Understanding Public VS Private Healthcare in Portugal

Happy Sunday, amigos! If you haven’t seen the DreamWorks movie Minions, this story might not make a lot of sense.

On Friday night, we took our daughter to her first-ever live symphony—Banda Sinfónica da PSP, in Alcobaça. We had a perfect view of the percussion section and watched, completely enthralled, as the percussionists switched seamlessly between instruments. It was magical.

There was just one problem: we didn’t understand a word of what was said—before the music, between pieces, or during the introductions of star performers.

After each speech, my husband would lean over and whisper, “King Bob!”—a callback to the moment in Minions when Bob is crowned and gives a speech no one understands... except for the triumphant “King Bob!” at the end.

Maybe it was high-level Portuguese. Maybe it was the acoustics in the conference centre. Either way, we heard mainly one sound… shhhhhhh…. and realized: it’s time to seriously level up our language skills.

Fortunately, the music needed no translation. It spoke straight to the soul.

And the best part? Entry was completely free. How cool is that?

Here’s what we’re digging into today:

🩺 The key differences between public and private healthcare in Portugal

📃 How to file your income tax return—on your own

👂️ A little listening comprehension practice to boost your Portuguese

Ready? Let’s dive in!

📷 Pic of the week

Nisa is a charming historic town in the Portalegre District of the Alentejo region, surrounded by medieval walls with two main entrance gates still intact. The Porta de Montalvão, one of these gates, is built atop a massive megalithic rock—a feature for which the region is renowned. Nisa is known for its distinctive Olaria Pedrada pottery, delicate hand embroidery, and the beloved Queijo de Nisa, a tangy sheep's cheese proudly bearing a protected designation of origin.

📰 What’s Happening in Portugal this April & Beyond

🎤 Music & Performance Events

The Lumineers: Performing at the MEO Arena in Lisbon on 2 May 2025

Rod Stewart: MEO Arena in Lisbon on 13 May 2025

*A major music event I missed in this newsletter issue:

OneRepublic—Escape To Europe 2025 Tour: MEO Arena, Lisbon, 16 November 2025

🏛️ Art & Museums

British Art – Convergence: brings together more than 100 works by 74 artists, principally from two major private Portuguese collections, CAM – Centro de Arte Moderna Gulbenkian and the Berardo Collection. The exhibition can be visited until 21 July.

International Day For Monuments and Sites (Dia Internacional dos Monumentos e Sítios): 18 April.

Cultural Events

Italian Film Festival'25: Festa do Cinema Italiano is the leading festival in Portugal for those who are passionate about Italian films and culture. 9-17 April, Lisbon

📰 News

You may have noticed I don’t cover Portuguese news events—but if you’re looking to stay informed, I’ve got just the thing.

Portugal Weekly, written by Jorge Branco, goes beyond the headlines to unpack the news that truly impacts life in Portugal—delivered weekly, in English.

🏡 Lifestyle: Eat, Pray, Love—and everything in between

Healthcare in Portugal: What We’ve Learned the Hard Way

Healthcare has played a front-and-centre role in our lives since moving to Portugal. From navigating emergency care during a near-death experience (which you can read about here) to now waiting over 16 months between ophthalmology appointments for surgery — the aftershock of that same emergency — we’ve seen both sides of the system.

We’re deeply grateful for the high-quality care that’s cost us less than €100 total, but we’re also no strangers to the frustration of navigating a system where urgency isn’t always a priority.

I’d love to hear about your own experience with healthcare in Portugal. What’s working? What’s confusing? Are you unsure how to access the SNS, or how to get assigned a family doctor through your local public health centre?

Reply to this email with your healthcare-related questions, and I’ll break them down in a future issue of The Expat Hustle. For now, here’s a clear breakdown of the key differences between Portugal’s public and private healthcare systems:

🏥 Public vs Private Healthcare in Portugal — What You Should Know

Portugal’s healthcare system offers both public (SNS) and private options, and while the public system is often praised for being universal and affordable, our experience revealed its painful limitations.

Here’s a quick breakdown of what to expect from each:

🩺 Public Healthcare (Serviço Nacional de Saúde - SNS)

Pros:

• Universal coverage for citizens and legal residents (yes, expats too!)

