I was curious why this should be, but closer inspection revealed that their split between private and public healthcare was very similar to what seems to be happening in Portugal.

Singapore has a very highly developed private sector at all levels, from family doctors to major hospitals with advanced technical facilities to treat major health problems. Their public free healthcare is equally as advanced.

What they seem to be doing is to actively encourage those who can afford private healthcare insurance to use the private sector. In this way they relieve the pressure on the public system which means those on lower incomes get faster service from the public sector.

Private health care helps public health care

This is a win-win situation. Looking at Portugal’s public health care, it’s obvious that its heavily under pressure. The facilities are good, the doctors and surgeons are first class but due to demand any non-urgent procedure can be subject to considerable delay. If those who can afford private health care insurance, and it’s not overly expensive, used the private sector, then the public sector would be able to treat those who can’t afford to go private much faster.

The Portuguese health system is currently ranked well by the World Health Organization. The 2019 Health Care Index lists Portugal’s system as 22nd best out of 89 countries, with a high score for quality of infrastructure.

Health insurance is affordable

Private insurance in Portugal is generally quite cheap. This could cost between €20 and €50 a month, depending on your age and the extent of your coverage. This means you can pay anywhere between €400 a year for a basic plan and €1,000 yearly for a more extensive coverage. Another critical consideration is that due to EU regulation (they do sometimes get something right) the insurance company cannot terminate your cover once you reach 70 years old (that used to be the age that cover was terminated). Once covered, you are covered for life. One company, Medicare, are now actively promoting medical insurance for those over 60. Others are bound to follow. If you don’t have insurance, the HPA group offer a CareCard for a nominal annual fee which gives discounts on their services and even a free annual health check.

Shop around for the best rate

You need to shop around for the best rate and make sure that the insurer you choose pays the hospital direct, rather than you needing to pay first and then make a claim.

MEDIS is one of the largest healthcare insurers, and from personal experience I know they have very close connections with the private health care system. For a normal minor consultation their computer systems are connected to most hospitals and doctors, and approval take a matter of one or two minutes. They are not the only insurers; competition is very high due to the demand for private health care.

The best way to be sure which insurance company provides ‘direct’ payment simply look on the hospital or clinic website. All major private hospitals and clinics list the companies they have direct arrangements with. A situation to be avoided is where you must pay the hospitals account and then reclaim from the insurance company. With all the best intentions, insurance companies rarely make payments with any sense of urgency. When the insurance company has a direct arrangement, the hospital charges them direct.

There is a private hospital or clinic near you

The private health sector in Portugal is extensive. In the Algarve there are five private hospitals as well as an extensive range of clinics offering routine consultations and treatments. The private hospitals have emergency departments and 24/7 availability of doctors. In Lisbon there is a large range of options, over twenty private hospitals in or near the centre of Lisbon. Porto has over fifteen private units. There can be no question that the availability of private health care is extensive in Portugal and of a very high quality.

Free dental care isn’t available on the health service unless you are classed as being in a vulnerable group unable to pay; this includes children, elderly, or disabled residents. Dental care is effectively all private, but many insurance companies offer dental insurance as well as the normal health cover.

By using private health care, you are helping the public sector and those who need to use it. Not only will you get much faster treatment and a choice of doctors, but those using the public health system may be able to get faster treatment.

Public demand for private health care

There is no evidence that the Portuguese government is promoting private health care in the same way as Singapore, but it’s clear that this is happening here in Portugal. It’s being driven by public demand and affordable health insurance, not government policy. The end result is the same. For a small monthly payment, you can get instant access to a doctor, and major (or minor) surgery at a time that suits you and within a few weeks at the most.

Meanwhile you will be helping the public health sector to treat people much quicker.


Resident in Portugal for 50 years, publishing and writing about Portugal since 1977. Privileged to have seen, firsthand, Portugal progress from a dictatorship (1974) into a stable democracy. 

Paul Luckman