Rute Ferreira

Did you know that it is possible to access healthcare without paying user charges? For many, this benefit makes a significant difference to managing health expenses and is available to specific groups. In this article, we explain everything you need to know about who is entitled to exemption from user charges and how to apply for it. What are user charges Moderating fees represent a contribution to the use of health services in the SNS, applicable in situations such as consultations, exams and hospital emergencies. However, these fees have been reduced in recent years and are currently only charged in specific cases. When do user charges apply? Since June 1, 2022, this amount has no longer been charged for consultations and exams, including follow-up consultations and prescribed exams. However, they are still applied in cases of hospital emergencies without prior referral by the SNS. In a nutshell: Hospital emergency without referral (not referred by the health center or SNS 24 line) is subject to a fee Hospital emergency with referral (referral by the health center or SNS 24 line) is exempt from the fee Emergency admissions are exempt from the fee. How much does a consultation at the Health Center cost? Consultations at the Health Center, as well as tests and examinations requested by the SNS, are completely free of charge when carried out within the Public Health System itself. See how to make an appointment on the SNS 24 Portal. Who is exempt from user charges in 2024? There are several groups of users who, due to their health, economic or social situation, are exempt from paying user charges. In 2024, they will be exempt: Pregnant and parturient women (including voluntary termination of pregnancy in legally permitted cases) Under 18s People with a degree of disability equal to or greater than 60% Users with economic insufficiency (average monthly household income equal to or less than 1.5 times the IAS) Donors of blood, cells, tissues and organs Fire Brigade Transplant patients Military and ex-military of the Forces Armed forces permanently disabled due to military service Unemployed people registered with the employment center (and their dependents), whose benefit is equal to or less than 1.5 times the IAS Young people in a situation of protection, accompanied by the Commission for the Protection of Children and Young People (CPCJ) or the court Asylum seekers and refugees and their spouses and descendants. How to request exemption from user charges To access the fee exemption, you need to prove that you fall into one of the eligible situations. Below, we detail how to apply for this exemption in different cases: Pregnant and parturient women Pregnant women and women giving birth are automatically exempt from user charges for all health care related to pregnancy and the postpartum period. The exemption applies on presentation of the user card and documentation proving the pregnancy. Minors Children under 18 are exempt from user charges in all NHS services. The presentation of a citizen’s or user’s card is sufficient to guarantee exemption. Disability of more than 60% For people with a degree of disability equal to or greater than 60%, exemption is granted on presentation of an up-to-date medical certificate of multipurpose disability from the health center or hospital unit. Situation of economic insufficiency The exemption for economic insufficiency applies to users from low-income households. To prove this situation, you need to present documents proving your income at the health center, and an assessment of the economic criteria is made to confirm eligibility. Blood and cell donors Blood and cell donors are also entitled to exemption from user charges. To benefit from this exemption, donors must request a voucher from the collection center and present it at the health center or hospital. Volunteer firefighters They can apply for exemption by presenting a declaration issued by their respective corporation, which must be renewed annually and handed in at the health unit. Transplant patients People who have had organ or tissue transplants are exempt from user charges for monitoring and treatment related to the transplant. The exemption can be requested at the health center, upon proof of the clinical situation. Military or ex-military of the Armed Forces Military personnel or ex-military personnel who are disabled as a result of their service are entitled to exemption. The exemption can be requested by presenting documentation issued by the branch of the Armed Forces to which they belong or belonged. Unemployed Unemployed people who are registered with the employment center and have no income above the minimum wage can apply for exemption. To do so, they must present an up-to-date unemployment declaration and, where applicable, proof of income. Young people in the process of protection, internment or foster care Young people who are in protection, internment or foster care are automatically exempt from user charges. The entity responsible for protection or foster care must provide the necessary documentation to formalize the exemption with the SNS. Asylum seekers or refugees Asylum seekers and refugees in Portugal are entitled to exemption from user charges. To do so, they must present a document proving their legal status issued by the competent authorities and show it at the health center or hospital. Where can I apply for exemption? On the SNS 24 User Portal, when accessing the personal area Contact SNS 24: +351 808 24 24 24 In person, at your Health Center. How do I know if I’m exempt from user charges? After submitting the exemption request, you can check the status of the process in the personal area of the SNS 24 Portal or at your Health Center. If you have an appointment, treatment or any other need for non-urgent medical transportation, you can count on Ambula ! We guarantee a safe, comfortable and punctual service, adapted to your travel needs. Partilhar:

