The Health System in Portugal and the Hospital network in Cascais

Healthcare is one of the first concerns for anyone considering a move to Portugal. The country has a public National Health Service, known as the SNS, alongside private hospitals, clinics and health insurance.

Foreign residents usually want to know whether they can use the SNS, how to register, what healthcare costs and where they should go in an emergency.

At RE/MAX Cidadela, we have assisted more than 4,800 families buying and selling property in Cascais, Estoril, Lisbon, Oeiras and Sintra since 2004. Healthcare frequently influences the choice of neighbourhood, particularly for families with children, retirees and people managing a chronic condition. This guide explains how healthcare in Portugal works and what residents can expect in Cascais.

Quick Summary

• Portugal combines the public SNS with private hospitals, clinics and health insurance.
• A foreign national legally resident in Portugal can obtain an SNS user number and register at a public health centre.
• An SNS number identifies the patient, but public coverage also depends on the correct residence and identification information being registered.
• Cascais has a main public SNS hospital in Alcabideche, primary-care units and several private or specialist providers.
• Call 112 for a serious emergency and SNS 24 on 808 24 24 24 for clinical triage and guidance.
• Many residents use the SNS for essential care while retaining private insurance for faster appointments and greater choice.

How Does Healthcare in Portugal Work?

Portugal has a mixed healthcare system. Its central pillar is the Serviço Nacional de Saúde, or SNS, which provides public primary care, hospital treatment, emergency services, maternity care, vaccination, screening programmes and other essential services.

Primary care is delivered mainly through health centres and Family Health Units, known as USFs. They provide general and family medicine, nursing, vaccination, maternal and child health, preventive care and monitoring of chronic diseases. When specialist hospital care is required, the patient is normally referred through the SNS.

Portugal also has an extensive private healthcare sector. Private hospitals and clinics allow patients to book many specialists directly, choose a doctor and often obtain diagnostic tests or treatment more quickly. Care may be paid directly by the patient or partly covered by private health insurance.

The two systems can be combined. A Cascais resident might use a public health centre for vaccinations, the Hospital de Cascais for an emergency and a private hospital for a faster specialist consultation.

Can Foreign Residents Use the SNS?

Yes, but access to treatment and entitlement to have the costs covered are not exactly the same.

Official Portuguese guidance states that a foreign person who becomes ill or requires healthcare can be assisted at a health centre or hospital. A foreign national legally resident in Portugal can obtain an SNS user number and use public SNS units. The number is commonly issued when the person first attends a public health centre or hospital.

However, an SNS number alone does not guarantee that every cost will be covered. The patient’s registration should also contain the necessary identification and eligibility information, including, where applicable:

• An identity document;
• A Portuguese tax identification number, or NIF;
• A permanent address in Portugal;
• A valid residence permit.

Special rules may apply in circumstances protected by Portuguese or European law.

How to Obtain an SNS Number and Register at a Health Centre

A foreign resident can normally obtain an SNS number at a public health centre or hospital. Portugal also offers a service allowing foreign residents with a Portuguese address to request the NIF, NISS and SNS number together, subject to the applicable conditions.

The practical process is usually:

1. Take your passport or identity document, residence permit or evidence of residence status, Portuguese address and NIF.
2. Visit the public health centre serving your residential area.
3. Request an SNS user number if you do not already have one.
4. Register with the health centre and confirm that your address and eligibility details are correct.
5. Ask how appointments are booked and whether a family doctor can be assigned.

Registration at a public health centre is free. Official guidance updated in May 2026 confirms that Portuguese citizens and foreign nationals with a Portuguese residence permit may register, normally at the health centre corresponding to their home address.

Health centres provide family medicine, nursing, vaccination and community-based services, which may include nutrition, psychology, oral health and social support.

Family-doctor allocation is not immediate in every area and depends on local capacity. Patients without an assigned family doctor should ask their health unit how to access medical consultations and nursing care.

What About Tourists and Temporary Visitors?

Eligible visitors from the European Union, European Economic Area and Switzerland should normally travel with a valid European Health Insurance Card.

The card facilitates access to medically necessary public healthcare during a temporary stay, according to the conditions applicable to the insured person. It does not replace registration as a Portuguese resident or travel insurance covering private treatment, repatriation and services outside its scope.

Visitors from other countries should check whether Portugal has a bilateral healthcare agreement with their country and should maintain adequate travel or private medical insurance.

