Bigs23
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Your perspective and detailed information is extremely helpful.I will give both a broad answer and personal one. And I apologize in advance, but this will be lengthy.
As a visitor, up to 90 days, you can stay in the EU/Portugal with no visa and insurance is not required. If you are injured or need medical attention, it will be provided to you by the NHS, or National Health System, at cost, which is typically 10-50% of the price in the States. Like nearly every other modern country in the world, Portugal has socialized health care and is actually ranked much higher than the US in quality (our experiences differ slightly). But, unless it is an emergency, there can be significant wait time. But there are many private hospitals and healthcare centers that you can pay for, and get quicker service, but at a cost of about 20% more (still under US prices). If you have a US prescription from a doctor, it can most likely be filled just by going to the pharmacy directly, and the pharmacists can do their own prescriptions for almost anything not a controlled substance, meaning most antibiotics, E.D., and mental health drugs are walkin and filled directly with no prescription. And most prices are well below similar drugs in the US. A prescription from a doctor does give a controlled government price which can be up to 30% less. However, OTC drugs in the US, like aspirin, Tylenol, and Ibuprofen, can only be gotten in a pharmacy or a rare drug store. You will not find them in the grocery store or anywhere else. And the largest quantity is usually 20 pills or most times just 10. And they are expensive compared to US prices. A 10 count package of Ibuprofen is about $3. We mule these back from the States on each visit.
Over 90 days, you must be working towards residency and obtain a longer stay Visa. A basic requirement is to prove that you won´t be a burden on the government, which means you must have proof of income (about $1200 a month currently), a place to live (lease, contract, or title), and health insurance. The easist is just to Goggle expat insurance and do your own research. If you are staying and have already obtained a NIF (kinda like a SS# number but only used for ID and taxes, there is a separate SS# here), then I would suggest local companies. And insurance is sold nearly EVERYWHERE. If you are younger and basically will be using the insurance for checkups and injury, then you can buy ACA (Obamacare) like insurance from your local bank, grocery store, utility company, and others! Cost is about $25-$35 monthly per person. There are also Hospital chains that sell their own insurance only usable in their chains. I will talk more about that in my personal section. Cost is about $20/m/pp If you are older, then are private insurance companies that can provide more significant insurance covering sickness and other necessities. Be warned though, that many policies expire once you hit 70 (legal in Portugal) so be sure to check if your does or not. Similar to the US, cost varies on many factors, and lie about pre-exisiting conditions if you can, because most are not covered.
Once you have obtained some type of residency, you are then eligible for the NHS and obtain a Utente number. You will be assigned a General Practioner and consultations with them are free, but appointments must be scheduled in advance and can be months out at times. Also, you can be assigned a GP in a neighboring town. Ours is 12 miles from our home and we don´t have a car. The bus can get us within a mile but the remaining walk is along a narrow and busy road with portions not having any sidewalk. We can Uber, but it is about $30 r/t. So we have only been there once. We have two different private hospitals within a quarter of a mile of our apartment and we just use those. There are private health centers too that many people use but we don´t have any experience with them. Emergency situations are handled promptly in a hospital. Most things in the NHS are fully covered so there is no expenditure once you get the Utente. I know many elderly that use the NHS exclusively and are very happy with their healthcare.
Now to more personal experiences. Our first year, we just paid for expat insurance and never even used it. There are two large private hospital chains and both were extremely close to our home. You can get a GP at a private hospital and visits to them cost about $40. The first dental exam, including X-ray, is typically free. At private locations appointments can usually be gotten within one or two days and many times we have gotten same day. We bought the chain insurance at $20 pp/m and some of the benefits included are 10 GP visits discounted to $17.50 each, and significant discounts on most procedures (I got a colonoscopy for $60 before I started using NHS). So it was ridiculous for us to use the NHS GP that was 12 miles away and would cost more (because of travel and/or hassle) than the one right down the street from us. We also bought an encompassing policy that covers us for bigger issues, and is good worldwide, including $50k in the US. I am 61 and my wife is 65. I am in good health but my wife has some health issues. Our insurance policy is about $250 per month total for both of us. So both plans together (chain and private company) for both of us is roughly $300 per month.
Experiences on getting health care. First off, every pharmacy that I have been in, both in my hometown and throughout Portugal, has at least one person within that speaks English well. Portugal´s economy is 20% tourism and most come from the UK. Never had any issues. As to doctor´s and nurses, it has been a mixed bag. Never a serious problem, but there have been occasions were we were assigned a specialist that didn´t speak English and a hunt would have to be made to find someone that did. We try to do most things online, and some doctor profiles do tell the languages they speak. Again, not a serious problem, but it has made for an occasional bump in the process.
NHS: Again, we don´t use our assigned GP, so I can´t speak of any experiences there. Once you are in the system, routine things become automated. I have a pre-scheduled colonoscopy every 5 years, next one is next year. Free. My wife´s mammogram, prescheduled and free. We got our Covid and flu vaccines prescheduled and free. There is a local NHS Hospital that we use for these and other similar items. We receive emails and texts for reminders.
Private: I can only speak for the chain that we use, but for the most part, the process has been outstanding. Again, most appointments can be gotten very quickly. Other than routine stuff, I personally really haven´t had to use the healthcare system. But my wife has had many processes done, including broken clavicle surgery, cataracts and Lasik, and a few others. Quality comparable or better than the US. Other than a mobility issue that comes and goes that the issue can´t be determined yet, we have had no complaints. The clavicle surgery that put a 7 inch titanium plate in her shoulder and included two nights in the hospital and many followup visits cost roughly $5500 before insurance and about $2500 after. The PT was $16.50 per visit before insurance and fully covered after. We know many people that just use NHS and their credit card is their insurance policy due to the much lower healthcare costs. But their budget is higher than ours, lol.
I want to add a few things about health. Because we live inner city, and don´t have a car, we walk most everywhere. Most preservatives are banned in the EU, so nearly everything is fresh. Other than a rainy winter season, there is sun most every day, so we do a lot more outside activities than we did in the states. It´s difficult to explain if you haven´t been, but Europe is different than the US in pace of life. There is a lot less stress here. No guns, so almost no chance of violent crime. We walk around at 2am in what looks like sketchy areas with no fear AT ALL. We are retired, so time is not an issue. The most stress inducing factor here is the bureaucracy. If you think it´s bad in the US, Portugl says "Hold my beer." Other than that, everything is chill. I feel much healthier here than I did in the US because of the lifestyle here.
Hope this helps and feel free to ask more about anything other than getting g a Visa. The process has changed at least twice since I went through it, and falls under a completely different government entity than the one I used.
Edited to add - Many doctors work both NHS and privately. We have seen the same doctors under both systems. And many times, under NHS they will tell you to go to a private doctor for a test and bring it back. My wife had a test that would be scheduled 11 months out under NHS, but we got the the same test done the next week privately and just brought the results back.
If it’s okay, I may be hitting you up with some questions/advice as we get closer to making the move.
