MEDICAL COSTS IN PORTUGAL
I meant to keep a track of all my medical (doctor, hospital and dental) appointments and relevant costs since we relocated to Portugal but life just got in the way and I forgot. I cannot be bothered to go back over 2.5 years of receipts and invoices so I have started from scratch. I did try to go over old calendars and invoices but with my menopausal brain fog and current wisdom tooth pain I lost the plot and was drawn towards the lounge bar at mid day so I stopped (ha ha). The costs listed are just my personal expenditure and not hubby’s. He has only occurred dental costs so far (lucky him). He has only been to visit the doctor for his driving licence medical check as he is fit as a fiddle. I have explained more in detail the Serviço Nacional de Saúde (SNS) costs for visiting a doctor on my previous post as well as the horrendous experience we encountered whilst trying to register at a local health centre, which you can view here if your interested: https://casavalhal.com/a-guide-to-signing-up-to-a-doctors-sns-obtaining-prescription-drugs/
Once registered your SNS Utente (User) number allows you to access the Portuguese public healthcare system which is similar to the NHS in the U.K. That doesn’t just mean emergency care at A & E but also access to doctors and nurses at your local community healthcare centre. It is not a totally free service but we receive medical care at a reduced cost. Hubby also pays towards healthcare via his automated social security contributions, a bit like the U.K National Insurance and NHS entitlement. His monthly payments from his salary are a similar price to what he was paying in the U.K and he still needs to top up his U.K Social Security to be entitled to his full state pension upon retirement age. This post is just a record of my treatment and costs so far and I will continue to add to it. Better late than never!
Basic SNS Doctors visit fees are €4.50 and in our case the local SNS Medical Centre stopped taking physical cash and card payments in 2021. This wil result in a bill that will show up on the SNS Website and a copy will be posted to home address. Don’t forget to show your NIF number when paying for private medical appointments and obtaining drugs (prescriptions and other non prescription stuff) from pharmacies as you can claim certain deductions off your yearly tax return for every transaction and although it’s not a significant amount every cent counts!
Doctor Costs (Including Tax)
I will start my doctors appointments from 01/11/2021 after a nasty trip/fall whilst running in my local area. Up to this date I really only encountered the odd €4.50 doctor visit fee so costs were a minimum. 2022 has not been a good year for me medical wise mainly due to my accident prone/clumsy ass (ha ha).
FAAD Hospital is not SNS but I always visit here as it’s very near and located a short 25 min drive from our home. I could visit the SNS Hospital in Coimbra and scans etc. would be a bit cheaper but it’s an hour drive and what I save in exam fee I will only go on petrol. I also love the fact that FAAD give you your results immediately if an X Ray or Ultrasound. They make you wait a few minutes then hand you your diagnosis (paper file with results or disc) which means you obtain automatic results which reduces my stress and anxiety. They also accept all SNS referrals from your doctor but it is best to email them for appointment although I have just turned up before and they have seen me without a prior appointment.
02/11/2021 SNS Arganil Urgent Care Hospital (Similar to A & E in U.K) X Rays to arm/shoulder no broken bones detected (€14).
08/11/2021 SNS Doctors appointment as still in pain, referral to Hospital for 2 Ultrasound scans. (No charge yet).
18/11/2021 FAAD Hospital, Shoulder Ultrasound (€30).
26/11/21 FAAD Hospital, Pelvic Ultrasound (No charge).
11/02/2022 SNS Arganil Urgent Care Hospital X Rays to foot from a boxing sporting injury, Don’t ask (ha ha). (No charge yet).
28/02/2022 SNS Doctors appointment as still in pain with foot unsure if related to boxing accident or RA which I have in my hands, referral for blood tests (No charge yet).
04/03/2022 FAAD Hospital Blood Tests for RA (No charge yet).
16/03/2022 FAAD Hospital Foot Ultrasound (€30).
26/03/2022 Private Hospital near Lisbon initial consultation with a surgeon (€90).