Is Public Healthcare in Portugal Free?

The SNS is publicly funded and many services are provided without a user charge, but healthcare is not automatically free in every situation.

Portugal has removed many user fees, particularly in primary care and when treatment follows an SNS referral. A charge may still apply to a public hospital emergency visit when the patient was not referred by the SNS and the visit does not result in hospital admission, unless the patient qualifies for an exemption.

This is one reason why calling SNS 24 before going to an emergency department can be useful when the situation is not life-threatening. The service can assess the symptoms and refer the patient to the most appropriate level of care.

Prescription medicines may be partly subsidised according to the medicine and the patient’s circumstances, but they are not universally free. Dental care, glasses, certain therapies and services outside the public pathway may also involve personal expenditure.

Public or Private Healthcare: Which Is Better?

Neither system is universally better. They solve different problems.

For many international residents, the most practical model is to register with the SNS and add suitable private cover when faster access or a wider choice of specialists is important.

Before choosing private insurance, check:

• Waiting periods;
• Pre-existing-condition exclusions;
• Age limits;
• Hospital and clinic network;
• Inpatient and outpatient coverage;
• Copayments;
• Annual limits;
• Prior-authorisation requirements.

A health plan offering discounted prices is not the same as an insurance policy that assumes part of the clinical risk.

Main Hospitals and Healthcare Providers in Cascais

Cascais combines public hospital care, local primary care and a significant private and specialist network.

Hospital de Cascais Dr. José de Almeida

Located in Alcabideche, Hospital de Cascais is the main public SNS hospital serving the municipality.

Its emergency department operates 24 hours a day throughout the year. The hospital provides general, paediatric, gynaecological and obstetric emergency pathways, together with inpatient care, outpatient consultations, surgery and maternity services.

For families, it is particularly relevant that the paediatric emergency department operates continuously for acute conditions in patients up to 18 years old.

The Hospital de Cascais is also the reference maternity hospital for the municipality. Its maternity and obstetric departments provide pregnancy monitoring, delivery, neonatal support and 24-hour gynaecological and obstetric emergency care.

Hospital CUF Cascais

Hospital CUF Cascais is a private hospital located in the Cobre area.

It offers a broad range of medical specialties, diagnostic services, surgery, inpatient treatment and multidisciplinary clinical units. CUF currently lists around 40 specialty areas at its Cascais hospital.

Its non-programmed adult and paediatric care currently operates daily from 8:00 to 22:00. It should therefore not be confused with a public emergency department operating 24 hours a day.

Patients should confirm the opening hours, insurance agreement and expected costs before attending whenever the situation is not a medical emergency.

Hospital Ortopédico de Sant’Ana

Situated in Parede, the Hospital Ortopédico de Sant’Ana belongs to Santa Casa da Misericórdia de Lisboa.

Its principal areas are orthopaedics and traumatology, supported by surgery, physical medicine and rehabilitation, imaging and related clinical services. The institution is officially described as a national reference in orthopaedics and traumatology.

It can be particularly relevant for planned specialist assessments and treatments involving bones, joints, the spine, trauma and rehabilitation.

Public Health Centres and Family Health Units

Public health centres provide the first level of SNS care for most residents.

They deal with routine consultations, nursing, vaccinations, maternal and child health, family planning, chronic-disease monitoring and preventive care. They are also the usual starting point for a referral to an SNS hospital specialist.

The appropriate health centre normally depends on the patient’s residential address, which means that healthcare access should be considered when choosing where to live in Cascais.

What Should You Do in a Medical Emergency?

Call 112 immediately for a serious or life-threatening emergency, including:

• Major trauma;
• Severe breathing difficulty;
• Suspected stroke or heart attack;
• Loss of consciousness;
• Serious bleeding;
• Another situation requiring immediate emergency assistance.

The call is free, and 112 operates throughout the European Union.

For an illness requiring clinical assessment that is not clearly life-threatening, contact SNS 24 on 808 24 24 24.

The service provides clinical triage, advice and referral. Official guidance recommends contacting 112 or SNS 24 before attending a public emergency department whenever appropriate.

SNS 24 may direct the patient towards self-care, a health centre, an SNS consultation or a hospital emergency department.

Private non-programmed care can be convenient for less serious problems, but it should never delay calling 112 in a genuine emergency.

Are English-Speaking Doctors Available in Cascais?

