Applying for private health insurance as an expat

Securing private health insurance in Portugal as an expat can be a seamless process if you follow these steps:

1. Assess Your Needs: Identify whether you need individual, family, or senior-specific coverage. Consider your health history, any chronic conditions, and any family members who might require coverage under your plan.
2. Choose a Provider: Research different providers like Médis, Allianz, Ageas, Fidelidade, and MGEN. Consider factors such as coverage, customer service, and pricing. You can also explore health insurance plans offered by Portuguese banks like Santander, Novo Banco, and Caixa Geral de Depósitos.
3. Get a Quote: Most providers offer online quote services where you can enter your details and receive a customized quote based on your health needs and personal information.
4. Apply Online or Via a Broker: After selecting a plan, you can apply online or enlist the help of a broker to guide you through the process. Brokers can help you compare options and comprehend the details of each policy.
5. Understand the Terms: Carefully review the coverage, exclusions, waiting periods, and any age-based premium increases before finalizing your insurance.

⚠️ We have a great insurance broker partner with the INOV Expat team. They have specialized service for expats, catering to both English and French speakers.

How to Hire Health Insurance in Portugal?

Hiring health insurance in Portugal is a straightforward process, but it involves careful consideration of your needs and budget.

As an expat, securing private health insurance offers an additional layer of protection beyond the public healthcare system.

We will guide you through the steps of hiring health insurance in Portugal, from choosing the right provider to understanding the documentation required.

1. Assess your healthcare needs

Before you start looking for health insurance, it's essential to assess your healthcare needs. Ask yourself these questions:

• Do you need individual or family coverage?
• Are you looking for basic coverage, or do you want a more comprehensive plan that includes dental, mental health, and chronic illness care?
• Do you have any pre-existing conditions that might affect your choice of insurance?
• How often do you use medical services, and do you need frequent specialist consultations or surgeries?

Understanding your healthcare needs will help you choose a plan that provides the right balance of coverage and cost.

2. Compare health insurance providers

Portugal offers a variety of health insurance providers, each offering different levels of coverage and services. To find the best plan, it’s essential to compare options from top providers like Médis, Allianz, Fidelidade, and Ageas.

You can either research online or use a health insurance broker to guide you through the process.

What to compare:

• Coverage: Check whether the policy covers outpatient care, hospitalization, surgeries, and specialist consultations.
• Exclusions: Pay attention to any exclusions, such as pre-existing conditions, and whether these will affect your coverage.
• Waiting Periods: Some insurance policies impose waiting periods for specific treatments (like maternity care or surgeries). Make sure you understand these.
• Network of Providers: Ensure that the insurance provider has a wide network of clinics, hospitals, and specialists near your residence - this is very important, especially if you choose to live in the country.
• Cost: Compare the monthly or annual payments and look for any additional costs like co-payments or deductibles.

You can use comparison websites or request quotes directly from the insurance company websites to get a clearer picture of pricing. Again, most companies offer tiered plans, allowing you to choose the level of coverage that fits your budget.

3. Decide whether to use a broker

As an expat, you might find it helpful to use an insurance broker to simplify the process.

Brokers are professionals who specialize in understanding the market and can compare multiple policies to find the best one for your needs. They can also assist you in navigating the complexities of insurance contracts, especially if you are unfamiliar with the Portuguese language or regulations.

Pros of Using a Broker:

• They do the legwork of comparing policies and negotiating terms.
• Brokers can explain the fine details of each policy, including exclusions, coverage limits, and legal obligations.
• They often have access to exclusive deals or discounts.

However, if you prefer to handle things on your own, most health insurance companies in Portugal have simple online application processes that allow you to get quotes and sign up without needing a broker.

4. Request a quote

Once you have narrowed down your options, you can request a personalized quote. Most insurance providers in Portugal offer online forms where you can enter your personal information to get a detailed quote based on your specific needs.

You will generally need to provide:

• Personal Details: Full name, date of birth, and nationality.
• Residency Information: Mainly your address.
• Health Information: Sometimes, you may need to fill a basic health questionnaire asking about pre-existing conditions, past surgeries, or ongoing treatments.
• Family Information: If you are applying for a family plan, you will need details about your spouse and children.

Some providers may also require a brief medical exam or further documentation if you are applying for a more comprehensive plan or have specific health conditions.

5. Review the policies and terms

Before signing any contracts, carefully review the terms of the policy. Pay close attention to:

• Coverage Limits: Check the maximum coverage amounts for different types of treatments, including hospital stays, surgeries, and specialist consultations.
• Exclusions and Pre-Existing Conditions: Ensure you understand which pre-existing conditions may be excluded from coverage and what other limitations apply.
• Reimbursement Options: Some insurance plans allow you to visit any doctor and receive a partial reimbursement, while others require you to use providers within their network.
• Waiting Periods: Make sure you know when your coverage will begin and whether any waiting periods apply to specific treatments.

It’s essential to fully understand the fine print to avoid any surprises later on, particularly regarding what is covered and what isn’t. Be sure to ask the insurer or broker to clarify anything you don’t understand.

6. Submit your application

Once you’re satisfied with the terms, you can submit your application. If you’re applying online, most insurers will allow you to complete the process electronically. However, some may require additional documents, such as proof of identity, proof of residency, or health records.

• Online Application: Many health insurers in Portugal provide user-friendly online portals or apps where you can complete the entire process. You’ll need to provide personal details, health information, and payment preferences.
• Through a Broker: If you’ve chosen to go through a broker, they will handle the paperwork for you, ensuring that everything is completed correctly and efficiently.

7. Set up payment

Most health insurance companies offer flexible payment options. You can choose to pay monthly, quarterly, or annually, depending on what suits your financial situation. Most insurers offer discounts for paying the full annual premium upfront.

• Direct Debit: To ensure automatic processing of your payments, many insurers allow you to set up direct debit payments from your Portuguese bank account.
• Credit Card: Some insurers also accept credit card payments for additional flexibility.

8. Receive your insurance card

Once your application is approved and payment is set up, you will receive your health insurance card. This card will be required when accessing medical services within your insurer’s network.

If your plan includes a reimbursement option, you’ll use this card when submitting claims for out-of-network services.

Common documentation needed:

• Residency Permit or proof of legal residency in Portugal (not always mandatory).
• Health Records: A brief medical history may be required, especially for higher-tier plans.
• Bank Details: For setting up payments, include IBAN or credit card information.

9. Start using your health insurance

Once your coverage begins, you can start using your health insurance to access healthcare services. Depending on the type of plan you selected, you can either go to providers within the insurer’s network (conventional system) or outside the network, where you may pay upfront and seek reimbursement later.

• Using In-Network Providers: Depending on your coverage, you typically only need to pay a small co-payment (or none at all) when using an in-network provider.
• Reimbursement for Out-of-Network Providers: For services outside your insurer’s network, you’ll need to pay out-of-pocket initially and then submit a claim for reimbursement.

Most insurance providers have mobile apps that allow you to find in-network doctors and hospitals, submit claims, and track your healthcare spending.