Preventative Healthcare in Portugal

What you get? ... and ... What it cost?

Denise is just about to turn 70. She is also one of those people who complies with all preventative healthcare guidelines without delay. (Me not so much…) So in anticipation of another “big” birthday, she made an appointment with a primary care physician at the local international (i.e. private) clinic.

You Can Get What You Ask For

I have spoken to several expats who are surprised/disappointed the first time they see a doctor or dentist in Portugal. They often complain that s/he “didn’t do anything”. That was our impression the first time we saw a dentist in Portugal. He did clean our teeth…but no X-rays,¹ no gap measuring. During our next visit, we learned we just needed to ask! While in the States we were accustomed to annual X-rays, his “protocol” was to only do X-rays if we had pain. If we wanted to “know our numbers” he would do the measurements, but neither of us appeared to have periodontal disease.

We have both also seen primary care physicians in Portugal. Not because we were sick, but because we wanted preventative screening. In a very similar fashion, we found you get what you ask for. Denise is retired from the military, and for several years took advantage of the VA healthcare system. She is also a registered nurse. Each year the VA would provide a very thorough annual exam! So when it came time to see a physician in Cascais, she listed the tests that she wanted. The physician placed the orders and she was good to go.

She had a similar experience just this past month in VRSA. She asked for a colonoscopy, mammogram, bone density test, EKG, and various blood/urine tests. The doctor suggested that she also have an endoscopy as she was turning 70. The doctor, who was trained in the Czech Republic, told Denise that such thorough preventative screening was not typical in Portugal. (She commented that she and other physicians were trying to educate the government on the benefits of more comprehensive preventative care for the public system.)

What it Cost

Before leaving the clinic, the receptionist scheduled the blood draw at the local clinic and the other tests at various hospitals in Faro and Loulé. The cost for the physician visit was €18.²

Having not drunk her morning cup of coffee, Denise walked back to the clinic a few days later to have her blood drawn and provide a urine sample. The tests included: CBC, a Chem-12 panel, fasting blood sugar, and urinalysis. Cost: €20.

A few days later, she drove to Faro and had the EKG, mammogram, and bone density test. Each test cost €20.

If you have had a colonoscopy, you know that the prep is worse than the procedure. Like in the States, there was a somewhat restricted diet a few days before the procedure and yucky stuff to drink.³ We drove to Gambelas about 3 weeks after she visited with the PCP, as her appointment was at 17:00. About 90 minutes later, we were pulling out of the parking lot. Denise had a pack of wafer cookies and a juice box in hand and mentioned she was really hungry. She also had some photos … she has a very clean colon. She reported that the procedures cost €80.

All test results are sent to Denise via email. I am pleased to report she is very healthy. If you have had a calculator nearby you know that the total cost for everything was €178.

It was 2020 when we last had any healthcare in the States. We were fortunate to have been covered by Medicare (Part A & B) and Tricare for Life (Supplemental Insurance). So when we saw a doctor or had any procedure done we rarely had to pull out our wallet. So today, we pay a bit more for medical care in Portugal than in the States.⁴ But we are very pleased with the healthcare we have received in Portugal.⁵ We have learned, you just need to ask!

Espero que isto ajude, fica bem

Nanc

Editor’s Note: If you are a new reader you may want to search for other posts on healthcare in Portugal. I have had a few surgeries, and have documented all of them.

1. Our first experience in VRSA with a dentist was the same as in Cascais…however, the cleaning took less than 20 minutes. Denise is meticulous about her teeth…flossing away every night, using a Waterpik and electric toothbrush. Me, not so much. (Perhaps you are recognizing a pattern here.) So I knew 15 minutes was not enough time. We looked for another dentist and found a wonderful one at the International Clinic. He does require X-rays on your first visit.

2. This is the copay for our private insurance for a routine office visit. As we are now 70, our monthly premium is €220/month/person for MGEN Advancecare. This is an increase of over €40/pp over last year when we were 69.

3. Yes, I also turned 70. And yes, I need to be screened. But I am not as good about this as Denise. So I am going the Hemacult route. This type of less invasive (and less precise) screening is common in many European countries.

4. I looked and Medicare Part B is now about $175/mo (depending on income). This is less than our private health premium. Also, typically preventative procedures were covered in full due to Tricare for Life.

5. While we are well aware of the physician and nurse shortages that plague the country, so far we have not been impacted by these things. We realize that wait times are much longer in the public system. And recently, some nurses in the private system held a one-day strike. Portugal is struggling to deal with the many professionals who emigrate to other EU countries for higher wages coupled with an aging population.