In the event of an illness, accident or other medical condition that prevents you from working, you may need to justify your absence from work. Many people confuse these two documents, without realizing that each one has its own specific characteristics and consequences. If you’ve ever wondered which one to use in different situations, or if you want to be aware of your rights in relation to sickness benefit, you’re in the right place to clear up your doubts What sick leave is and how it works Sick leave is a support measure that allows workers to be absent from work for health reasons without losing all their income. To do this, you need to obtain a Temporary Incapacity Certificate (CIT), issued by a health professional from the National Health Service (SNS), which serves as proof of temporary incapacity for work. This document must be given to the employer and is transmitted electronically to Social Security, which is responsible for processing the sickness benefit. Is sick leave the same as a medical certificate? No. Both are commonly confused, but have different purposes. While a doctor’s certificate is used to justify occasional absences of up to three days, without entitling you to an allowance, sick leave applies when the incapacity for work exceeds this period, ensuring partial remuneration for absences from the fourth day onwards. You can also choose to make an appointment by telephone. To do this, contact the Health Center where you are registered and indicate your User Number. If you don’t know which center you are registered with, call the SNS 24 line: 808 24 24 24. This is useful for those who don’t have digital access or prefer to make an appointment in the traditional way. Temporary Incapacity Certificate (CIT): what it is The CIT is the official document that confirms the need for sick leave. It is issued by SNS doctors and is only valid with the professional’s signature and the institution’s authentication. This certificate can be issued at Health Centers, Hospitals and Permanent Attendance Services (SAP). Types of sick leave There are different types of sick leave, depending on the worker’s specific situation: Ordinary sick leave: applied when the worker is unable to work due to a temporary illness Long-term sick leave: valid for long-term or chronic illnesses Psychiatric leave: issued for mental health conditions that prevent the performance of duties. Who is entitled to sick leave? Employees with social security contributions, including domestic service Self-employed workers who issue green receipts or are sole proprietors Voluntary Social Security beneficiaries on foreign ships or research fellows Beneficiaries of pensions for accidents at work or occupational diseases who work and pay contributions Home workers Recipients of compensation pensions who work and pay contributions Pre-retirement beneficiaries who continue to work and pay contributions Invalidity or old-age pensioners in public service, not receiving a pension Beneficiaries with compensation for accidents at work or occupational diseases who work and pay contributions, with compensation lower than the sickness benefit. How much does a consultation at the Health Center cost? How to request sick leave Sick leave is issued exclusively by authorized entities, such as: NHS health centers (generally by family doctors) Hospitals (except emergency services) Permanent Assistance Services (SAP) Drug addiction prevention and treatment services. What if you need transportation to go to a health unit to claim your sick leave? You can count on Ambula to take you there safely. Where can I check my sick leave? On the SNS 24 Portal, in the “Personal Area” you can consult various details of sick leave, such as: Start and end date Record typeDisease classification Health unit of record. Sickness benefit: how much and how is it paid? The amount of sick pay is calculated on the basis of the worker’s reference pay and the length of sick leave. The percentage to be received varies according to the length of the sick leave: Up to 30 days: 55% of reference pay From 31 to 90 days: 60% From 91 to 365 days: 70% More than 365 days: 75%. This allowance is intended for workers who have paid their Social Security contributions for six months and does not cover the first three days of sick leave for dependent workers, or the first ten days in the case of self-employed workers. There are exceptions where payment is immediate, such as in cases of hospitalization or tuberculosis. You can consult Social Security’s Practical Guide to Sickness Benefit. Ambula: support during recovery Do you need safe and comfortable transportation during your recovery? Ambula offers non-emergency patient transportation services and guarantees all the comfort and safety you need for your appointments and treatments. Secure your transportation with us and focus on what matters most: your recovery. The most frequently asked questions about sick leave When is sick leave paid at 100%? In the case of serious illnesses such as cancer or tuberculosis, there may be a 100% payment, depending on the Social Security assessment. How many days can I be on sick leave? The sick leave can last up to 1,095 days for dependent workers and 365 for self-employed workers, with an unlimited duration for cases of tuberculosis. How much do I get for psychiatric leave? Psychiatric leave is treated like ordinary sick leave, with percentages between 55% and 75%, depending on the duration. Can private hospitals grant sick leave? As a rule, the family doctor is the one who issues the document. As of March 1, 2024, sick leave can be obtained from public, private and social sector entities. Does time off work count towards unemployment benefit? No, sick time does not count towards unemployment benefit. Can Social Security request a disability check? Yes, Social Security can ask the worker to undergo medical examinations to prove the need for sick leave. I’m on sick leave, can I go out at the weekend? Not recommended. During sick leave, you may only leave the house to receive treatment or within specific hours, from 11 a.m. to 3

