Portugal healthcare for foreigners: what is changing

More than 330,000 emergency visits without payment in four years: on October 16, 2026 Portugal's parliament approved in first reading a bill making foreigners without residency pay for public healthcare or show insurance. Who is affected and how to keep access to doctors.

In detail

For years Portugal's public healthcare behaved like a generous neighbour: it treated everyone who turned up and rarely sent a bill. Between 2021 and 2024 foreigners without Portuguese status visited hospital emergency departments more than 330,000 times without their costs being covered. Debts from such patients are estimated at up to €15 million.

On October 16, 2026 parliament decided the neighbourly arrangement needs a contract. A bill from the governing parties was approved in first reading: foreigners who do not officially live in Portugal will pay for the SNS or show insurance. Here is who it affects and who it does not.

What Portugal's parliament approved

The bill is 786/XVII from the PSD and CDS-PP, passed alongside similar proposals from the Chega party. It amends the Basic Health Law (Lei de Bases da Saúde), the framework law the entire public health system rests on.

• Who it covers: foreigners who are not residents of Portugal.
• What changes: treatment in the SNS (Serviço Nacional de Saúde - the national health service, public hospitals and health centres) requires payment or proof of health insurance.
• The exception: emergency care and life-threatening situations. A person without insurance will still get emergency treatment.
• New requirements: proof of address or insurance when seeking care, and tougher debt collection.

Three parties voted in favour - PSD, CDS-PP and Chega - and seven against, including the Socialists. Health Minister Ana Paula Martins acknowledged that collecting money from non-residents is currently almost impossible.

When the law takes effect

A first reading in Portugal is a vote on the principle. The text can still change. Three steps follow:

1. article-by-article review in the relevant parliamentary committee;
2. a final vote of the full chamber;
3. the president's signature and publication in the Diário da República official gazette.

The governing coalition and Chega together hold a majority, so the law will pass. The open question is detail: which documents reception desks will ask for and how residency will be assessed.

Who is affected and who is not

The patient number (número de utente) is your ID in the health system. Your local health centre issues it once you have a residence permit, an NIF tax number and an address. Without it, at a public clinic you are an outsider, even if you have lived around the corner for three years.

The most exposed group today is people waiting on the AIMA migration agency. Its queue is enormous: at the start of October 2026 about 6,000 of 46,000 golden visa applications had been processed. How to speed up a case through the courts is covered in our article on court actions against AIMA.

How much healthcare in Portugal costs without insurance

A visit to a public hospital emergency department costs a non-resident about €100, with tests and scans billed separately. A few days in hospital easily runs into thousands of euros.

Private insurance for an adult costs noticeably less than a single serious hospital stay. For a visa you need it anyway: consulates require a policy when you apply for Portuguese residency or the digital nomad visa. How to choose a policy accepted by both the consulate and the clinic is covered in detail in health insurance when relocating.

Practical advice: even with a patient number, many expats keep private insurance. Portugal's public healthcare is good, but the wait for a specialist in the SNS is measured in months, while a private clinic will see you within the week.

What it means for residency and moving to Portugal

The bill does not change the conditions for residence permits, the D7 passive income visa, the D8 remote work visa or the golden visa. It makes life without formal status more expensive. The person hit hardest is easy to picture: living in Lisbon on 90 tourist days, working remotely and using the doctor as if at home. That model is ending.

For a legal move the sequence is simple:

• get an NIF and open a bank account;
• obtain a visa and residence permit, detailed in how to get residency in Portugal;
• register at a health centre and get a patient number;
• keep private insurance until the residence card arrives.

For the long view, see our articles on Portuguese citizenship after the 2026 timeline changes and on buying a flat in Portugal; taxes for new residents are on our Portuguese taxes page.

How to get a patient number in Portugal

The patient number is the key document for public healthcare, and getting it is easier than it looks if you go in the right order.

1. The NIF tax number. Nothing in Portugal works without it: not a lease, not a bank account, not a phone contract. You can get it before moving through a representative.
2. A residence card or proof of application. The health centre looks at your immigration status. A residence card settles the question at once.
3. Proof of address. A lease or a residence certificate from the parish council (junta de freguesia - the lowest tier of local government, similar to a district office).
4. A visit to the health centre for your address. Registration is free; the number is issued on the spot or sent later. You can also ask to be assigned a family doctor there.

It is also worth getting a NISS social security number: you need it for work, benefits and tax deductions for medical costs. Medical receipts in Portugal reduce your tax if the provider puts your NIF on the invoice, so give the number at every clinic and pharmacy.

Families need a patient number for each member. Children receive one on the strength of their parents' documents, and it opens free paediatric care and vaccinations under the national schedule.

If Portugal feels complicated: alternatives

Portugal has been tightening rules for a second year running: citizenship timelines, the immigration law, now healthcare. If you are still choosing a country, compare:

• Spain - the digital nomad visa, with public healthcare access after registration.
• Other remote-worker visas - compared in our digital nomad visas section.
• Residency by investment in Greece and Cyprus - an overview in our residence by investment section.

Our Portugal services

We run relocations so that by your first doctor's appointment you have status, a patient number and a policy for the transition.

Plus the formalities where people get stuck most: the NIF tax number, a patient number at the health centre, a social security number, a bank account and company formation. If you are choosing a city, start with our guides to Lisbon and Porto.

FAQ