Certain categories of patients are exempt from co-payments: pregnant women, children under 18, people with low incomes, or those with at least 60% work incapacity. Consultations related to certain conditions (diabetes, cancer, mental health, HIV, chronic pain, etc.) are also exempt from co-payments. Additionally, the co-payment is waived when the healthcare center consultation follows a request to the SNS call center.
In Portugal, the majority of co-payments (taxas moderadoras) charged to insured persons were gradually eliminated between 2020 and June 2022. However, a fixed contribution is still required from insured persons for emergency services (€14/16/18 depending on the service, and up to €40 additional for examinations). This co-payment should not apply if the emergency visit occurs following an SNS prescription* or if it is followed by hospitalization.
A financial contribution from insured persons is also maintained for medication purchases.
- Following a consultation at a health center or a call to 808 24 24 24 (SNS 24 line).
Hospitals
Except in emergencies, hospitalization must be prescribed by a general practitioner. It is free for insured persons within a National Health Service facility.
For emergency consultations, the patient’s contribution is €14. This co-payment is waived when the emergency visit occurs on recommendation from a doctor or the SNS call center.
Outpatient consultations generally require patient contribution. However, the co-payment may be waived in certain cases (particularly for the first specialist consultation when prescribed).
Dental Care
The system includes a “dental voucher” (cheque-dentista) program allowing access to care, provided that patients consult a practitioner participating in the program.
The insured person has free choice of dentist within the National Health Service system. Certain treatments are covered for:
- children up to age 16 (sometimes 18);
- pregnant women monitored under the National Health Service;
- beneficiaries of the elderly solidarity supplement;
- AIDS patients.
Dental prostheses are partially covered by health insurance for elderly people in difficult economic situations.
Pharmaceutical Products
Coverage of medications depends on the patient’s illness and varies according to medication category:
Category A: 90% Category B: 69% Category C: 37% Category D: 15%
Note: The coverage rate is higher for pensioners who receive an annual pension less than 14 times the guaranteed monthly minimum remuneration (Retribuição Mínima Mensal Garantida) from the previous calendar year or 14 times the current IAS** value when the latter is higher than the minimum remuneration.
Certain pharmaceutical products, intended to treat specific conditions or defined patient groups, are either fully covered by the State or partially covered, according to special provisions.
- Specifically 95% for Category A medications, or 84%, 52%, or 30% for medications in categories B, C, and D. ** The IAS (indexante dos apoios sociais) is an indexing mechanism for certain social benefits. IAS in 2020: €438.81.
b) Cash Benefits (Sickness Benefits)
To qualify for daily sickness benefits (subsídio de doença), an employee must demonstrate 6 months of membership with registered earnings and have worked at least 12 days during the 4 months prior to the month preceding the start of incapacity.
Cash benefits are provided to employed workers starting from the 4th day of incapacity. In cases of tuberculosis, hospitalization, outpatient surgery, or illness beginning during parental leave and extending beyond it, benefits are paid from the first day of incapacity.
When work incapacity lasts less than 91 days, a 5% increase is applied if the reference income does not exceed €500 or if the insured person has at least 3 dependent children for whom family allowance is paid (or children who are eligible for the disabled child supplement).
The daily benefit amount depends on the duration of incapacity*:
- Up to 30 days: 55% of reference income
- From 31 to 90 days: 60% of reference income
- Between 91 and 365 days: 70% of reference income
- More than 365 days: 75% of reference income
The income taken into account is that of the 6 months prior to the 2 months preceding work stoppage. The average income for this period must be divided by 180 to obtain a daily amount.
- In cases of tuberculosis, the daily benefit amount represents 80% of reference income (100% if there are more than 2 dependents).
The minimum monthly benefit amount equals 30% of the IAS*, or equals the reference income if this is lower than this amount. In 2020, unless reference income is lower, the daily benefit is at least €4.39 (approximately €131.64 per month).
A guide is available regarding sickness benefits.
Daily benefits are provided for up to 1,095 days (indefinite duration in cases of tuberculosis).
Compatibility with Other Social Benefits Sickness benefits cannot be combined with:
- Disability pension (pensão de invalidez)
- Old-age pension (pensão de velhice)
- Unemployment benefit (subsídio de desemprego)
- Unemployment assistance (subsídio social de desemprego)
- Cash benefits from maternity insurance
Competent Organizations The district centers (Centros Distritais) of the Social Security Institute and the competent institutions of the autonomous regions of the Azores and Madeira are responsible for providing cash benefits under sickness insurance.
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Maternity
Healthcare services provided to the mother are covered under the same conditions as regular health insurance (residency requirement in Portugal). Medical examinations and care related to maternity are not subject to co-payments.
The right to cash benefits is available to employees who can demonstrate 6 months of membership with registered earnings, consecutive or not.
a) Parental, Maternity, and Paternity Benefits
Employees who meet the membership duration requirement are entitled to paid parental leave (licença parental inicial) of 120 or 150 days according to their choice, including up to 30 days of optional leave before childbirth and 6 weeks (42 days) of mandatory leave after childbirth reserved for the mother (licença parental inicial exclusiva da mãe). The father is entitled to mandatory leave of 20 days to be taken within 6 weeks following the child’s birth, including 5 days immediately after birth (licença parental inicial exclusiva do pai). After this period, he can take an additional 5 optional leave days during the mother’s leave period. Parents can share the remaining days as they wish. The parental leave is extended by 30 days when both parents share it.