The ease of making appointments with the National Health System (SNS) has increased thanks to the various digital options available. Today, through the SNS 24 Portal, scheduling a medical appointment is more accessible and allows you to avoid unnecessary travel and long waiting times. In this article, we explain how you can book an appointment and what other features of the SNS 24 Portal you can explore. How to make an appointment on the SNS 24 Portal: step by step Log in to the Staff Area on the SNS Portal 24 Log in with one of the available authentication methods (Digital Mobile Key, Citizen Card or Health User Number) In the menu, select “I need” and then choose “Appointments for me” and “Booking appointments” Select the type of consultation you want (from the various options available) Set your own hours or choose the next free time slot. If you want to make an appointment for someone else Access the Staff Area on the SNS 24 Portal Log in with the same authentication methods mentioned above In the menu, choose the option “I need consultations for others” Fill in the person’s details (User Number, full name and date of birth) Choose “First available time” or “Choose appointment period”. How to make an appointment at the Health Center Those who prefer can go in person to the Health Center where they are registered and make an appointment. They will need to show their SNS User Number (their own or that of the person they are making the appointment for). You can also choose to make an appointment by telephone. To do this, contact the Health Center where you are registered and indicate your User Number. If you don’t know which center you are registered with, call the SNS 24 line: 808 24 24 24. This is useful for those who don’t have digital access or prefer to make an appointment in the traditional way. What appointments can I make at the Health Center? The SNS allows users to schedule various types of appointments, either through the portal, in person or by phone call. General and family medicine consultation: for routine consultations or regular monitoring Nursing appointments: for treatments, such as administering vaccines or medication Family planning, maternal health, child health and adult health: important areas for those who need specialized support Teleconsultation: in some cases, it is possible to have a consultation remotely, depending on the doctor’s prior assessment. Please note: emergency appointments cannot be booked online. For these, you must go to the hospital or call the SNS 24 line (808 24 24 24) for advice on the nearest health unit. A household is considered to be in a situation of economic insufficiency if the average monthly income, divided by the number of members responsible for supporting the household, does not exceed 763.89 euros. This figure, which can vary annually, corresponds to 1.5 times the value of the Social Support Index (IAS), which in 2024 is 509.26 euros. In addition, unemployed people registered with the Employment Centre, as well as their spouse and dependents, are also recognized as being in a situation of economic insufficiency. Other features available on the SNS 24 Portal and App In addition to making appointments, the SNS 24 portal and app offer a number of useful features: Renewal of chronic medication Access to the vaccination bulletin Health history and exams Consulting prescriptions Access to self-declaration of illness Request for exemption from user charges. How much does a consultation at the Health Center cost? Consultations with the SNS are often free or subject to reduced fees. Always check whether the exemption from user charges applies to your situation. If you are not registered at a Health Center To book appointments with the National Health System (SNS), it is essential that the user is registered with a Health Center. If you’re not already registered, you can do so easily by following these steps: Go to the Health Center in your area of residence and present your Citizen Card; Taxpayer Number and proof of health benefits (if applicable). If you are temporarily living in a different municipality, you can request a temporary registration. This registration suspends the original one and will automatically resume after 12 months. For more information, contact the Health Center where you wish to register. If you don’t know which Health Center is in your area, call the SNS 24 Contact Center 808 24 24 24. Remember: without registration, you won’t be able to make routine appointments, except in urgent cases. Do you need transportation to your appointment? If you need transportation to your appointments, exams or treatments, Ambula is ready to help! Explore our platform and ensure safe and comfortable transportation to your next appointment. Partilhar:

