Do I need healthcare insurance
 

We have been officially resident in Portugal since October 2018. Due to an emergency situation when we purchased our house in March that year (when we were not resident in Portugal) we registered with the local GP practice who requested our EHIC cards to complete the registration process. We noticed last year that our utente A4 paperwork seems to expire when the EHIC card expires. We have tried to get this change at the Saude by showing our residency form etc but they will not change it because they want to know who is going to pay. We are self financing here (through rental income in the UK) and a state pension is some 4 years away. We can not obtain a social security number because we do not work here, nor can we obtain an S1 from the UK. The Saude says that we need to pay for private health insurance but I understood (perhaps incorrectly) that a resident has the same rights to access healthcare as a Portuguese citizen. Can anyone help point us in the direction of someone who can assist? My husband is a diabetic with heart problems so I am, naturally, quite concerned. Sorry this is long-winded but I've been going around in circles for the best part of a year! Many thanks

Re: Do I need healthcare insurance
 

Are you registered for tax here with AT?

Re: Do I need healthcare insurance
 

Hi and welcome to the forum from me :)

No, you do not need private healthcare insurance if you are actually resident in Portugal. You should be covered as a resident in the public health system under any circumstance : working, pensioner, or neither and the "who pays?" is entirely an administrative matter for the health service and nothing to do with you being enrolled as a patient per se. Sorry to hear you're having a problem with this.

It has been posted previously on here that the British Embassy (who have an official facebook page BritsInPortugal, if thats your kind of thing) have been very helpful on such matters. I can't vouch for them personally (in whatever approach you might choose), but maybe worth a try in the first instance.

If no joy there, there are various PT bodies, government or otherwise, that you could request assistance from. I can suggest this one as a start, for instance .

If those don't yield a satisfactory result, there are one or two more I can suggest.

Hope you can get somewhere quickly on this - keep us updated with any relevant feedback if you can.

Re: Do I need healthcare insurance
 

RedE - :goodpost:
but your link is not working - gets the following 502 error -

Proxy Error

The proxy server received an invalid response from an upstream server.
The proxy server could not handle the request GET /-/linha-sos-imigrante.

Reason: Error reading from remote server
then after a long delay, it opened up in https://www.acm.gov.pt/-/linha-sos-imigrante

JayneJ - try my link if you are having problems with RedE's ...
Have you actually been to the Social Security office? They should be able to help.
One thing is that the Health Centre should never have asked for your EHIC card to give you access to the Portuguese health system as you were Resident in Portugal. The EHIC card is only (and was then too) for emergency use while traveling in the EU away from the country that issued it - not to sign on for long term health care. Are you in a small Health Centre or the major one for your local town - there should be a Health Service Administrator who should be able to clear up the original problem, but failing that the Social Security would be involved if somehow the UK has been charged on the basis of your UK EHIC card for your health care. Not being employed in Portugal, and not being pensioner with the UK, means you fall between the two stools, but because you were accepted as Resident as EU member state citizen at the time, means you have rights to the health service the same as any legal resident in Portugal.
Also as a resident, not claiming health costs via the UK (S1 or other eg students) means that you should now get your EHIC (for travel as an EU resident throughout the EU) from Portugal. In fact since you were resident in the Portugal for the last couple of years, your UK EHIC should not have covered you for travel eg to Spain in case you needed treatment there!! The Social Security Office sorts out the EHIC card for you.
Take a look at the following also
https://www.gov.uk/guidance/living-in-portugal
https://www.gov.uk/guidance/living-i...gal#healthcare
https://www.gov.uk/guidance/healthca...luding-madeira

Hope you can get it sorted out - let us know how you get on!

Re: Do I need healthcare insurance
 

RA - I suspect that JJ possibly has already been to Social Security and drawn a blank - they really should only get involved if there's an S1 form to register or if someone needs a SS number because they're working. If neither applies, they'll probably just shrug because it's not their area. I doubt they'd intervene with the health authority on her behalf to tell them that they should register her without a SS number and also not via the EHIC. I could be wrong, though.

