My Expat ER Experience Using a Portuguese Public Hospital

Wondering what it is like using a Portuguese public hospital as an expat? This was my emergency room experience.

Navigating any health issue can be challenging at the best of times, but doing it in another country and language makes it even more complicated. And for someone like me, who has multiple chronic illnesses, understanding the health system is extremely important.

Below, I’ll share what it was like visiting a public hospital emergency room as an American expat. 

But first – a little bit of information about Portugal’s healthcare system. 

The Portuguese Health System

Portugal’s universal healthcare system (Serviço Nacional de Saúde or SNS) is mostly financed by taxes.

It provides free health services to children under 18 and adults over 65 who contribute to social security, while everyone in between pays state-subsidized medical costs at much lower rates. 

The SNS coexists with private healthcare options. You can choose to visit a private or public doctor or hospital for your needs. 

Does Portugal Have Good Healthcare?

Yes. According to Numbeo’s 2025 Healthcare Index, Portugal ranks 23rd globally and 14th in Europe for quality care. For comparison, the United States ranks 39th globally. 

But it’s important to be aware that universal healthcare isn’t all sunshine and rainbows.

Many Portuguese complain about long waiting times to see doctors and schedule surgeries. 

Can Expats Access Portugal’s Universal Health Care? 

Once you gain residency status in Portugal, you will have access to public healthcare. However, you’re required to have international healthcare coverage that includes the Schengen area to obtain a D7 or D8 visa.

Josh and Kalie highly recommend using SafetyWing for your visa health insurance needs. 

Although you can use the public system after receiving your residency card, be aware that you are still required to have private health insurance for your residency appointment.

But don’t worry, private insurance costs typically start at less than $120 per month for basic coverage. 

My Experience in a Public Portuguese Hospital

Okay, now that you know more about the health system here, let’s get back to my story.

During one of the many summer heat waves here in Portugal, I experienced a horrible flare of my POTS symptoms to the point of shaking, severe lightheadedness, dizziness, and a drop in blood pressure.

This kind of heat is not typical where I live in Porto, but extreme temperatures can greatly impact illnesses.

I tried my usual management techniques, but after hours of suffering, I decided I needed help, so I called the national emergency number, 112. 

While I can get by with the amount of Portuguese I know for my daily activities, I’m not at the level of speaking with medical terms.

I asked for a representative who could speak English and was immediately connected with someone.

This process was typically the same as I experienced in the U.S. I was told emergency medical technicians were being dispatched to my apartment. 

Twenty minutes later, two EMTs arrived and took my vitals.

The two gentlemen were very kind, and one of them was able to speak English with me.

They helped me into an ambulance, and it was a quick drive to the public hospital. 

I wasn’t sure what to expect. I had heard from expats and Portuguese friends that the public hospital was the best place to go.

One of the EMTs stayed with me through triage and translated for me. I was told it was a crazy day, busier than usual, and that there would be a very long wait to see the doctor.

So, I needed to plan to be there most of the night. I was wheeled back into the emergency department.

Once there, I passed two large waiting rooms filled with people sitting on plastic chairs. Then, I was brought into a third area filled with some beds and reclining chairs.

I was given a reclining chair and told it would be a few hours' wait to see the doctor, as there were probably close to 100 people ahead of me. 

Five hours later, a nurse came over and said my name was being called. I was confused.

Throughout my wait, I kept hearing nurses call out names, but also saw medical providers approaching patients where they were seated. I wasn’t sure how the system worked.

But, she directed me to one of the rooms where the doctor was waiting to see me. Typically, in the U.S., the doctor comes to the patient in the emergency room. This system is foreign to me, but I was able to navigate it with the Portuguese I knew.

Some of the staff did get annoyed with my lack of understanding, and one man yelled at me when I didn’t understand his question. 

It’s important to remember that no matter where you are, you need to advocate for yourself as much as possible in any medical setting.

I wish I had asked for a wheelchair to get to the doctor because I was still so lightheaded, even more so after those five hours without water or food.

The nurses were extremely busy, and I didn’t have anyone assigned to me before I saw the doctor, so don’t assume that someone knows your symptoms and make sure you ask for what you need.

My husband wasn’t allowed to stay with me. Whether this is the regular policy or just because of how crowded it was, I’m not sure. 

The doctor was kind and attentive. He ordered tests for me that were done back in my reclining chair, where I also received fluids.

One thing to note, especially for American and Canadian expats, is that while taking my blood and doing my IV, my nurse did not wear gloves. I asked him why he wasn’t and was told it’s not typical for them to wear gloves while doing the blood tests.

I don’t know if this is typical throughout Portugal or Europe, as this was my first hospital visit outside of the U.S.

I’ve heard Europeans call the U.S. the “land of health and safety.” Perhaps this is just one of those differences. 

I waited another two hours for results and was discharged home at 3 a.m.

Because I’m still waiting for my residency appointment, I was given a temporary SNS identification number and only had to pay the taxes on the services received during my visit, which came to $165.

Honestly, I’ve paid 5x for an ER co-pay in the past, so I wasn’t upset with the cost. Although, the man at discharge apologized to me repeatedly for the price and said that when I get my residency card, I will never pay more than $40 for my visit. 

I wouldn’t say it was a pleasant experience (because when is going to the hospital ever pleasant?).

But I felt well taken care of by the doctor. And I know if the situation were dire, I would’ve received medical attention quicker.

If you need emergency care, I still recommend going to the public hospital. Just be prepared for a long wait.

Thinking of moving to Portugal?

Kalie is available for one-on-one consultations, or you can bundle a course and a consult.