Non-emergency patient transportation is a vital part of access to healthcare, ensuring that all users receive the care they need, even if they can’t travel themselves. But how does this service actually work? Who is entitled to it and what options are available? REQUEST TRANSPORTATION What is non-emergency patient transportation? It is a service that ensures the safe movement of patients in specialized vehicles such as ambulances and Dedicated Patient Transport Vehicles (DPTVs), to specific healthcare-related destinations. It is aimed at users who need support to travel to and from healthcare facilities – such as hospitals, health centers and clinics – whether for appointments, regular treatments (such as hemodialysis or physiotherapy) or to return home after a hospital stay. Unlike emergency transport, which is activated by 112 and requires an immediate response and specialized medical care, non-emergency transport focuses on the comfort and safety of the user, guaranteeing an adequate and peaceful journey, regardless of whether the need is one-off or ongoing. Types of non-emergency patient transport This type of transportation can take place in ambulances or dedicated patient transport vehicles (VDTD) and can occur in two main ways: Individual transportation: Carried out exclusively for a single patient and intended for cases where it is clinically indicated that the person does not share the vehicle with others Multiple transportation: when the health conditions of several users allow, transportation can be shared with other patients who need similar care. Thus, on some routes, it is possible to make stops to pick up other patients, as long as the total journey does not exceed the distance and time limits stipulated by the SNS. In these situations, small deviations from the initial route are allowed, with a limit of up to 10 km or 30 minutes. Transport timetables are ideally organized to take several users who have appointments or treatments scheduled for the same period. With Ambula, you have access to different types of transportation, including ambulances for non-emergency individual transportation and vehicles adapted for different mobility needs. REQUEST TRANSPORTATION Who is entitled to transportation for non-urgent patients? In order to benefit from free or reduced-cost transportation, certain specific requirements defined by the SNS must be met. The conditions for exemption from payment are: Economically handicapped: patients who can prove that they are economically handicapped may have access to free transportation, provided that they meet one of the following additional conditions: Disability of 60% or more Need for transportation due to an incapacitating medical condition such as motor sequelae of vascular diseases, heart or respiratory failure, oncological or neuromuscular diseases, high-risk pregnancy, among others. Long-term illness: patients with conditions that require continuous and prolonged treatment, such as chronic renal failure (requiring dialysis), long-term motor rehabilitation or palliative care. Special situations: people recognized as victims of natural disasters (such as the fires of 2017 and 2018) are also entitled to free transport for treatment. Note that in order to take advantage of this benefit, the attending doctor, preferably from the SNS, must issue a prescription attesting to the patient’s health condition and the need for transportation. How is the situation of economic insufficiency determined? A household is considered to be in a situation of economic insufficiency if the average monthly income, divided by the number of members responsible for supporting the household, does not exceed 763.89 euros. This figure, which can vary annually, corresponds to 1.5 times the value of the Social Support Index (IAS), which in 2024 is 509.26 euros. In addition, unemployed people registered with the Employment Centre, as well as their spouse and dependents, are also recognized as being in a situation of economic insufficiency. How do I request transportation for non-emergency patients? To request this type of transportation, the patient must obtain a medical prescription confirming the need for the service. This prescription can be issued by an NHS doctor and must include a detailed clinical justification. With the prescription in hand, the user can request the transport from the health services or directly contact entities authorized to provide this service, such as the fire department, the Red Cross, associations or specialized companies, such as Ambula . REQUEST TRANSPORTATION Can I have a companion during transportation? Yes, as long as the doctor justifies the need, such as in cases of younger age or profound disability. What if I’m not entitled to free transportation? If you are not entitled to free transportation, you can rely on Ambula an intuitive and easy-to-use digital platform for scheduling transportation for non-urgent patients. With the Ambula app, you can quickly schedule the necessary transportation, which can be adjusted to the user’s specific needs, always with a focus on safety, comfort and cost transparency. Ambula offers several advantages for users: Intuitive platform: makes it easy to schedule transportation, simplifying the process for those who need to travel frequently Real-time monitoring: allows you to follow the route via geolocation, which gives caregivers and family members peace of mind Total transparency: offers clear information on prices and timetables, with no surprises Electronic payments: the payment and invoicing process is simple and fast and allows secure electronic transactions Guaranteed quality: Ambula works with companies that follow strict quality and ethical standards, ensuring reliable and excellent services. With these features, Ambula contributes to a safe, modern and humanized transport experience. How much does it cost to transport non-emergency patients? For those who are not entitled to free transportation, the cost of the service varies depending on the route, duration and type of transportation required. This may include departure taxes (a flat rate for shorter journeys, which already includes the patient’s round trip), price per kilometer, waiting time and, in some cases, additional costs, such as the use of oxygen or the presence of a companion. With the Ambula app, we guarantee total transparency: clear information on prices and timetables, with no surprises. REQUEST TRANSPORTATION Partilhar: