sherbert

I'm seriously considering a move to Portugal. I'm currently in the US, but am a UK citizen. My OH is Portuguese but has been out of the country for many years so has no clue on how things work anymore/costs etc. I'm looking for cost estimates for private health insurance and wonder if people can give me a rough idea of monthly costs of premiums/deductibles etc for a couple under 45, one of whom has a chronic health condition that requires hospital treatment every couple of months.

This is why we are looking into private health insurance on top of what we'd get on the SNS. I cannot imagine monthly costs are anything like what they are in the US ($500/month for two people plus $4000 yearly deductible that we have to pay out of pocket before the health insurance will pay anything - and this is a good deal :/).

mfesharne

If your partner has a Portuguese passport then he/she has the right to enter, work & remain & you have the same rights under the reunification of family rules & once resident here, you both have the right to the same more or less free healthcare as any Portuguese person.

You also have the right to enter, reside & work under your UK passport but that will probably fall away if you don't enter & register residency before Brexit is complete.

IMO & that of all of my friends who have used the NHS system here, it's very good indeed & health insurance is not necessary.

liveaboard

We have private health insurance and my OH would be dead without it.
There are a lot of threads on the subject on this forum, with different people relating their very different experiences.

As to cost, a couple of thousand Euros per year for the two of you will buy a good policy from Allianze.
The actual cost is reckoned after you submit a form, and depends on a lot of factors.
BUT!
Pre existing conditions are not covered by private insurance. They are particularly diligent when it comes to non-emergency hospital admissions, which are pre-approved by the insurer.

We've both had surgery, many tests, many treatments, much care. The insurance company has been good, they cover what they say they cover, but they do check.

So if you emigrate to Portugal, you will be dependent on the public health system for your hospital needs. You should move into an area where it's known to be good.
As I understand it, that would be Lisbon, Porto, or Coimbra.

Not the south, here in the Algarve the public hospitals are underfunded and understaffed.

Ukkram

The cheapest medical insurance in PT is Allianz. If you join AFPOP you get a good discount and they have an agent called Medal that deals with Allianz. Cost is around € 1 000.00 pa paid in advance for 2 people. As was said, pre-existing conditions are not covered.

Pilou

We are also thinking of private insurance as member of Afpop. The price you mention of 1000 pa for 2 people is for people younger than 45 years I suppose.
For a couple of 60 years old, it would be 3000- 3500 for 2 ?????
When it would be 2000 -2500 for a couple, I would immediately say 'yes'.

Loafing Along

Both in our 60s total cost €1700,-

liveaboard

There are different plans, and the quote depends on more than just your ages.
Just download a form from the Medal website, fill it out and send it in.
They'll tell you how much the premium will be.

sherbert

Thanks all - very helpful. Is there a difference between domestic/local private health insurance and expat health insurance or is it all the same? i.e. might local insurance cover the pre-existing condition? I had not considered that might not be covered as it's now illegal in the US to deny coverage for pre-existing condition (about the *only* good thing about the health insurance system here!). I assume we'd be going for local insurance since OH is a citizen.

Livaboard, yeah we'd be heading to Lisbon/Porto for sure if we took the plunge. Having had a health emergency in the country before, we used a private hospital (covered by our current insurance) and was impressed by the level of care.

Just FYI, Portugal ranks as 12th in the WHO's healthcare rankings: World Health Organization’s Ranking of the World’s Health Systems | thepatientfactor.com

Ukkram

We chose the cheapest Medal aka Allianz medical and it was € 1300.00 odd per year for the 2 of us at age 60. This is for a € 300k cover pa. A visit to a private doc costs € 12,50 with Allianz and € 2,50 with a state doc.

You pay a certain percentage of the cost of private care and in severe illnesses this can be astronomical such as cancer treatment that can be as high as € 150k as it was with my wife but totally free at a state hospital. Food and lodging included. Plus superb and high tech treatment.

So you must weigh the pros and cons before you decide.We dumped Allianz for state medical..

liveaboard

Residents are all equal under the law, it doesn't matter where you're from or [usually] even your nationality.

The public health system is big; hospitals, doctors, specialists, staff, ambulances, etc etc. They just have a huge patient load.
All residents of Portugal are entitled to public health care, preexisting conditions are covered.
There's barely any copay / deductible [compared to the US] and no spend ceiling.
It's paid for through [equivalent of] social security payments, which everyone pays on their earned income.
If you earn no income, and don't pay social security tax, you still get health care, at government expense.
This part is complex and depends on your circumstances; some people are covered by their home country health insurance schemes for instance. But everyone gets health care, that's the law now. I'm even covered by Portugal when I journey out of Portugal.

The private hospitals are for-profit private enterprise, and either you pay the bill out of pocket or you have an insurance policy that will.
The private hospitals are much smaller, and fewer. They've been improving and expanding, but some high tech stuff like radiation treatments and bone marrow transplants can only be done at the larger public hospitals.
The private hospitals pay more, so attract the top talent.
The private insurance policies have annual spend caps, and if you exceed it you're out until Jan 1.

So I suggest you plan a trip to Portugal and walk into a couple of public hospitals. See if you can talk to someone about your condition and how it's treated there, see whether their infrastructure makes you happy.

And then go to an international tax consultant and do a tax simulation. Taxes here are very high, and might eat up all of what you just saved on health care.
Again, it's complex and depends on the precise details of your income.

sherbert

Thanks Liveaboard: yes, how the OH's condition will be managed will be a deal breaker so I will encourage OH to do research. We've been in both public and private hospitals in PT so are aware of the differences.
I did not realize taxes in PT were so high - thanks for pointing that out. 48% at the highest level! I previously lived in the Netherlands so I'm used to massive chunks of money being spirited away by the government and I currently live in the second most expensive city in the world. So I would hope things can only improve financially speaking with a move to PT. Of course, it will depend on our salaries, which is another set of problems altogether .

Red Eric

A very minor and pedantic point here - and nothing to do with the OP's questions - but the public health service is mostly paid for out of general taxation and not social security payments. Just so anybody who isn't making SS payments in Portugal doesn't feel guilty

Red Eric

Are you aware of the existence of Portugal's special tax regime for new residents? It's called - slightly confusingly - the Non Habitual Resident regime. Depending on what type of income you have and where it arises, it can confer significant advantages over the standard resident regime and would apply for a period of 10 years after your inscription, were it to be of use to you.

sherbert

I was not aware and will look into this.

mfesharne

NHR status is now very easy to register & can be done online so don't let anyone try to charge you obscene amounts to get registered............... but you do need to register within the same fiscal year as you become a resident.