20/08/2022 FAAD Hospital Blood Tests. I had to have blood tests before my private surgery and my surgeon sent me a paper document from his private clinic. These blood tests were not via SNS so cost more. I could have got the blood tests done cheaper if I had visited my SNS doctor and obtained the SNS paper document then took it to FAAD but this would of resulted in a 30 min journey each way and petrol cost so I didn’t bother. The receptionist at FAAD was lovely and said that it will be expensive without the SNS paper but in fact the total cost was only €22.60 for 9 different blood tests which I thought was very reasonable and saved me the hassle and time.
September 2022 Private Hospital near Lisbon, Pending Private Operation around €8000 (I think before tax) but I will confirm in due course. Unfortunately my surgery had to be cancelled last minute due to a serious infection in my jaw bone after my wisdom tooth removal, beyond gutted!
03/09/2022 SNS Arganil Urgent Care Hospital Severe agony after wisdom tooth extraction and serious infection, wish I hadn’t bothered going, was told to go back to dentist and just given a prescription for 1 packet (20) paracetamol & codeine which don’t touch the sides of my chronic throbbing pain! (No charge yet).
26/11/2022 SNS Coimbra University Hospital Random “Out of the blue” vision loss in right eye! Emergency visit to Urgent Care (A & E) and immediately had laser eye surgery to repair a hole and a separate tear in my retina! BeJesus I’m having a really bad year regarding my health. I wasn’t charged anything on the day but a couple of weeks later and I received a bill in the post for €18. I emailed the Hospital because as from June 2022 certain fees were abolished. There is not supposed to be any fee for an Emergency room visit if you were referred by the SNS helpline which I was on this occasion. Hospital replied and waived the €18 fee. Please refer to the end of this post and Important Update regarding fees.
30/11/2022 Coimbra University Hospital Follow-Up appointment. Not great news, vision loss may be permanent, it’s a waiting game now, only time will tell. (No charge yet). Another follow up appointment in a couple of weeks. Wish me luck!
22/12/2022 Coimbra University Follow-Up appointment. No significant change to vision and now experiencing headaches from hell! Doctor is happy with repair to retina and has signed me off now – discharged. (No charge).
Dental Costs (Including Tax)
I wrote a previous post about our experience of finding a local Dentist here: https://casavalhal.com/my-first-visit-to-a-portuguese-dentist/
As I have mentioned before, in my previous post, there are no dentists available on the SNS unless you are an extreme case so all Dentists are private and costs can vary. In my opinion Dentistry costs here in Central Portugal are cheaper than most Private Dentists in the U.K but they are not as cheap as the NHS Dentist costs in the U.K which have fixed set bands. An emergency appointment or simple filling usually costs around €30-€40 but they sometimes do not include a clean, scale and polish with this so they often make you return and pay a further €30-€40 for a separate appointment which is with the same dentist not a hygienist. It all really depends on who you get as in 2020 I paid the 2 separate costs but when I had my last filling the dentist included a quick clean so it’s all a bit hit and miss.
Again, I forgot to record all my dental appointments but I will start from the beginning of 2022 as up to this date we only encountered check up fees, clean/polish/scale and one filling which averages at €35-€40 per visit. Let the expenses explode! (ha ha).
11/01/2022 Chipped my front tooth! Emergency appointment & tiny white filling (€40).
15/02/2022 Regular 6 monthly check-up (€35).
02/06/2022 Emergency Appointment for severe pain, X-Rays showed nothing so referral to hospital for full facial X-Ray (€30).
22/06/2022 FAAD Hospital Full facial X-Ray (€25). Not technically Dentist Cost but related to dental pain so I included it here.
29/07/2022 Wisdom tooth extraction (€350) €50 was tax.
10/08/2022 Emergency appointment as in severe pain from extraction, removed stitches & prescription – antibiotic, anti-inflammatory and pain relief (No charge for appointment just a small cost for drugs).
