Non-Residents Would Pay or Show Insurance for Non-Urgent SNS Care Under a Bill the Governing Parties Have Brought Back to Parliament
PSD and CDS-PP have retabled their change to the Health Framework Law. Foreigners here regularly remain covered; non-residents and people here irregularly would pay or prove cover, except for emergency and life-saving care.
The two governing parties have tabled their bill again to limit the Serviço Nacional de Saúde (SNS, the National Health Service) for foreigners who do not live in Portugal. Projeto de Lei n.º 786/XVII, signed on Friday 25 September by twelve PSD and CDS-PP deputies headed by Hugo Soares and Paulo Núncio, would make non-residents and people in Portugal irregularly pay for their care or show proof of health cover. The only exception is emergency, urgent or life-saving treatment.
The text is short. It rewrites one article, Base 21, of the Lei de Bases da Saúde (the Health Framework Law, Lei n.º 95/2019). It would take effect the day after publication.
Who would still count as an SNS beneficiary
Portuguese citizens remain beneficiaries, as now. The new paragraph 2 adds foreigners "in a situation of regular stay in national territory, or on a visit or temporary residence in Portugal", whether they are nationals of EU member states or equivalent, of third countries, stateless people or applicants for international protection.
What disappears is the phrase the bill's authors object to most. They say the current wording covers third-country nationals and migrants even "without their situation being legalised". That, they write, makes it impossible for the health service to control foreigners' access at all.
The authors say they do not intend "to remove or reduce any rights of legitimate beneficiaries of the SNS". Foreigners whose stay is regular, including those on temporary residence, are named as beneficiaries in the new wording.
What non-residents would have to do
A new paragraph 5 covers people "in a situation of irregular stay" and non-residents not listed in paragraph 2. For them, using the SNS "implies payment for the care provided, under the law, or presentation of proof of health cover", for example from an insurer or another party legally or contractually responsible, plus whatever documents the SNS needs to identify and contact the patient.
Emergency, urgent and life-saving care is exempt, but the exemption does not waive the paperwork: proof of cover and documents must still be produced afterwards. A paragraph 6 leaves it to a later law to set up the machinery for identifying who pays, collecting the charges and, "when necessary", demanding a guarantee or payment in advance.
The bill does not define "irregular stay". Público, which reported the bill on Saturday, reads it as also reaching people who already live in Portugal but whose residence permit has expired.
The case the parties make
The explanatory note leans on a report by the Inspeção-Geral das Atividades em Saúde (IGAS, the health inspectorate) of 27 November 2024. It found that about 330,000 foreigners not resident in Portugal were treated in SNS hospital emergency departments between 2021 and September 2024, and that more than 140,000 of them had no insurance or international agreement covering the care.
The note also cites the head of the Amadora-Sintra local health unit, who said this month that 40 percent of the unit's obstetrics patients are foreign women. Our report on that hospital's pressures has the detail. The authors concede they do not know "the exact size" of the problem.
A bill that has been here before
The text "essentially" repeats Projeto de Lei n.º 384/XVI, which the same two parties tabled on 12 December 2024. It passed its first reading with the votes of the Aliança Democrática (Democratic Alliance) and Chega, then lapsed when the last legislature ended early.
Visitors from other EU countries are generally covered through the European Health Insurance Card; our guide to the card explains how it works, and our overview of the health system covers SNS registration for residents.
