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Disputing a Hospital or Clinic Bill in Portugal

What a clinic must tell you about cost before treatment, what the bill must show, and how to complain to the health regulator if you were overcharged.

Disputing a Hospital or Clinic Bill in Portugal

Last verified: September 2026.

Who this is for

  • You paid a private clinic or hospital more than the price you were quoted.
  • You were charged for a test or extra that nobody priced before it was done.
  • You used insurance, ADSE, or a health plan, and the bill came at private prices.

Not for you if: your complaint is about a shop, a bank, or a phone company. Read "Filing a Consumer Complaint in Portugal (Livro de Reclamações)".

Before a clinic or hospital treats you, it must tell you what the care will cost. That includes tests, materials, medicines, and room fees. If it did not, you can complain. Complaining is free and there is no deadline.

You can write in the provider's complaints book or complain straight to the health regulator, the Entidade Reguladora da Saúde (ERS). The provider must send your complaint and its reply to the ERS within 10 working days. The ERS can order a provider to cancel a bill and give your money back.

What the clinic must tell you before treatment

The rule is that you get the cost information before you decide, whether or not you ask for it. It must be complete, clear, and given in a way you can understand. A clinic's price list must always be available for you to see.

Before your care starts, the clinic must tell you:

  • the prices, fees, or estimate for the care you are about to receive;
  • whether it has an agreement with the SNS (the national health service), with your health subsystem such as ADSE, or with your insurer, and what that agreement covers;
  • what your insurer or plan pays and what you pay yourself;
  • any forms, authorisations, or other steps your insurer or plan needs.

The estimate must cover the whole cost you can expect to pay: medical acts, tests, materials, medicines, and the room fee (piso de sala). A clinic should not give you a partial estimate. If it cannot predict everything, it must say so clearly and warn you that the final bill may be higher.

If your treatment runs over several visits, you should be told the cost of the whole treatment, not just the first stage.

A clinic may ask for a deposit (caução), but only if it tells you beforehand, and explains how you pay it and get it back. A private clinic working outside the SNS may charge you for a missed appointment, but only if it told you about that fee in advance.

What your bill must show

Your invoice or receipt must show:

  • the provider's name, address, and tax number (NIF);
  • your name and address, and your NIF if you ask for it;
  • the name of your health subsystem or insurer and your member number, if you used one;
  • each act or service in plain words, how many, where, and on what date.

The clinic should give you the invoice when you are discharged. It should not send extra bills later, except in rare cases that it explains and tells you about beforehand. When you pay, you have the right to a full receipt that settles the bill.

How to complain

  1. Talk to the clinic first. Ask the front desk or the patient office to explain the charge. The ERS suggests this as a first step, because the clinic may be able to sort it out.
  2. Choose one way to complain. Use only one of these, so your complaint is not counted twice:
    • the paper complaints book at the clinic. In private clinics it is red (Livro Vermelho), and you keep the blue copy. In public hospitals and health centres it is yellow (Livro Amarelo);
    • the electronic complaints book at livroreclamacoes.pt, for private, social, and cooperative providers only;
    • the ERS online complaint form, or an email to [email protected], or a letter to the ERS.
  3. Write it clearly. Name the clinic and give its full address, because some clinics have similar names. Give your name, address, and contact details. Then say what happened in a few plain sentences, with the dates and amounts.
  4. Attach what you have. Add the quote, the invoice, and any messages about the price.
  5. Keep your reference number. You need it to add information later or to check progress.

A complaint must always be in writing. If you need help writing it, call the ERS on 309 309 309.

A clinic cannot refuse you the complaints book. It must hand it over at once and free of charge, whatever it thinks of your complaint. If it refuses, you can call the police (PSP, GNR, or municipal police). The officer writes a report, which goes to the ERS.

You can complain anonymously, but the clinic still has to be able to answer. Describe what happened without details that identify you.

Do you have to pay while you complain

After you complain, it is your decision whether to pay the amount you dispute. The ERS will give its view on your complaint. If you do not pay, the clinic can go to court to recover the money.

A private clinic working outside the SNS may refuse you further care while you owe it money. It cannot do this in an urgent or emergency case. A public SNS hospital or health centre cannot refuse you care because you owe user fees (taxas moderadoras).

What happens after you complain

The clinic is responsible for looking into your complaint and answering you. It must send the complaint, its reply to you, and its comments to the ERS within 10 working days. If you complained to the ERS directly, the ERS asks the clinic for its answer.

The ERS then:

  • checks the quality of the clinic's answer and what it did about it;
  • steps in where it sees a serious failure;
  • opens a case for a fine where the law may have been broken;
  • makes a final decision on your complaint.

In deliberations published in September 2026, the ERS ordered private clinics to cancel bills for tests that patients had not been told about, and to refund the money.

If the clinic never answers you, tell the ERS. If you disagree with the clinic's answer, you can challenge it with the clinic or with the ERS. If you disagree with the ERS decision, you can challenge it too, giving your reasons. You can check where your complaint stands on the ERS website, using the ERS reference or the number on your complaint sheet.

Asking the ERS to mediate

If you want to reach an agreement with the clinic, the ERS offers free mediation. A trained ERS staff member helps you and the clinic find a solution, and can suggest one.

  • You ask in writing, by email to [email protected] or through the ERS form. You can ask alone or together with the clinic, but the clinic must agree to take part.
  • The ERS decides within 10 days whether to accept the case. It can extend this by another 10 days if it needs more information.
  • The whole process can last up to 90 days from when both sides have agreed. The ERS can extend it by another 90 days.
  • Sessions usually take place at the ERS office in Porto, and only in some cases by video call. You can bring a lawyer.
  • Any agreement you sign can be enforced without going to court first. If you do not agree, you can still go to arbitration or to court.

Mediation is not available for complaints about front desk service or waiting times at reception.

Contacting the ERS

  • Call centre: 309 309 309, 09:00 to 17:30.
  • Email for complaints: [email protected].
  • In person: Rua S. João de Brito, 621 L32, 4100-455 Porto, on working days from 10:00 to 12:00 and 14:30 to 16:30, by appointment.

The ERS handles complaints about health providers on mainland Portugal. This guide does not cover the Azores or Madeira. It is general information, not legal advice.

Sources

This guide is written from official Portuguese and EU sources and, for prices and contact details, the providers' own websites.

Last verified September 2026. Rules and fees change; check the official source before acting.

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