Registering for Portuguese Healthcare. Another Success Story of the Complaints Book.

A few days ago I wrote about the Complaints Book in Portugal, and how it could act as an official recourse to seek redress. I wanted to give another example that I had resolved yesterday after a 3 month stand off with the Portuguese healthcare system.


Portugal has a National Healthcare Service, largely mirrored off the UK system. The basic premise is that anyone who is a legal resident here has the right to free healthcare and registration in the system. But it is this latter part which I had been struggling with since the end of last year.

In a previous post I mentioned my friend Thomas. We live in two different cities which have significant demographic differences, myself in Porto and him in Cascais. For a start my day-to-day interactive language is Portuguese whereas his is English. We had heard from other migrants expats on both sides that there were huge discrepancies in how people were being treated when trying to register for healthcare.

As a comparison we both agreed to attempt to register at our local healthcare centres on the same day. He was in and out in 10 mins. Nothing noteworthy there, until you compare it with my experience.

The Portuguese government's “Portal for Citizens” explains in both Portuguese and English that the only conditions that apply are if you have one of: A residence permit; a residence visa; or residence certificate. EU citizens will have a residence certificate which is an A4 piece of paper issued by the local town hall.

By law the residence certificate plus your national ID card or passport are the only things required to show to the healthcare centre in order to get your User Number (“Número de Utente”). Except my healthcare centre receptionists were refusing to register me without showing a Social Security Number. This is a very annoying situation because it is actually very difficult to get a Social Security Number, even as an EU citizen, if you are anything except a salaried employee of a Portuguese company.

The User Number is extremely important as it helps residents use the Portuguese online services (e.g. instant messaging with a trained medical practitioner so you don't go seeing a family doctor) and a makes things a whole load easier when registering for private healthcare.

I went back to the healthcare centre a second time, this time with the relevant laws and regulations printed in Portuguese explaining that they were wrong and I was correct. But on both visits I had the same two receptionists refusing to acknowledge this. The typical Portuguese civil servant response of “the Government's website is wrong” was being used, as well as “the rules have changed recently” – and of course they had not. (And as an interesting observation they had to check their ‘folder' to see if the UK was a member of the European Union despite having my EU citizen's registration certificate in their hand. Surely they should know that Brexit has not happened yet, it's in the Portuguese news channels everyday!)

Feeling frustrated by the whole situation I decided to record my situation into the online version of the Complaints Book, then just forgot about the situation assuming it would not be resolved in my favour.

Fast forward 2 months, this week I received a letter in the post (a mere 13 days after the date on the letter) by the provincial administrator for the National Health Service, indeed confirming that my complaint was valid, that the health centre were wrong to refuse and that they had been notified. With this official letter in hand I went back to the same two receptionists and attempted to register for a third time.


They did try to fight back again saying they were following ‘their rules', but I was able to point to the letter to state again they wrong and this is the result of my official complaint. After a grumble about how I “didn't contribute to the Portuguese system and didn't deserve it” they gave me my User Number. (Not true anyway, I probably paid more tax to Portugal last year than 95%+ of local residents here, even under the “Non-Habitual Resident” scheme as described in this post with Nomad Capitalist)

The reason I stated the demographic differences between Thomas' area and mine was because in the big cities of Porto and Lisbon there are many Chinese, Brazilian, and other African Lusophone immigrant jobseekers. Not being EU countries they are subjected to much greater scrutiny than EU citizens, even with the correct EU documentation. Down where Thomas is it's a whole load of white, rich EU citizens who aren't deemed to be a drain on the social security system. They don't even have a public healthcare centre of hospital there! Not that any of it should make a difference to an EU citizen by law, but it certainly changes day-to-day interactions you will have with government agencies.

So the moral of the story here is you must stick up for your rights and flex your rights where you feel you are mistreated. In Portugal it involves using the Complaints Book (for me a second time) and this should be seen as a safeguard for your protection.

About Tim

Tim is an engineer and a nerd who analyses every travel deal, travel hack. He has travelled to around 90 countries and also speaks Spanish, Portuguese and Mandarin.

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  1. Hey Tim, as a brazilian who has done master degree and PHD in Portugal, I can say that this is what could be called “ignorance racism”. I think they could also try to play you because you don’t speak the language and you are asian looking. Trust me, I have asian background as well, but being able to speak in portuguese really made me put some ignorant people in their right place. Other than that, portuguese service is still far from being good. Some people are like a bad AA flight attendant on an acid trip.

    First thing is that you can get a Número do Contribuinte in Loja do Cidadão (I think it is still at Antas Tower). This was the fastest thing I did over there and it took me no time whatsoever. I only had to present a copy of my EDP bill so that they could check where I live, plus my passport (with a visa, but the lady did not look at it, just the front page of the passport) and a photo.

    About registering in the National Health Service, what happens is that between Brazil and Portugal there are a lot of bilateral agreement between the two. The National Health System is one that works both ways. Another one is the driving license. For instance, I easily changed my Brazilian driver’s license to a portuguese one in two days time. A portuguese person can get free healthcare in the brazilian public health care system. The only thing required is that the brazilian does not overstay their visa. There are some more agreements that really works for both brazilians and portuguese.
    So I managed to register myself really easily over there.

    I have to say that I love love love love love Portugal, but it does have its faults.

    About jobseekers, Portugal has really no say in this, because Portugal is known as a country of emigrants. And not so long ago (2009 until 2014) a lot of them came to Brazil. Others to Canada, USA and other countries in EU (also England).

    • Hi, apologies for the late reply to your comment!

      Judging by my experience compared to other Brits around Portugal though, it seemed mine was an exception to the norm. Everyone else had been able to register without issue. Maybe it really is that ‘ignorance racism’ at play, as you describe?

      I already had a Numero de Contribuinte which was taken as part of the registration for the health centre. I definitely think the Bilateral Portuguese-Brazilian treaty resolves a lot of issues which other foreigners would get, although I also thought that being an EU citizen also helped!

      PT has been a country keen to promote immigration for some time, like allowing people to work here on a tourist visa, easing the rules on becoming a Portuguese citizen twice in 3 years.

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