31/08/2022 Emergency appointment as still in severe pain after 1 month! I had 2 of the most painful X-Rays I have ever encountered in my life. It turns out I have an infection and was given a prescription – antibiotic, anti-inflammatory, pain relief and vitamins (No charge for appointment just a small cost for drugs).
08/09/2022 Emergency appointment as it appears I now have developed a bone spur with bone poking through the gum which is absolute agony. Dentist chiselled off bone it was horrific. (No charge for appointment and no prescription, I was told to just buy Ibuprofen from pharmacy.
12/09/2022 Emergency appointment still in with bone spurs. More cutting, chiselling and this time I had stitches which need to be removed in 1 week so I have an appointment for 19/09/2022, the irony is my appointment time is 2.30pm tooth hurty! (ha ha). I would laugh if I wasn’t crying in pain. Prescription for pain relief and no cost for appointment. The dentist advised that I also buy a gel and apply it after food.
16/09/2022 Emergency appointment in agony. Dentist took a look, painted something on the area and gave me a prescription for 2 drugs, one pain relief and one to aid with healing. I have an appointment on Monday to remove stitches, god help me! No charge for appointment just a small cost for drugs.
19/09/2022 Appointment for removal of stitches, the stitches dissolved on their own but I still attended appointment as in agony as bone spur has re-grown. Dentist was shocked and has a recommend a further procedure which involves ordering in a special membrane and covering the exposed bone area. Not gonna lie, I’m shitting a brick! Appointment booked for 26/09/2022. No charge for todays appointment. When will this ever end?
26/09/2022 Appointment for membrane cover over bone spur. The procedure was abolished as it would apparently cause more harm than good. More bone spur cut off without any anesthesia. A prescription for 3 days of antibiotics and no pain relief prescribed, just told to buy paracetamol and use the gel after eating. A further appointment was made for 10/10/2022. No charge for todays appointment just a small cost for antibiotics.
10/10/2022 Final Appointment to check out my bone spurs. After my last appointment things got worse and the bone started growing back through at rapid speed but after a few days it settled back down beneath the gum line. I can’t tell you my sheer relief! This is my final appointment re: Wisdom tooth extraction (hopefully). No charge for todays appointment. Time to CELEBRATE!
My wisdom tooth extraction was a painful and traumatic experience which is currently still on-going, no fault of the dentist who is amazing. It was a tricky procedure as a severe impacted wisdom tooth under the gum pressing on a nerve. I was told it would cost €300 but they didn’t add the €50 tax so I didn’t have enough cash on me which was mildly awkward but not as embarrassing as the time where we visited a private surgeon near Lisbon and I walked out without paying the €90 consultation fee. The receptionist chased me outside in the rain (ha ha). I also need to mention that the local dentist receptionist here is fantastic. Complete opposite to the doctors receptionist. She is so kind although her English is limited and she has even hugged me! I know OCD Helen hugging strangers, what ever next (ha ha). I often wonder why our dentist and vet regreets are the friendliest people I’ve ever met yet the doctors receptionist is a cold rude fish (ha ha). Unfortunately my dentist drama is on-going 1 month on. I have been on 3 courses of antibiotics now and have a serious infection which looks like it has spread to the jaw bone. The pain is insane and I am very gutted that my other major planned private surgery had to be cancelled last minute as I could not go through traumatic surgery with this current infection still at large. I just wanted to say that a friend had a wisdom tooth extracted by my dentist and it only cost €60 so I have no idea why mine was €350 but it was impacted. I also have not been charged for any of my return appointments or X-Rays, (so far 2). I don’t actually care about the money, I just want my health to return to some kind of “Normal” what ever that is!
Cost of Prescriptions
Costs of prescriptions in Portugal can vary depending on the drug and manufacturer. I am extremely lucky as my under-active thyroid drugs and co-codamol pain relief for my back condition are very cheap. I am not going to list every cost of my drugs I have obtained from the pharmacy but just as a guide, I was prescribed 3 different drugs after my wisdom tooth extraction:
Amoxicillin + Clavulanic Acid Mylan 875 Mg + 125 Mg (Antibiotics) 16 units (€5.95) I paid (€2.78).