• Essential services like GP visits, emergency care, and hospital stays are free or come with minimal co-pays

• Urban hospitals generally offer good quality care

Cons:

• Long waiting times for specialists and non-urgent surgeries

• Must go through a GP for specialist referrals

• Overcrowding and staff shortages, especially in smaller towns

• Rural areas often lack proper infrastructure

• Non-EU expats need to meet specific residency and contribution requirements

💶 Private Healthcare

Pros:

• Fast-tracked access to specialists, often within days

• Ability to choose your doctors and facilities

• English-speaking professionals are more common

• Often includes extras like dental, mental health, and alternative therapies

• Private insurance plans offer flexible coverage for different budgets

Cons:

• Out-of-pocket costs can add up quickly without insurance

• Full coverage plans are more expensive, but often worth it for peace of mind

💡The Hybrid Approach: Many expats choose a mix of both. Use the SNS for routine care and emergencies, and go private when you need fast access to specialists or want more personalized care.

❤️‍🩹 

Now that you’ve got a clearer picture of how Portugal’s public and private healthcare systems stack up, I’d love to know: what would you like to dive into next? Do you have a burning question about navigating the SNS? Curious about emergency protocols, or finding English-speaking specialists? Or maybe you’ve had your own eye-opening experience (good or bad) that could help others.

Hit reply and share your questions or stories. We might feature your insight in an upcoming issue of The Expat Hustle, because learned experience is one of the most powerful tools we have — especially when healthcare is on the line.

Thank you for being part of the conversation!

Show us some ❤️‍🔥 

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💰 The Hustle Fund — Money, Taxes, and all things Financial

Feel Like Filing Your Own Tax Return in Portugal? Bless Your Brave Soul

Taxes have always scared me. Even when we ran our business in South Africa, we leaned heavily on our accountant to guide almost every financial decision we made. Almost. We did once surprise him with a car purchase that made him raise an eyebrow and ask—rather dryly—why a water treatment company needed a BMW 5-Series. Cough.

Fast-forward to today: our income feels a lot simpler. I work remotely and receive a contract-based salary, and my husband issues Recibos Verdes (“green receipts”) for his freelance services. You’d think that sounds basic enough. But despite that, we’ve still chosen to work with a local accountant since moving to Portugal. (And gulp, we’re about to surprise him with another car purchase… It’s a small cargo van this time, not a BMW, so hey—we’re learning. Just FYI.)

But here you are, bold soul, ready to tackle your own Portuguese tax return. I salute you.

This guide was compiled using information from the official Portuguese Tax Authority (Portal das Finanças) and The Portuguese Public Services Portal and is surprisingly well laid out. If your income is simple and fits the criteria listed below, you just might be able to tame this bureaucratic beast.

Otherwise, speak to a local accountant—or someone familiar with expat tax situations—so you can also enjoy the thrill of surprising them with your impulse purchases.

Let’s dive in and figure out if you can file your own IRS tax return in Portugal. And if this PDF download is for you.

Who should file their own taxes, and when is it advisable to use an accountant or tax lawyer?

1. Self-Filing (DIY)

• Simple tax situations: Salaried employees with one income source, no investments, or foreign assets.

• NHR/ITS beneficiaries: Those under Portugal’s tax incentives (e.g., 20% flat rate) with straightforward income streams.

• Tech-savvy expats: Use Portal das Finanças for filings and tools like ATGo for expense tracking.

2. When to Hire an Accountant

• Self-employed/freelancers: Complex deductions (e.g., business expenses, VAT credits) or using simplified/organized accounting methods.

• Multiple income streams: Rental income, investments, or side businesses requiring consolidated reporting.

• Cross-border transactions: Expats needing alignment with Double Taxation Agreements (DTAs) or Madeira IBC tax regimes.

3. When to Engage a Tax Lawyer

• Legal disputes: Audits, appeals, or criminal investigations by Portuguese tax authorities.

• International complexities: Reporting foreign assets (e.g., FBAR), expatriation, or multinational business structures.

• High-stakes planning: Estate transfers, divorce tax implications, or mergers/acquisitions requiring legal privilege

Ready to do it yourself? Here is your step-by-step guide for filing your income tax return in Portugal:

🏠️ Coming up this April 

Our Property Expert returns next week with Part 2 of the Rental Series: "Avoiding Pitfalls — Practical Tips for Landlords in Portugal." Stay tuned, and better still, tell your friends to sign up so they don’t miss this and upcoming property-related issues!

Missed Part 1? Catch up here: Renting Property in Portugal

🗣 Lost in Lingo

To help sharpen your Portuguese listening skills, we’re sharing a podcast from Portuguese Academy. It features simple, engaging storylines and breaks everything down in English, making it easy to follow along. Give your ears a workout and level up your comprehension with these well-crafted episodes:

…And That’s All Folks

Thanks for reading! 💌

Hustle on!

Angelique🧞‍♀️

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