How to choose private health insurance in Portugal and understand the co-payments
This guide will help you tell real health insurance from a discount card and compare the monthly premium, the cover and the co-payments for treatment. Before signing up, check the waiting periods, exclusions, clinic network and limits: the same plan name does not mean the same terms.
Decide whether you need insurance or a discount card
A seguro de saúde (health insurance policy) takes on an agreed financial risk: it pays for treatment within the cover, limits and other terms of the contract. Within the partner network you usually pay only the co-pagamento (patient co-payment), and for treatment outside the network you pay yourself first and can then claim reimbursement — if the plan provides for it.
A plano de saúde or cartão de saúde (health plan or discount card) usually just gives access to agreed prices at certain clinics. It may take effect at once and cost less, but it does not have to pay for a hospital stay or major surgery. CUF+ and some plans linked to Continente should be checked on exactly this point: a name and “special prices” do not make a product insurance.
Ask for the Documento de Informação sobre o Produto de Seguros (insurance product information document). If there is no such document and all you are promised is a table of discounts, it is most likely a health plan, not an insurance policy.
“have a look at the insurance plans from Keep Wells. To sign up you only need a NIF and a Continente card. They have several plans. The lowest one is free with the Continente card, on the middle plan you can go to appointments at CUF and Da Luz for 25 euros. That plan starts at 12 euros per person.”
Translated from Russian; the original is at the linkMotorbike chat 🇵🇹04.05.2026
“Quickly get CUF+, I paid for it at the last minute, and in the end instead of 5500 it came to 3200, CUF+ itself is something like 80 or 90 euros”
Translated from Russian; the original is at the linkberemennost_portugal07.03.2026
Ask for a quote for each family member
There is no single price “by age” in Portugal. The insurer takes into account your exact date of birth, the make-up of the family, the modules chosen, limits, the excess, the medical questionnaire and any bank or employer discounts. So ask for a written quote for several levels of cover at once, and separately for the price of each adult and child.
From practical examples: people paid €64 a month for two adults; basic Multicare cost about €350 a year; family Multicare 3 for two adults and two children — €205 a month. Adding a child under different contracts raised the payment by €40–75 a month. The ages of the people in these examples are not given, so the amounts cannot be used as an official age-based rate.
Check how the premium will change when you move into the next age group and at each annual renewal. An old family contract may cost noticeably more or less than a new policy with a similar name.
“I recommend Multicare Fidelidade We pay 64 euros for two adults. With it you get 8 appointments a year at 19 euros, if you go to the doctor more than 8 times, the rest are 30. An ultrasound came to 42 euros, I haven't had other tests yet)) Dentistry isn't included, but it seems to be inexpensive here. They glued my crown back on in an emergency for 32 euros.”
Translated from Russian; the original is at the linkRussosEmPortugal25.08.2026
“Frankly, I didn't want to add our newborn daughter to the insurance. And I still don't see much point in it, because if the baby is healthy it's just paediatrician check-ups and paying for enfermagem for vaccinations. Our centro de saúde is close by. But my husband insisted. We have Multicare 3. My husband, me, our grown-up son, and now our daughter — €205. Our daughter added €40. For both children it's €40 each. But we've been with Multicare for a very long time, probably 9-10 years already.”
Translated from Russian; the original is at the linkpequenos_PT03.06.2026
Compare the cover, the network and the annual limits
Check separately consultas (doctor's consultations), exames (examinations), análises (tests), internamento (hospital stays), cirurgia (surgery), parto (childbirth), saúde mental (mental health) and estomatologia (dentistry). One plan may have only network prices and a few cheap consultations, another insurance cover for hospital stays and reimbursement outside the network.
Look at the capital anual (annual cover limit) for each section. For example, an outpatient limit of €1,000 may be used up not by your co-payment but by the part of the bill the insurer pays. Once the limit is used up, you may be left with only the network's agreed price or the full cost — it depends on the terms of the policy.
Check not only the clinic but the specific doctor: one specialist at CUF, Hospital da Luz or Lusíadas may work with your plan, and another at the same clinic may not. Orthodontics, implants, genetic tests and the extended non-invasive prenatal test are often excluded or have a small separate limit.
“with Multicare, standard contracts have no direct cover for orthodontics and implants. — a small discount will apply, but only at network clinics and doctors. — cover is only possible under the PROTESAO VITAL cancer insurance if it includes dental cover with a capital of 1000 euros.”
Translated from Russian; the original is at the linkmed_strahovki_pt08.04.2026
Check the waiting periods and chronic conditions
The período de carência (waiting period) is the time after the start of the contract when certain cover does not yet apply. For ordinary outpatient care a period of 60 days has been seen, but it depends on the product. For pregnancy and childbirth, the contracts in the examples required the insurance to have been in force for at least a year by the time of the birth. Older versions of the same plan had 365 and 500 days, so go only by your own contract.
