Find out what user fees are and whether you qualify for exemption
Did you know that it is possible to access healthcare without paying user fees (taxas moderadoras)? For many, this benefit makes a significant difference in 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 fees and how to apply for it.
What are user fees
User fees represent a contribution towards the use of healthcare services within the SNS (the Portuguese National Health Service), applicable in situations such as appointments, tests and hospital A&E. However, these fees have been reduced in recent years and are currently charged only in specific cases.
When do user fees apply?
Since 1 June 2022, this charge is no longer applied to appointments and tests, including follow-up appointments and prescribed tests. However, they still apply in cases of hospital A&E without prior referral by the SNS. In summary:
- Hospital A&E without referral (not directed there by the health centre or the SNS 24 line) is subject to a fee
- Hospital A&E with referral (directed there by the health centre or the SNS 24 line) is exempt from the fee
- Admission to hospital resulting from A&E is exempt from the fee.
How much does an appointment at the health centre cost?
Appointments at the health centre, as well as the analyses and tests requested by the SNS, are completely free of charge when carried out within the public health service itself.
See how to book an appointment on the SNS 24 Portal.
Who is exempt from user fees in 2024?
There are several groups of patients who, because of their state of health, economic or social situation, are exempt from paying user fees. In 2024, the following are exempt:
- Pregnant women and women who have recently given birth (including voluntary termination of pregnancy in legally permitted cases)
- Under-18s
- People with a degree of disability equal to or greater than 60%
- Patients in financial hardship (average monthly household income equal to or below 1.5 times the value of the IAS, the Portuguese Social Support Index)
- Donors of blood, cells, tissues and organs
- Firefighters
- Transplant patients
- Serving and former members of the Armed Forces
- Armed Forces personnel with permanent disability due to military service
- Unemployed people registered at the job centre (and their dependants) whose benefit is equal to or below 1.5 times the IAS
- Young people under protection, supported by the Commission for the Protection of Children and Young People (CPCJ) or by the court
- Asylum seekers and refugees and their respective spouses and descendants.
How to apply for exemption from user fees
To obtain 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 women and women who have recently given birth
Pregnant women and women who have recently given birth are automatically exempt from user fees for all healthcare related to pregnancy and the postnatal period. The exemption applies on presentation of the patient card and documentation proving the pregnancy.
Minors
Under-18s are exempt from user fees in all SNS services. Presenting the citizen card or patient card is sufficient to guarantee the exemption.
Disability greater than 60%
For people with a degree of disability equal to or greater than 60%, the exemption is granted on presentation of an up-to-date multipurpose medical disability certificate at the health centre or hospital unit.
Financial hardship
Exemption on the grounds of financial hardship applies to patients in low-income households. To prove this situation, you need to present documents evidencing your income at the health centre, where an assessment of the economic criteria is carried out to confirm eligibility.
Blood and cell donors
Blood and cell donors are also entitled to exemption from user fees. To benefit from this exemption, donors must request a certificate at the collection centre and present it at the health centre or hospital.
Volunteer firefighters
They can apply for the exemption on presentation of a declaration issued by their respective brigade, which must be renewed annually and submitted at the health unit.
Transplant patients
People who have undergone organ or tissue transplants are exempt from user fees for follow-up and treatments related to the transplant. The exemption can be requested at the health centre, on proof of the clinical situation.
Serving or former member of the Armed Forces
Serving or former members of the Armed Forces with a disability resulting from service are entitled to the exemption. The exemption can be requested on presentation of documentation issued by the branch of the Armed Forces to which they belong or belonged.
Unemployed people
Unemployed people who are registered at the job centre and have no income above the minimum wage can apply for the exemption. To do so, they need to present an up-to-date unemployment declaration and, where applicable, proof of income.
Young people in protection, residential care or placement proceedings
Young people who are in protection, residential care or placement proceedings are automatically exempt from user fees. The body responsible for the protection or placement must provide the documentation needed to formalise the exemption with the SNS.
Asylum seekers or refugees
Asylum seekers and refugees in Portugal are entitled to exemption from user fees. To this end, they must present a document proving their legal status issued by the competent authorities and present it at the health centre or hospital.
Where can I apply for the exemption?
- On the SNS 24 Patient Portal, by accessing your personal area
- By contacting SNS 24: +351 808 24 24 24
- In person, at your health centre.
How do I know whether I am exempt from user fees?
After submitting the exemption application, you can check the status of the process in your personal area on the SNS 24 Portal or at your health centre.
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