In case of multiple births, the leave duration is extended by 30 days for each additional child.
- Sharing arrangement consists of 30 consecutive days each, or two periods of 15 consecutive days (after the mother’s mandatory leave).
Daily Allowance Amounts:
| Situation |
Duration |
Allowance Amount (% of reference income*) |
| Parental Leave |
120 days |
100% |
| 150 days |
80% |
|
| Shared Parental Leave |
150 days (120 + 30) |
100% |
| 180 days (150 + 30) |
83% |
|
| Multiple Births |
+30 days per additional child |
100% (regardless of duration) |
| Father’s Parental Leave |
20 days (mandatory) |
100% |
| 5 days (optional) |
100% |
|
- Reference income equals the total income of the 6 months before the 2 months preceding work stoppage, divided by 180. Source: Social Security Institute
Note: The daily allowance amount cannot be less than 80% of 1/30 of the IAS (IAS in 2020: €438.81), meaning €11.70 per day.
b) Child Care Allowance
For a child with a disability, chronic illness, or cancer, an allowance (subsídio para assistência a filho com deficiência, doença crónica ou doença oncológica) may be paid for up to 6 months (possible extension up to 4 years, or up to 6 years in case of cancer). The benefit cannot exceed twice the IAS (€877.62 in 2020).
A child care allowance (subsídio para assistência a filho) may be granted to the parent who takes leave from work to care for a sick child under 12 years of age (no age condition if the child is disabled or has a chronic illness). The allowance is paid for a maximum duration of 30 days per year (limited to 15 days for children aged 12 and over). As of April 1, 2020, its amount corresponds to the parent’s net income*, and cannot be less than 80% of 1/30 of the IAS (IAS in 2020: €438.81), meaning €11.70, nor less than 65% of gross reference income*.
- Reference income corresponds to the total income of the last 6 months before the 2 months preceding work stoppage, divided by 180.
Competent Organizations
The centers (Centros Distritais) of the Social Security Institute and the competent institutions of the autonomous regions of the Azores and Madeira provide maternity insurance cash benefits.
C. Work Accidents and Occupational Diseases
The management of workplace accident insurance is handled by insurance companies with which employers are required to register their employees.
Work accidents are recognized as damages occurring at the workplace and during working hours, resulting in bodily injury, functional disorder, or illness that causes a reduction in work capacity, earnings, or death. Commuting accidents are also covered (particularly home-to-work travel).
Occupational diseases are listed in an official register. However, bodily injuries and functional disorders that are a direct consequence of the activity performed can be recognized as occupational diseases even if they do not appear on this list.
In case of workplace accidents, healthcare is fully covered by private insurance companies. These companies may specify the healthcare provider. The patient does not pay any contribution.
For occupational diseases, care is provided by healthcare providers chosen by the insured person. These may be subject to reimbursement of costs advanced by the patient, or provided directly by the National Health Service (Serviço Nacional de Saúde).
Cash benefits are paid without any waiting period and without minimum membership duration requirements.
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Temporary Disability
In case of total temporary disability, the monthly benefit equals 70% of reference income* for the first 12 months, and 75% from the 13th month.
In case of partial temporary disability, the monthly benefit amount equals 70% of the loss of general earning capacity.
- Reference income = gross annual remuneration at the date of risk occurrence (workplace accidents), or in the 12 months preceding cessation of risk exposure or the date of disease certification (occupational diseases).
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Permanent Disability
The pension amount depends on the extent of disability. Three situations should be distinguished:
In case of total permanent disability (all professions): the pension amount equals 80% of reference income*, increased by 10% for each dependent family member up to 100% of reference income*.
In case of total disability for usual profession: the pension amount is between 50% and 70% of reference income* depending on remaining capacity to perform another profession.
In case of partial permanent disability: the pension amount generally corresponds to 70% of estimated lost earnings.
- Reference income = gross annual remuneration at the date of risk occurrence (workplace accidents), or risk exposure or the date of disease certification (occupational diseases).
Supplement for Third-Party Assistance (prestação suplementar para assistência de terceira pessoa): granted to recipients of a permanent disability pension due to accident or occupational illness who require third-party assistance for daily activities. The supplement amount corresponds to the remuneration paid to the person providing assistance, up to 1.1 times the IAS (IAS in 2020: €438.81).
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Death
In case of the insured person’s death following a workplace accident or occupational disease, a survivor’s pension may be paid to:
- the surviving spouse
- former spouse who received alimony at the time of death
- person who lived with the deceased in a marriage-like relationship
- children or parents who were dependent on the deceased
The pension is paid to the surviving spouse, former spouse, and person who lived with the deceased under the same conditions as in the survivors’ pension insurance scheme (see Survivors section). The orphan’s pension covers children under 18 years (22 or 25 years if studying, depending on the type of studies). The age limit may be removed in cases of disability or chronic illness affecting work capacity.
