Learning how to operate in a socialized medicine country as an American Expat presents its own challenges and learnings.  What is the Portuguese SNS?  What is a “numero de utente” and why do you need one?

Our family has been in Portugal, in the Lisbon area, for two years.  We moved here as a family of seven (five kids ages 16-6) and are navigating our way around living in a foreign country. 

What is a Número de Utente?

The direct translation, “user number or number of user”, doesn’t imply the real purpose of this little number: it’s actually your health number. The full name is numero de utente de saúde, but I typically see it referenced as numero de utente.

Portuguese citizens have this number printed on the back of their citizen card, or Cartão de Cidadão. However, we received our Temporary Residence Visas (Título de Residência), and on the back, the area for the social security number and health number both say “n/a.”

Having your SNS Number/Utente Number grants you access to Portugal’s national healthcare system. When you go to a doctor or hospital, you’ll be asked if you have this number. In the private system, it’s not necessary. Going public you will want to have this number handy.

Why Do You Need A Health Number in Portugal?

One of the requirements of our residence visas is to have health insurance with certain minimums.  We did not try to get a health number to get access to the healthcare system, although I am sure we will use it soon.

When Covid was in full swing, we needed an SNS number to get our children vaccinated. For a while, our oldest child wasn’t allowed to even eat in restaurants due to the lack of vaccination. 

The bottom line is this: you really cannot do anything, health-wise, in Portugal, that requires registration with the government without this health number.  

What Can You Use Your Portuguese Health Number For?

Basically, accessing the SNS, or Serviço National de Saúde, allows for medical care at little to no costs.  When I recently took two of my kids to the Centro de Saude (local health clinic in each city) for pink eye I paid nothing for the visit. You do pay for prescriptions, but they are drastically less expensive than in the US.

The Portuguese healthcare system ranks highly among the EU systems.  Granted, European healthcare is NOT US healthcare.  Don’t expect private rooms, quick turn-around, etc., unless you are paying privately. 

We’ve had several medical issues around the world (read about them here) and always had excellent care.  However, paying privately (which isn’t as expensive as it might sound) will get you care similar to what you might expect in the USA.

Portugal is a relatively small country, and registration systems are interconnected. Your fiscal number, or NIF, tracks all purchases you make for tax purposes. This system is also linked to the SNS system.

How Do You Get A Portuguese Health Number?

There is an easy way and a difficult way to do this. 🙂 There is also a free way and a paid way.  Can you guess which goes with which?

Personally, we are all about saving time as our time is worth a lot of money.  We own several businesses, have five children (and two Portuguese pets!), and are always crunched for time.

We used a lawyer to help get our NIF and residence visas, which was well worth the money, in my opinion.  You can read more about that process here.  That same lawyer helped us with our health numbers, and we paid around 1500€ for our family of seven. I was told it would take at least three months to get the numbers, and shockingly, they came back in about two weeks!  Another reason it was worth it.

However, getting a health number is a free process, albeit slow and painful.  

Local Health Center, or Centro de Saúde 

Start with your local centro de saúde in the small town you live in.  Portugal’s healthcare system is decentralized, so you should go to the Health Center nearest to your residence.

Lisbon is a connected string of many smaller towns, called parishes, that were once all separate.  Over time, the population filled in the gaps, but all government operations still reside in your local parish (town).  

For example, we were required to get another government document, a certificate of residence, or Certificado de Residencia, for our daughter’s basketball club.  For this, we went to our local “Junta de Freguesia”, had to fill out a form, get two Portuguese citizens to vouch for us, and turn it back in with 10€.  

We live in Paço de Arcos, so we go to the Centro de Saúde de Paço de Arcos.  The next closest one, in Oeiras, is only about 4 minutes away, but if we go there, we will be turned away.

Our lawyer filed our health numbers in the Paço de Arcos Health Center, and the paperwork clearly states this. 

What To Bring To File For Your Health Number

If you are not using a lawyer, you’ll need to apply for your SNS numbers at the Social Security Office (Segurança Social). Make an appointment at your local Social Security office (Segurança Social) to apply for the SNS number. At the appointment, you’ll need to provide your identification documents, proof of residence, and any other required documentation.

