The SNS and the número de utente
Portuguese law considers EU and third-country citizens residing in Portugal, whether regularised or not, as SNS beneficiaries. Access is managed through the national número de utente (or número de utente), obtained from the national register of users (RNU): simply go to an SNS health unit with basic details — name, sex, date of birth and nationality.
What determines whether the SNS covers the costs is the type of registration. With an up-to-date registration, the SNS assumes financial responsibility and you only pay the moderating fees for each procedure. If the registration is incomplete, the costs are yours.
Your company's employees
An employed worker pays Social Security contributions, and those contributions fund healthcare: they pay nothing extra to be covered. Registration is done at the centro de saúde of their unidade local de saúde, where they enrol and choose a family doctor.
Dependants can register at the same centre as part of the household. For a newly arrived employee, the practical order is: contract, Social Security and, in parallel, registration at the health centre to get the número de utente as soon as possible.
If you arrive without a contract
An EU citizen who settles without a job also registers with the RNU, but it is worth knowing that an incomplete or pending registration (more than 180 days without completing the data) leaves the bill with the patient. There are important exceptions: maternal and child care, minors residing in Portugal, vaccination and family reunification when someone in the household pays Social Security are always covered.
Without a residence permit, urgent and life-saving care is covered if you present a declaration from the junta de freguesia proving more than 90 days of residence. This is the mechanism that ensures no one is left without assistance.
Private insurance and visas
For residence visas (D2, D7, D8), the law requires proof of healthcare coverage: private insurance or enrolment in the SNS scheme if you are not going to work as an employee. The main insurers are Multicare, Médis and AdvanceCare, with premiums depending on age and coverage.
Once you have a contract and pay contributions, private insurance becomes optional: many keep it as a complement for specialists and private hospitals, but it is not a requirement. For the company, the recommendation is not to pay twice for the same thing.
What healthcare costs in Portugal
SNS consultations carry moderating fees of a few euros, with many exemptions: minors, pregnant women, pensioners and low-income households pay nothing. The SNS 24 line (808 24 24 24) provides free telephone advice to decide whether you need to see a doctor.
Copayment is the most visible part, but the system works: emergency care, hospitals and prescription medicines are covered, and the actual out-of-pocket cost for an average family is small compared with the cost of full private insurance.
