Clínica
SNS vs private:
how each system works
Access, waiting times, costs and when each option makes more sense — for residents, expats and anyone passing through.
They are not competitors — you can use both
In Portugal, healthcare is divided into two systems that operate independently: the private system and the public system (SNS). They are not competitors in the strict sense — you can use both, at the same time or according to the situation — but they have completely different access and funding models. It is worth understanding clearly how each one is organised before you decide where to seek care.
Private
Open access, paid — one-off, through insurance or through a plan. Resident or not.
SNS
Universal and, as a rule, no fees for consultations, emergency care and tests since 2022.
EU tourist
European Health Insurance Card (EHIC) in public emergency departments and health centres. Does not cover private care or vaccination.
Expat
You can stay on private care only until you have an SNS user number — and keep both afterwards.
Three types of response
The private system is made up of independent services that anyone can access — resident or not, whether or not you pay tax in Portugal — freely, by paying a fee (one-off, through insurance, or through an access plan).
1. Private online consultations
Telemedicine services, such as LON Clinic, indicated for matters that can be handled by video call, without the need for an in-person assessment — for example:
- Travel consultation (advice before trips, recommended vaccination)
- Mental health consultation (psychology, psychiatry)
- General medical consultation, without warning signs and without the need for a physical examination
2. In-person consultations
At independent clinics or private hospitals — the best-known groups in Portugal are CUF, Hospital da Luz and Lusíadas Saúde — for situations that need a physical examination, in-person diagnostic tests, or ongoing follow-up.
3. Private emergency care, inpatient stays and surgery
The same hospital groups (and other smaller or regional ones) also offer a private emergency service, inpatient care and surgery — usually with much shorter waiting times than the public sector, but always paid (one-off or covered by health insurance).
How the SNS is organised
The National Health Service (SNS) is universally free of charge — which means free for everyone, not only for those who contribute to funding it. It is supported by the amount deducted from citizens in tax, but that does not prevent people who do not pay tax (tourists, migrants in an irregular situation, and so on) from using certain services, such as emergency care.
The SNS is organised into three main components:
- Hospital emergency care — attendance by priority triage (Manchester Protocol, below)
- Primary healthcare — family doctor, nurse, psychologist, and so on, available at health centres, usually the first point of contact with the system
- Hospital or continuing care — specialist consultations, inpatient stays, surgery and long-term care, generally by referral from primary care
Manchester Protocol
In SNS emergency departments, the order of attendance is not the order of the queue: it is the order of severity. The Manchester Protocol assigns a colour and a target time.
A “green” complaint may wait two hours or more. That does not mean the service refused to treat you — it means there are more urgent cases ahead. If the complaint is not an emergency and you do not want to wait, you can book a same-day online consultation.
If you are a tourist and need assistance, where can you go?
Public system: emergency care
It is free at the point of care for citizens of the EU/EEA/Switzerland/United Kingdom who hold a European Health Insurance Card (EHIC) — you pay on the same terms as a Portuguese resident (that is, at no cost, since moderating fees in emergency departments were abolished in 2022). The cost of treatment is then settled directly between the Portuguese health system and that of the country of origin, through European agreements — you do not pay that difference yourself.
For tourists from outside the EU/EEA, access to emergency care is not refused for lack of documents (an emergency is always attended), but, without an EHIC or a bilateral agreement with the country of origin, it is normal to be charged for the attendance.
SNS 24 or 112?
Before going to an emergency department, the most appropriate step is to contact the SNS 24 line first (808 24 24 24) — the team carries out telephone triage and directs you to the most suitable response, including, if necessary, to the nearest emergency department according to your symptoms. This prior contact is not currently mandatory for most emergency departments — it has only been required for obstetrics and gynaecology emergencies, nationwide, since February 2026. Outside that specific case, it remains a recommendation (to speed up attendance), not an entry requirement. In any life-threatening situation, direct contact is always still 112, without going through telephone triage.
Private system (paid by you)
Online consultation — for mild complaints, with same-day attendance. Clinic, private hospital or private emergency department: contact or go directly to the location.
You are an expat, digital nomad, and so on — you intend to stay for a long period
If you plan to stay in Portugal for an extended period, you essentially have two options, which are not mutually exclusive:
- Option 1: stay in the private system — through private health insurance or paying as you go, without depending on the SNS. This is usually the faster option while your residence situation is not yet regularised.
- Option 2: obtain an SNS user number (Número de Utente, NNU) — as soon as you have a residence permit (or more than 90 days of documented stay), you can register with the SNS and gain access on the same terms as a Portuguese resident, while keeping private care in parallel for whatever you prefer to treat more quickly.
How to obtain an SNS user number (NNU)
| Situation | How to obtain it |
|---|---|
| Portuguese citizen | Assigned automatically with the Citizen Card, printed on the reverse |
| Brazilian citizen | PB4 certificate |
| Foreign national with a residence permit | Present the Residence Permit at the local health centre |
| Foreign national in Portugal for more than 90 days | Certificate of Residence (obtained at the local parish council, Junta de Freguesia) |
| Newborns | Assigned automatically at the hospital, through the “Nascer Cidadão” process |
The request is always free of charge. Since 2022, moderating fees have been abolished for consultations, emergency care and tests in the SNS — only some specific situations (such as physiotherapy) retain a residual cost.
Frequently asked questions
When public care does not reach you — or does not apply
For anyone on holiday who needs prompt medical advice (without the limits of the EHIC, which covers neither private care nor vaccination), for anyone without an SNS user number, or simply for anyone who prefers not to wait months for the SNS — LON Clinic offers telemedicine consultations in Portuguese, English, Spanish, French and German, and has a component with a special focus on travel medicine.
Need a consultation
without waiting for the SNS?
Book online, the same day, in Portuguese, English, Spanish, French or German.
See consultations →Telemedicine · no travel · prescription when clinically indicated
A compilation of public information on the SNS and the private sector in Portugal. Access rules, fees and international agreements may change — always confirm at sns24.gov.pt or at your local health centre.
Revisto pela equipa médica da Lon Clinic ·