There are policies to cover Portugal only, the rest of Europe and Worldwide but by restricting your cover to treatment just in Portugal you will certainly reduce the premium and this could be combined with a travel insurance to cover any trips outside of your country of residence. The total cost of a Portugal only health insurance policy plus a worldwide travel insurance policy would be far less than the cost of a worldwide health insurance policy!

There is a maximum amount that insurers will pay in a policy year and the lower you set the limits, the lower your premium will be. However, the limits should be realistic at both the lower and top ends – a €15,000 limit may not quite cover a hip replacement but at the other end of the scale you are unlikely to use a €2 million limit.

You could opt for policy to cover as a hospital inpatient only but whilst a policy that just covers hospital admission will be less expensive, outpatient treatment can become costly so think carefully before taking out a restricted policy. Many policies also include optional extras for dental work, medication, and complementary treatment such as chiropractor, osteopathy or Chinese medicine, but if these risks are included, then the premium will be more expensive so again think carefully as to whether you are going to need them.

There will be an excess, or deductible, which is the amount that you must pay from your own resources before the insurer will reimburse you. It is usually on an annual basis but some policies apply the excess to each medical condition. If you are generally healthy and don’t habitually go to the doctor then taking a voluntary higher excess is a good way of reducing the premium as most insurers give generous discounts for this, but our advisor will give you guidance on the way that the excess works for each policy so that you can make an informed decision.

If you wish to use only your own doctor, some policies may not be suitable as most Portuguese health insurers use a network of doctors and hospitals that you will need to use to maximise the benefits of the policy, and your own doctor may not be within the insurer's network. Lena will be able to verify this at the time of your discussion, but if your doctor is not listed, you can still go outside of the insurer's network but be aware that the reimbursement may be lower with usually a monetary cap on doctor consultations.

You should be aware that there could be a waiting period of up to 3 months before any claim can be made, and even 12 to 18 months for certain medical conditions and again, our advisor will confirm to you. International policies tend not to have this waiting period and if you are moving from one health insurer to another without a break, usually, the waiting period is waived.

A most important aspect is pre-existing and ongoing chronic medical conditions requiring regular check-ups and medication as whilst some may be accepted, they will often be excluded from the policy, although if transferring from one provider to another, the new insurer may cover pre-existing conditions. You will usually be asked to complete a medical questionnaire and the underwriters will:

  • include any previous/on-going condition or,
  • exclude the condition for a certain period of time or,
  • exclude the condition completely.

With some insurers you do not need to complete a questionnaire and they will underwrite the policy on a moratorium basis, which means that any medical condition that you have had in the previous (usually) 5 years would be excluded for (usually) 1- 2 years. At the end of the moratorium, assuming that you have not taken medication, consulted with a doctor or experienced symptoms for the condition, it would then be included for cover.

Because Private Medical Insurance is extremely complex with many options and costs, it is worth contacting Ibex Insurance as we have access to a range of policies and we are more than happy to provide comparisons to show the different covers and costs, and help you choose the right policy at the right premium.

If you have any queries, please don't hesitate to call into one of our offices in Almancil or Tavira to get the most suitable policy to meet your needs or call us on 800 860 708 / 289 399 774 for Almancil or 281 325 842 for Tavira. Or if you prefer, send an e-mail to ptnews@ibexinsure.com