A doença preexistente (condition that existed before the policy was taken out) may be excluded from cover, accepted on extra conditions or refused cover for that risk altogether. Fill in the medical questionnaire truthfully: hiding a diagnosis may lead to a refusal to pay or a dispute over whether the contract is valid.
If you need cover for pregnancy, an operation or regular treatment, ask the insurer to confirm the cover in writing before you sign up. A network discount price is sometimes available during the waiting period, but that does not mean the insurer is already paying for treatment.
“I have AdvanceCare, after the 3-month grace period it did NOT kick in for anything to do with pregnancy, I had my 3rd-trimester ultrasound at CUF for €112 again 🥲 I wrote to the insurer, like, ‘so where's the discount?’, they replied ‘for pregnancy, wait a year’”
Translated from Russian; the original is at the linkberemennost_portugal22.01.2026
“Right after the first payment you get special prices at clinics in the Multicare network (CUF, Luz, Lusíadas etc.) with doctors who work with Multicare Access to cover (if it's included) comes after 60 days.”
Translated from Russian; the original is at the linkmed_strahovki_pt28.12.2025
Understand the excess and the co-payment for each service
The co-pagamento (patient co-payment) is a fixed amount, or one set out in a table, for each appointment, test or examination. Under one Multicare contract the first eight consultations in the policy year cost the patient €19 each, and later ones €30. On the Keep Wells health plan a consultation at CUF and Hospital da Luz cost €25.
The franquia (excess) is the part of a large bill the patient pays before the insurer pays. For example, under several Multicare contracts the excess for a covered birth was €500. This is not the same as the monthly premium or the co-payment for an ordinary appointment.
Ask whether pré-autorização (prior authorisation) is needed for magnetic resonance imaging, an operation, a hospital stay or a birth. Without approval, the clinic may ask for a deposit or full payment, and you will have to fight for the refund later.
“That's exactly what happened to me. My pregnancy was followed by one doctor, but at the time of the birth she was on holiday and the birth was delivered by the doctor on duty Multicare insurance covered everything above the €500 excess. The birth itself came to 3000, we did have to pay the whole amount at first, but that was our and the doctor's mistake, the request to the insurer wasn't done properly. Then we explained everything to the insurer and CUF refunded us 2500.”
Translated from Russian; the original is at the linkberemennost_portugal12.12.2025
Check the cost right before booking
Before the visit, give the clinic the name of your insurer, the exact name of the plan and the policy number. Ask them to confirm three things: whether the doctor you have chosen works with your contract, how much the co-pagamento (patient co-payment) will be and whether a referral is needed. For tests and examinations, not having a referral sometimes changes the price or means the service is not covered.
In the cases quoted, an ordinary consultation at CUF without full insurance cover cost about €70–100, and with active cover a co-payment of €19 was seen. This is not an official single CUF rate: the cost depends on the speciality, the doctor, the branch and whether there is a network discount. There is no reliable evidence here of the current price of an ordinary appointment without insurance at Lusíadas and smaller clinics — you need to ask for it when booking as the preço particular ou sem acordo (price for a patient without an agreement).
Keep the autorização (confirmation of approval), the invoice and the recibo (receipt). If the clinic wrongly failed to apply your insurance, you will need these documents for a recalculation or pedidos de reembolso (reimbursement claims).
“I recently had an MRI at CUF Descobertas with Multicare insurance. It came to 70 euros. They gave me a disposable gown, explained everything before the procedure in English, I liked the service. Only a week has passed and they still haven't sent the MRI result they promised — so even private clinics can be slow. And the second thing, if I understood correctly, the price of the service depends on whether you have a referral from a doctor. Probably if there's no referral it'll be more expensive even with insurance. But I'm not sure. At least blood tests without a doctor's referral are more expensive.”
Translated from Russian; the original is at the linkchatlisboa20.04.2026
“I also took my son to have his tongue-tie cut when the Multicare insurance hadn't fully come into force yet, but they still gave us a discount at Instituto CUF Porto and I paid 40 euros instead of 70 or 80 for the consultation.”