You’ll need to prove the following:

• Your identity.  A passport will work fine.
• Proof of Residence.  You MUST have your residence card before you can get the health number, period.  This proves this. You also need to register your residency at the local Civil Registry Office (Junta de Freguesia) or town hall (Câmara Municipal) in the area where you live. This is usually done within 90 days of arrival in Portugal.
• Your NIF (Número de Identificação Fiscal). Portuguese tax number (NIF) comes from the Tax Authority (Autoridade Tributária e Aduaneira). However, to get your Portuguese visa, you need the number, so you should already have this.
• I’d also recommend bringing, just in case:
  • A second form of ID
  • Visa information
  • Lease agreement
  • Health Insurance Info

During your appointment, you’ll fill out an application for your SNS number.

If you are using a lawyer, your lawyer will take care of your application and probably get you an appointment. However, plan to still bring these documents with you to the appointment.

Alternatively, you can go straight to your local Centro de Saude and ask them for help with your SNS number. They can probably get you started as well.

Fill Out the Registration Forms

You will be asked to fill out registration forms with your personal information. These forms are typically available at the Health Center. Our lawyer filled these out for us with the information that we provided.

Meet with a Health Professional

During your visit, you may meet with a healthcare professional or nurse who will ask about your medical history and conduct a basic health assessment. This helps in assigning you to a doctor and ensuring you receive appropriate care.

Be Prepared To Wait

We recently went to our health center and waited an hour and a half to ask a two-minute question.  Waiting in line is practically a requirement for Portugal (and I think most of Europe).

Once you speak to someone, you’ll give them the info, and they will file it with the government.

After completing the registration process and providing all necessary documents, you will be issued an SNS number. This number is your unique identifier within the Portuguese National Health Service.

Request a European Health Insurance Card (EHIC) or a Portuguese Health Card (Cartão de Utente)

Depending on your status, you may also be eligible for a European Health Insurance Card (EHIC) if you are an EU/EEA citizen or a Portuguese Health Card (Cartão de Utente) if you are a resident or have private health insurance.

Register with a Primary Care Doctor

Once you have your SNS number, register with a primary care doctor (médico de família) at the Health Center. Your doctor will be your first point of contact for healthcare services. The family doctor will follow your health (or their successor will) for your lifetime and becomes a friend to many Portuguese! However, note that the waiting list for a family doctor is several years. We’ve already been on the list for two years and no movement.

From what I’ve heard, you will use this primary doctor for all your questions. You may even get their direct number! However, getting one actually assigned to you may take years.

For more information about obtaining your health number yourself, read here.

Other Things To Know About Your Portuguese Health Number

Congratulations on obtaining your Portuguese Health Number! There are a few additional aspects of the healthcare system you should know that can enhance your experience. Let’s dive into some friendly advice and essential information to make your healthcare journey in Portugal even smoother:

• Understanding Your Family Doctor: Your family doctor, or “médico de família,” is your go-to healthcare professional for routine check-ups and general medical care. Developing a good relationship with your family doctor is key to receiving personalized healthcare. Don’t hesitate to ask questions or discuss any health concerns during your appointments.

• Specialized Care and Referrals: While your family doctor handles general health matters, there may be instances when you require specialized care. In such cases, your family doctor will provide a referral to a specialist. This ensures you receive targeted treatment for specific health conditions.

• Emergency Services and Hospitals: In case of emergencies, Portugal’s healthcare system is well-equipped to handle urgent medical situations. Familiarize yourself with the nearest hospital or emergency care facility. Keep in mind that your Health Number is essential for accessing emergency services, so always have it on hand.

• Prescriptions and Pharmacies: When your family doctor prescribes medication, you can pick it up at any pharmacy using your Health Number. Pharmacies, known as “farmácias,” are widespread in Portugal. Pharmacists are knowledgeable and can provide advice on over-the-counter medications as well.

• Digital Health Services: Portugal is progressively embracing digital health services, making it easier for residents to access medical information and appointments online. Explore platforms such as the Serviço Nacional de Saúde (SNS) website for digital services, appointment scheduling, and health-related information.

• Health Insurance and Additional Coverage: While the Portuguese healthcare system is robust, some residents opt for additional health insurance for extra coverage. This can include services not covered by the public healthcare system, such as dental care or certain medications.

Additional Reading

How To Obtain A Portuguese D7 Visa For Your Family: Everything You Need To Know

Moving Your Family to Portugal from the United States: What to Know

My Experience Learning European Portuguese: Portuguese Connections School in Lisbon, Portugal