You're absolutely right that the initial registration should never have been done using a UK EHIC (NB JayneJane that EHIC card is now doubly obsolete both because you're resident in Portugal and because it's a pre-Brexit issued card and thus is no good after 1st Jan this year) and I second everything else you say on the matter. Once JJ is correctly registered in the health service (:fingerscrossed:), then she can apply to SS for the EHIC.

Re: Do I need healthcare insurance
 

Quite on the contrary. The initial registration was correctly done using UK EHIC as JJ was not resident at the time. The only way she could have been registered then was with EHIC.

As soon as she became resident few months later, then EHIC was no longer valid, and she should have updated that with the GP, providing them with CRUE, NIF, and possibly SS number.

It also matters on what grounds was the residency given - if it was not (self-)employment, then it must have been self-sufficiency. There is no absolute right to reside in another EU country as shown below, and if they did not tick the employment box in 2018, they must have ticked the self-sufficiency box.
https://eportugal.gov.pt/en/cidadaos...ir-em-portugal
Finally, "we don't work here" statement makes one wonder whether they are registered with AT for their UK rental income with a view of the reporting obligations on worldwide income.

While I'm sympathetic to any such situations, I am afraid that there may be more and deeper issues here, so ideally JJ should contact the embassy, as well as a solicitor/accountant, the latter being way overdue.

Re: Do I need healthcare insurance
 

OK, I'll accept that correction. I'd overlooked the not resident at the time of first registration in my last post and I didn't realise emergency use of an EHIC card would trigger a full registration and the issuing of a utente document, if indeed that is how things should work :unsure:

I don't see the relevance of any of that. The health authority doesn't need to know anything about the tax affairs of residents in order to enrol them correctly in the system and nor are there any grounds whatsoever from what she has posted for speculating that the OP is not fully compliant in that department. It is an entirely separate area anyway, whatever the case.

Re: social security number, no, it is not required. I have posted the enrolment procedure chart on here on a number of previous occasions. Here is the relevant part again :

ACCESS TO HEALTH CARE BY FOREIGN CITIZENS

It's the rightmost column that applies to the OP. "Permanent residence" heading used here in the sense of being here for an indeterminate period as opposed to someone who's here for a period of study or a work secondment with a defined end date or otherwise understood as limited to a maximum period. So "permanent" in this instance would apply from day one rather than the usual meaning of after 5 years' residence.

Re: Do I need healthcare insurance
 

Red Eric I don't agree with your view, but really can't argue for the sake of the argument. It does appear however that the OP is having difficulties with the SNS registration.

Obviously, mistakes were made, including not amending the initial SNS registration, and, in my view, not consulting an accountant prior to taking residence.
Any reasonable accountant probably would have suggested registration in 2018 as self-employed (almost endless list of jobs and activities available, with no requirement, or expectation, of an earnings threshold, although having very little, or no earnings would probably ring a bell at some point).

Had that been done in October 2018, the OP would have had an exemption from SS contributions in the first 12 months, and then there is 21.4% on 70% of the monthly earnings, with a minimum of €20pcm. She would have also got SS number, easy entitlement to SNS treatment, and, most importantly, qualifying pension years.

Instead, there is a Catch 22 situation, where the initial registration for residence was perhaps based on self-sufficiency, not on (self-)employment, no SS number was obtained, the SNS registration remained linked to the UK EHIC and some time later the combination of all that causes endless troubles.

No forum is the right place to obtain a professional advice on such matters. I think that the OP should contact an accountant, or a solicitor with a view of seeking the easiest, and the quickest, resolution of the problem looking forward. She may indeed try to write to various institutions for help, she may complain, etc, but she needs to consider the time it would take, as well as the uncertainty of the outcome (I still think that there is no absolute entitlement to SNS care no matter what).

My very unprofessional view, which is no way any recommendation, would be for OP to try to commence self-employment (a consultation with an accountant would clarify whether the husband would be covered in such case), to try and earn some money, pay the respective SS contributions after the first 12 months, and in 4 (?) years when reaching pension age, retire peacefully with 4 extra qualifying years with the Portuguese social security system.
Once she is in possession of SS number there would be no obstacles whatsoever to registration with the SNS.