Translated from Russian; the original is at the linkberemennost_portugal23.03.2026
What it costs, according to community conversations
| policy, two adults | €64 a month for two; ages not given | source |
| basic Multicare | about €350 a year | source |
| family Multicare 3 | €205 a month for two adults and two children | source |
| dental policy | about €10–15 a month | source |
| Keep Wells plan | from €12 a month per person | source |
| appointment under Multicare | €19 for the first 8 appointments a year, then €30 | source |
| appointment under Keep Wells | €25 at CUF and Hospital da Luz on the plan described | source |
| excess for a birth | €500 with cover in force under the contracts quoted | source |
| ultrasound under Multicare | €42 co-payment in one case | source |
| MRI under Multicare | €70 co-payment at CUF Descobertas | source |
| intensive care, child, 2 weeks | €500 with insurance on a total bill of about €6,700 | source |
| Multicare, crown | €32 | source |
| Multicare, filling | €50 | source |
| CUF, extended blood test for fetal chromosomes (NIPT) | €620 | source |
| CUF, speech therapy session | €15 | source |
| Multicare, dental capital | €1,000 | source |
| Multicare, discounted birth | about €3,000 | source |
| CUF+, discounted birth | 5,500 instead of 3,200 | source |
| CUF+, cost of the plan | €80 or €90 | source |
| Multicare, a day without ventilation | €525 a day | source |
| Multicare, standard insurance per month | €65 a month | source |
| AdvanceCare, emergency care | €90 | source |
| AdvanceCare, nurse visit | €5 | source |
| Multicare 3, adding a daughter | about €40 | source |
| AdvanceCare, 3rd-trimester ultrasound | €112 | source |
| Multicare, consultation without insurance | €80 | source |
| Multicare, refund after the birth | 2,500 | source |
| AdvanceCare, ultrasound with insurance | €155 | source |
| Multicare, procedure without insurance | €450 | source |
What to bring
- identity document
- Número de Identificação Fiscal (NIF) — tax number
- policy number and insurance card
- Documento de Informação sobre o Produto de Seguros (insurance product information document)
- Condições Gerais e Particulares (general and specific terms of the contract)
- tabela de copagamentos (table of patient co-payments)
- tabela de capitais (table of cover limits)
- medical questionnaire and details of diagnoses
- doctor's referral for a test or examination
- pré-autorização (prior authorisation)
- invoice and recibo (receipt) for reimbursement
Where people most often trip up
- People buy a discount card thinking it is full health insurance.
- People compare only the monthly premium without checking the limits and hospital cover.
- People don't check whether the specific doctor is covered, even though the clinic works with the insurer.
- People confuse co-pagamento (co-payment for a service) with franquia (excess on a large bill).
- People think network prices mean full cover has started.
- People miss the separate waiting period for pregnancy and childbirth.
- People count on treatment for a condition that existed before the policy was taken out.
- People don't ask for prior approval of an operation, an examination or a birth.
- People don't check how the annual outpatient limit is used up.
- People go by the name of the plan: the terms of old and new contracts may differ.
- People try to get reimbursed again for a bill the insurer has already paid.
- People don't keep the authorisation confirmation, the invoice and the receipt.
How it went for people
The Multicare limit ran out in the tenth month
A person had Multicare 2 insurance and by the 10th month of the policy year had used up the €1,000 limit for appointments and tests during pregnancy. There was one consultation left before the limits renewed, and it had to be paid in full — €100. They decided not to take a more expensive plan: one or two consultations at the full price worked out cheaper than a higher monthly payment for family insurance.
A birth before the end of the waiting period
A person took out Multicare 3, but by the time of the birth the one-year waiting period had not ended, so the insurer refused to cover the birth at CUF in full. The clinic offered a reduced price: instead of the full cost of about €6,000 it issued a bill for €3,300. As a caesarean section was planned, the bill had to be paid a few working days before the operation.
The insurance didn't cover pregnancy in the first year
A person came to Portugal more than 17 weeks pregnant and took out AdvanceCare Tranquilidade, but the insurance did not cover pregnancy and childbirth in the first year. Tests at a private laboratory cost about €35, the second screening at CUF €155 instead of the €189 quoted when booking, the third €112. After getting a special document, the third-trimester tests became free, and from week 31 the check-ups before a planned caesarean at a state hospital also cost nothing.
A vaccination paid for on the spot, then a bill for another €60 a year later
A child was given a vaccination from the national schedule at a private clinic: they were told straight away that it was not free, and the family paid €35, believing this was the full cost. A year later the clinic sent a bill for €60 — not for the €25 difference but for the whole amount, and with no explanation. The only answer to their questions was that all vaccinations are paid for and not covered by insurance. Why the member of staff hadn't said so a year earlier, whether the bill shows the insurance being applied and where the amount came from — all remained unclear.
A policy you can't use in your own town
A family with AdvanceCare insurance lives in São Pedro do Sul, which simply has no specialists or examinations they need — they are advised to go to Viseu for them. Once in Viseu, the woman went to a clinic, but there was no appointment with a specialist available, and she was seen in the emergency department: the visit cost €90 with insurance, and each later visit to the nurse €5. The clinic said the discount had been applied. Where they live the policy doesn't work at all, so the family began thinking about another insurer with cover in Viseu.
A doctor in and out of the network: 50% back instead of 70%
This year a woman's cover for services outside the insurer's network is 50%, and last year it was 70%. The difference shows in practice: with a doctor in the network she pays the price with insurance at once, but outside the network she pays everything first, then submits a claim, and the insurer takes a while to decide how much to refund. A further problem is that a doctor may move to a clinic or terms where they don't work with insurers, and then it is unclear whether anything will be refunded at all.
Retold in our own words from messages in open chats. The link leads to the full original message.