The pension amount for surviving spouse or person who lived with the deceased equals 30% of the deceased’s annual earnings*. This increases to 40% for beneficiaries who have reached legal retirement age or have a disability or chronic illness. For former spouses, this amount cannot exceed the previously received alimony.
The orphan’s pension is respectively 20%, 40%, or 50% of the deceased’s annual earnings* for 1, 2, or 3 or more children.
The pension amount for dependent parents varies from 10% to 20% per dependent person, based on the number of survivors, beneficiary’s age, and presence of disability or chronic illness.
Note: The total of pensions must not exceed 80% of the deceased’s annual earnings*.
- Annual earnings of deceased: gross annual remuneration at the date of accident or risk exposure or the date of disease certification.
Death Allowance
The death allowance (subsídio por morte) is paid as a lump sum to family members of the insured person who died following a workplace accident or occupational disease.
The amount corresponds to 12 times the value of 1.1 times the IAS*.
Funeral Expenses Allowance
The funeral expenses allowance (subsídio por despesas de funeral) aims to cover actual burial expenses, up to 4 times the IAS*. This amount is doubled if body transport is required.
D. Pensions
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Old Age Conditions
The general social security pension system in Portugal is mandatory for employed workers.
To qualify for an old-age pension, one must have contributed for at least 15 years (including credited contributions), with at least 120 days of registered earnings each year.
Note: Residents who do not meet the required contribution period for an old-age pension may be eligible for a social pension (pensão social de velhice). Monthly income must not exceed €175.52 (€263.29 for a couple). In 2020, the social old-age pension amounts to €211.79 per month. A solidarity supplement of €18.44 or €36.86 (paid before and after age 70 respectively) may be added. More information available.
Upon the death of a social pension beneficiary, family members may, subject to means testing, receive a widow’s pension (pensão de viuvez) or an orphan’s pension (pensão de orfandade). The surviving spouse can receive 60% of the social pension (€127.07 in 2020) while the amount paid to orphans depends on the number of eligible recipients (in 2020: €42.36, €63.54, €84.72, or double these amounts if there is no surviving spouse).
Legal Retirement Age The legal retirement age is regularly adjusted according to life expectancy. In 2020, it is set at 66 years and 5 months.
For 2023 and 2024, the legal retirement age is set at 66 years and 4 months.
The increase* in the legal retirement age also applies to access to the social old-age pension (non-contributory pension) and the elderly solidarity supplement (complemento solidário para idosos).
Furthermore, when the old-age pension replaces a total disability pension (invalidez absoluta), it is not possible to engage in professional activity.
If the insured person continues working beyond the legal retirement age, the pension is increased for each month completed beyond this age and up to age 70. The increase rate varies between 0.33% and 1% depending on years of contributions:
The insured person aged 60 or over who has at least 40 years of contributions with registered earnings may request early pension liquidation.
The months of anticipation (between pension liquidation and normal retirement age) used to determine the pension reduction rate (0.5% for each month of anticipation) are reduced by 4 months per year of contributions beyond 40. The anticipation coefficient is eliminated after 48 years of contributions, or after 46 years of contributions for people who started contributing before age 17.
Early retirement is also possible from age 57 or 62 for insured persons in long-term unemployment situations (pensão antecipada por desemprego de longa duração).
Note: To calculate the amount of a Portuguese old-age pension, insurance periods completed before 2002 are distinguished from those completed after that date. The following explanations concern periods contributed since 2002. For people with earlier insurance periods, the pre-2002 calculation rules are partially used. More information available.
The pension is calculated based on average monthly earnings over the entire professional career, up to 40 years. For longer careers, the 40 years with the highest earnings are considered. For a year to be counted, it must include at least 120 days of registered earnings.
The old-age pension amount equals the product of the reference income and the annual rate applied based on insurance duration.
For certain early pensions, a sustainability coefficient (fator de sustentabilidade) is applied (depending on insurance duration and early pension category). This corresponds to the ratio between average life expectancy at 65 in 2000 and that observed in the year preceding pension liquidation. In 2020, it is 0.8480.
As of January 1, 2023, the sustainability coefficient is 0.8617.
Where: R = reference income, calculated as total remuneration over the entire career, divided by the number of professional years (minimum 15 and maximum 40) x 14
Ta = annual rate (number of years with registered earnings considered for calculation). Up to 20 years of contributions, the annual rate is fixed at 2%; beyond that, it ranges between 2% and 2.3%, depending on the reference income.
The minimum old-age pension amount depends on the insured person’s contribution period:
Elderly Solidarity Supplement (complemento solidário para idosos) Subject to residing in Portugal for at least 6 years, pensioners* whose annual income is below €5,258.63 (single person) or €9,202.63 (couple) may receive a monthly payment equal to the difference between their income and these amounts (2020 values).
Dependency Supplement (complemento por dependência) In 2020, a monthly amount of €105.90 (1st degree of dependency) or €190.61 (2nd degree) is paid to pensioners who need daily assistance from a third party.