Re: Do I need healthcare insurance
 

I suspect you are not being of help to the OP on the matter of the question asked (which is what we should be focussing on), in favour of making rather rash pronouncements on your presumed situation of the OP in quite another area, on which it is not our business to comment in the absence of it having been asked.

If the OP is, indeed, lacking in information with regard to your assumptions, perhaps she could initiate a conversation on that specific subject should she wish to do so.

Re: Do I need healthcare insurance
 

The OP and her husband have only the following options ahead of them:

1. Insist to be registered with the SNS based on residency alone - probably best, but could take time, and I reiterate my doubts on this.
2. Pay for private insurance - hardly useful, given the pre-existing conditions, which will have to be disclosed, and quite likely excluded from cover.
3. Do nothing and pay out of pocket any health costs from now, possibly beyond pension age.
4. Try to exercise self-employment (or become employed) and benefit from immediate inclusion with the SNS; that being reversible if/when 1. eventually works.
5. Return to the UK and after 6 months of continuous residence there be entitled to NHS care as ordinarily residents (citizenship alone will not suffice).

The final decision is cost vs benefit vs risk analysis, which is for them to take.

Empathy is fine, it simply does not provide a resolution per se.

Re: Do I need healthcare insurance
 

With sincere apologies to JayneJayne for this lengthy digression - goodness knows what you must be thinking of us.

The OP's health centre, quite simply, has it wrong and the OP has every right to pursue the matter to a satisfactory conclusion. All other "suggestions" are irrelevant to that and unhelpful in terms of getting the matter resolved.

Here is an excellent summary from the British Embassy.

http://www.facebook.com/BritsInPortu...7580762405640/

Note - all residents have the right to register in the public healthcare system. You do not need a Social Security number.

Couldn't. Be. Plainer.

Re: Do I need healthcare insurance
 

This is correct, OH and I have our public health registrations and numbers this way.
It took a couple of tries.
Even if you use private doctors or insurance, you get steep discounts on prescriptions when you have your PT national health patient number on the script.

Re: Do I need healthcare insurance
 

https://europa.eu/youreurope/citizens/residence/residence-rights/index_en.htm#inactive-citizens-1

As an EU citizen, you have the right to move to any EU country for a period of up to 3 months as long as you have a valid identity card or passport. If you want to settle in another EU country but you have no intention to take up any work or education there, you need to prove that you:

• have sufficient resources for you and your family during the time you want to stay in your new country
  
• have comprehensive health insurance
  

Reporting your presence and registering your residence

During the first 3 months of your stay in your new country, as an EU citizen, you cannot be required to apply for a residence document confirming your right to live there - although in some countries you may have to report your presence upon arrival.

After 3 months in your new country, you may be required to register your residence with the relevant authority (often the town hall or local police station), and to be issued with a registration certificate.

You will need a valid identity card or passport and:

• proof of comprehensive health insurance
  
• proof you can support yourself without needing social assistance benefits: resources may come from any source, including from a third person.

Re: Do I need healthcare insurance
 

My understanding of the above is that for economically inactive residents, who are not of pension age, acquiring residence is conditional upon proof of funds and of comprehensive health insurance.

Although residence may have been granted in the absence of fulfilling those requirements, the likely conversation in the circumstances could well be:

- I want to register for SNS, here is my residence certificate.
- We have you registered here with your EHIC, which has now expired. Do you have SS number?
- I don't, I don't work, I'm self-sufficient.
- Hmm, weren't you supposed to have your own health insurance then?
- I don't think so, I had EHIC.
- Well, let me check with SEF then...

And then it could all easily go back to reconsideration of the initial decision to grant residence as the proper procedure may not have been followed at the time. If it were followed to the letter of the law, then both proof of funds, and proof of health insurance should have been required prior to granting residence to someone who is economically inactive and is neither a worker, nor a self-employed, nor a pensioner, nor a student. The right to reside in another EU country has never ever been unconditional.

Again, the OP could try and fight and may well even succeed to register with SNS based on the residence certificate only. But she could equally open a can of worms with unpredictable outcome.

Re: Do I need healthcare insurance
 

Your understanding of the latter is incorrect when it comes to Portugal and registering EU citizens as resident.