Ask any expatriate why they left the United States and chances are you’ll get some variation of: To live in a country where my retirement dollars go a lot farther without sacrificing quality of life. And while quality of life is a bit abstract, healthcare is arguably the major determinant. Sure, you could live in some third-world country for pennies a day, but when you need help, you want John’s Hopkins, not Jack’s House of Snake Oil. Portugal has what seems like an oxymoron in the United States: high quality medical care at an affordable price.
So, what does affordable mean and where does health insurance fall into this picture? Indeed, does health insurance even exist in a country with socialized medicine? And what about prescription medications? In this article, we’re going to address each of these.
Cost of Medical Treatment
The United States has by far the highest healthcare costs in the world, a staggering 61% higher than the next county (the Netherlands)[i]. For this reason, the idea of not having medical insurance in the States is simply terrifying. Even with health insurance, a life-threatening illness (such as cancer) can be ruinous to a family.
In Portugal, you don’t really need health insurance because quality medical care just doesn’t cost that much. Let’s say you needed a tonsillectomy; under the public health system it’s completely freeiii! That’s for the entire procedure including an overnight stay in the hospital. The downside is that you may need to wait several months* for the procedure, but in the end, you still get excellent care. (Obviously patients are triaged. Those with critical or life-threatening needs are seen immediately.)
If you don’t want to wait, you can still go to a private hospital and have the same procedure done much faster. You just need to pay for it. But even then, it’s affordable. While the average cost of a tonsillectomy in the States is $5500[ii], the same procedure in Portugal (both without insurance) is only $1,100[iii]. Hip replacement surgery in the US (without insurance) averages $39,300[iv]. Here in Portugal it’s only $6,600iii.
Even though Portugal has socialized medicine, many people still have private health insurance, but not to ensure superior care. Indeed, many of the same doctors who work in the private hospitals also work in the public ones. In Portugal, health insurance is more of a time saver. With private health insurance, you can go to a private hospital and be seen and treated much faster. Though as mentioned before, one need not have insurance to be able to go to the private hospitals.
So, what does health insurance cost in Portugal? For my wife and I (ages 58 & 52) it runs $165 per month…for both of us! With no deductible! A far cry from the $850/month and $5,000 per person deductible that we were paying back in the States. We happen to be with Allianz (a German company) but there are many companies to consider. Most banks offer policies, but I would suggest that you use a broker (as we did) and that you read the fine print. For example, if you are over age 55 when you take the policy, some companies will drop you when you hit age 75. Others do not have this stipulation, but it’s something to know going in. Also, some won’t cover pre-existing conditions. Just read the entire document before you accept it. This is an area where having a local source of help is invaluable such as the folks at Prisco Business Group!
Cost of Prescription Drugs
Back in the States, I was on Eliquis™; a blood thinner that was not covered by my insurance. Even with a coupon from the manufacturer, a one-month supply would cost me around $480[v]. That same drug in Portugal (there is no generic yet) costs me $77iii, and that’s without being on the public system. With the public health discount, the cost is around $20. Many more examples could be listed, but suffice it to say, the cost of prescription medication is lower, as well, which brings us to our final point.
Do You Need Medical Insurance at All?
The take-away from all this is that you COULD choose to go without insurance and not face the crippling medical expenses found back in the States. Everyone’s situation is unique, and everyone must evaluate their situation based on their own health conditions, cost, and speed. On the other hand, the cost of insurance (and by extension that peace of mind) is also affordable. The point is, there is a very real safety net here. Whether or not you have insurance, you will always have access to high-quality medical care at affordable prices. And THAT is why so many expats arrive on the shores of Portugal each year!
[iii] Based on personal experience.