Many healthcare professionals in Cascais’s private hospitals and clinics can consult in English. Some public-sector professionals also speak English, but language availability should not be assumed for every department, appointment or shift.

When booking private care, ask specifically for an English-speaking doctor. For an important public consultation, consider bringing a Portuguese-speaking companion or asking the healthcare provider about available interpretation support.

It is also advisable to keep a written list of medications, allergies, diagnoses and relevant medical history, preferably using the generic names of medicines rather than only international brand names.

Does Healthcare Affect Where You Should Live in Cascais?

Healthcare should not determine a property decision on its own, but it can have a real impact on everyday convenience.

Alcabideche, central Cascais, Cobre, Estoril, Parede and Carcavelos offer different combinations of access to hospitals, health centres, private clinics, pharmacies, public transport and Lisbon.

For an older resident, a family expecting a baby or someone requiring regular treatment, accessibility may be more valuable than a prestigious postcode.

The best location is therefore not simply the one closest to a hospital. It is the area that combines appropriate healthcare access with schools, transport, walkability, privacy and a home suited to the buyer’s long-term routine.

Our guides to where to live in Cascais and living in Cascais examine these lifestyle and location trade-offs in greater detail.

Frequently Asked Questions

Can an American use public healthcare in Portugal?

An American legally resident in Portugal can obtain an SNS user number and register in the public system. A tourist may receive necessary treatment but should not assume that the SNS will cover every cost and should maintain adequate travel insurance.

Do I need a Portuguese Social Security number to obtain an SNS number?

Not necessarily merely to be identified and assigned an SNS number. However, eligibility for public coverage and certain benefits can depend on residence and other administrative information. Make sure your identity, NIF, Portuguese address and residence details are correctly registered.

Can I choose my doctor in the SNS?

Choice is more limited than in private healthcare. The allocation of a family doctor depends on local capacity, while hospital specialists are normally accessed through referral and established clinical pathways.

Is private health insurance compulsory in Portugal?

It is not generally compulsory for every resident entitled to use the SNS, although insurance may be required in particular visa or residence situations. Many expats retain private insurance for faster appointments and greater provider choice.

Which is the main public hospital in Cascais?

Hospital de Cascais Dr. José de Almeida in Alcabideche is the municipality’s main public SNS hospital. It provides 24-hour general, paediatric and gynaecological-obstetric emergency care.

Is healthcare in Cascais adequate for retirees?

Cascais offers public hospital care, private specialists, laboratories, pharmacies and access to Lisbon’s broader medical network. Retirees should still evaluate their treatment needs, insurance exclusions, mobility and proximity to recurring care before choosing a neighbourhood.

Final Verdict: Is Healthcare a Strength of Living in Cascais?

Healthcare is one of Cascais’s practical strengths, but not because every service is immediate or free.

Its advantage lies in the combination of a local public SNS hospital, primary-care services, private hospitals, specialist providers and access to Lisbon’s larger medical network.

The safest relocation strategy is to organise healthcare before it becomes urgent:

• Clarify your residence and insurance position;
• Obtain an SNS number;
• Register at the appropriate health centre;
• Identify the nearest public emergency department;
• Save the 112 and SNS 24 numbers;
• Review any private insurance policy carefully.

At RE/MAX Cidadela, we help international buyers assess the practical side of living in Cascais, including access to hospitals, transport, schools and daily services.

If you are considering buying a home in Cascais, speak with our team before choosing the area. The right home is not only the one that looks best during a viewing. It is the one that continues to work when real life begins.

RE/MAX CIDADELA

Avenida 25 de Abril nº 722, Cascais.

Tel.+351 967604141. E-Mail: ppettermann@remax.pt

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👤About the Author

By Pedro Pettermann
Pedro Pettermann is a Broker at RE/MAX Cidadela in Cascais, with over 20 years of experience in the real estate market across the Cascais coastline, Lisbon, Oeiras, and Sintra. With an MBA from IE Business School, he combines strategic vision with deep local expertise. Recognized as a specialist in the real estate market, mortgage financing, and digital marketing, he helps owners and buyers make confident and profitable decisions.

Pedro Pettermann | LinkedIn

At RE/MAX Cidadela, we have already helped more than 4,800 families successfully sell or buy the home of their dreams

This article provides general information and does not replace medical, legal, immigration or insurance advice. Rules, services and insurance conditions may change, so confirm your circumstances with the relevant authority or healthcare provider.