the Algarvian sun  will do wonders for me anyway!


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## Antonina (Mar 7, 2009)

silvers said:


> Hi Nick,
> To see a GP costs around €3 per visit, prescriptions vary, I have paid upto €21 for one item but have also paid as little as 56c.
> To go to A&E costs €8 ish.
> When you arrive you need to register with your local GP, speak with the locals to find out which is the best one. You will then get your Cartao do Utente, this will entitle you to the cheaper health care.


Hi Silvers

Long time no speak I have just read your reply to Nick ref Medical advice and was woundering the same as the time is getting nearer for us to come perminanly.
Although we are slightly younger does the same apply. Also what if you are taken ill in an emergency would they see you in a state hospital for free as Portugal has this joint treaty with the UK. I have looked into private health care to which is very expensive can you suggest an company in Portugal which is quite good and not so competitive??

Hope you are both keeping well

Antonina :


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## Antonina (Mar 7, 2009)

canoeman said:


> Health care is generally very good in Portugal, a lot depends on area. The procedure is or should be very straight forward for Registering, but again can depend on area.
> Obtain a S1 from the UK NHS
> Register at your Regional Social Security Office which gives you a Social Security Number.
> You then Register with your local Centro de Saude and receive a Utente Number,this gives you the same access as a Portuguese Citizen to "free" healthcare anywhere within Portugal.
> ...


Canoeman

Not sounding thick but this S1 I get from the NHS in the UK do I then register this in portugal at the social security?? then in turn I get this other card to which I can register at the doctors

As when we are over perminantly next year hopefully, but neither of us will be getting our uk pension as yet. Also once in portugal perminanly we cannot use our Blue e11 card no longer sorry if this sounds a bit higgley piggley just trying to get my head around it all.

Thanks Antonina


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## silvers (Sep 22, 2008)

Hi Antonina,
The same thing has just happened to friends of ours. They decided it would be easier to use a relative's address to get a new EHIC.


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## canoeman (Mar 3, 2011)

S1 from UK gets you registered with the Social Security here, you go to Regional Centre not local. You get an A4 sheet with number NO card.

When you register at your local Health Centre, you receive a Patient Number on a A4 sheet NO card (keep original at home and carry a photocopy) you get them to enter Social Security number, because some areas are not giving reduced price prescriptions without it.

When you are Registered with Health Service you then go to your LOCAL Social Security office for the Portuguese issued EHIC(European Health Insurance Card which I think you are calling an E11), you need this card to get Health treatment anywhere in the EU including UK.

The NHS consider useing a UK issued EHIC that is invalid, because you are no longer UK Residents etc fraud. There was a change to EU laws last year, the EU country who pays you State Pension also now HAS to issue your EHIC for use outside Portugal.

When you arrive in Portugal your UK EHIC is valid for 6 months, you would need it for treatment until you get yourselves registered. 

When you pay pharmacy for a prescription you should if you want to reclaim tax etc have your name and Fiscal Number printed on receipt, tax changes effective this year.


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## Antonina (Mar 7, 2009)

silvers said:


> Hi Antonina,
> The same thing has just happened to friends of ours. They decided it would be easier to use a relative's address to get a new EHIC.


Silvers/ canoeman

Many thanks for the advise

Antonina


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## canoeman (Mar 3, 2011)

Antonia, if your visiting Portugal you need a UK issued EHIC for treatment from the Portuguese NHS, you might be charged, you must keep all receipts, treatment, prescriptions etc and then claim a refund from Portuguese Social Security or from NHS overseas at Newcastle which takes much longer to get refunded.
Majority of travel insurances state you must have a valid EHIC to travel in EU.


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## Mr.Blueskies (Feb 24, 2009)

flashfolly said:


> Thanks very much to everyone who's replied, canoeman in particular for a detailed response. The picture is much clearer now - I'll strike private medical insurance out of my budget, but still make sure I've got a contingency to cover unexpected extras. I have friends who live there who can advise me on where to go and which doctor to sign up with.
> 
> I'm hoping that the warmth of the Algarvian sun  will do wonders for me anyway!


 Just don't forget the sun cream, hat and sunglasses and it is wise to stay indoors between 11am - 4pm in summer. A mozzie net over the bed is also good. I got ate alive by them the first year and had bites on bites. They seem less attracted to you for some strange reason if you can survive year one. lol


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