Lepicortinolo 20mg (Anti-Inflammatory) 16 units (€3.90) I paid (€2.46).
Dol-u-ron Forte 30/500mg (Pain relief similar to co-codamol) 20 units (€2.95) I paid (€2.01).
The current prescription charge in the U.K per item is £9.35 but I must mention that my under-active thyroid condition entitled me to free prescriptions in the U.K despite me working full time. I didn’t realise this exemption for a while as no one tells you shit (ha ha).
Follow up medication:
Azitromicina ratiopharm 500 mg (Antibiotics) 3 units (€4.84) I paid (€2.11).
Ibuprofen 600 mg (Pain relief) 20 units (€2.22) I paid (€1.35).
Another follow up – medication due to an infection
Amoxicillin + Clavulanic Acid Mylan 875 Mg + 125 Mg (Antibiotics) 16 units (€5.95) I paid (€2.78).
Lepicortinolo -Prednisolona 20 mg (Anti-inflammatory) 20 units (€3.90) I paid (€2.46).
Neurobion Cianocabalamina & Piridoxina & Tiamina (B Vitamins) 0.2 Mg + 200 Mg +100 Mg 20 units (€5.51) I paid the full price.
Dol-u-ron Forte 30/500mg (Pain relief similar to co-codamol) 20 units (€2.95) I paid (€2.01). I ran out of these drugs fairly rapidly and the A & E Doctor who I visited prescribed a mother packet of 20 tablets when I visited on 3rd September, they only cost a couple of €.
Ibuprofen €7.40, I was shocked to have to pay over €7 for a packet of 20, 400mg Ibuprofen at the pharmacy.
Adalgur Paracetamol 500 mg & Tiocolquicosido 2 mg, Pain relief, 30 units, (€7.29) I paid the full price. Bexident anti-bacterial gel (€7.95).
Tramadol Pain relief 50 mg, 20 units, (€2.59) I paid (€1.50). Medrol Metilprednisolona 16 mg, 50 units, (€12.80) I paid (€8.06). I was shocked at the cheap price of Tramadol! I am not good with Tramadol but I didn’t look at the prescription until after I left the dentist. Last time I took these for my back pain I blacked out. This was over 5 years ago so I think I will give them a shot as I am in so much pain. What’s the worst that can happen? Hubby will have to drag me by my feet to bed.
Azitromicina bluepharma 500 mg (Antibiotics) 3 units (€4.84) I paid (€2.11). Ben-u-ron Paracetamol 1000 mg, 18 units, no prescription, purchased over counter for €2.79.
I will leave you with a final funny true story. Yesterday hubby received an email from our old NHS dentist in Bristol, U.K requesting a £37.00 payment for an outstanding balance! Weird coincidence as I just had my wisdom tooth extracted. Anyway, we haven’t visited that dentist in nearly 3 years and we always had a regular 6 monthly check-up with any follow up treatments but they always made you pay immediately after your visit so I know damn well that there is no balance owed. Why the F wait 3 years! I personally think they have mixed him up with someone else as he has a very common name. We also informed them that we were leaving the country so we didn’t take up an NHS place that someone else could use, I’m a kind spirit! It’s all a bit of a mystery and one for Miss Marple or in our case hubby (ha ha). We are awaiting a response but they are not very forthcoming.
Important Update (SNS ‘User fees’ to fall in June 2022)
I am not sure how I missed this information but today is 6th December 2022 and I have only just found out that the small fees charged to SNS users ceased in June 2022. Due to Covid, we were not charged our regular €4.50 fee to see our doctor during 2021 as the receptionists were not allowed to accept/handle cash payments. So I knew at some point that we would receive a bill which is fine. What confused me was the fact that I was not charged the normal €14 fee on 2 of my recent visits to the hospital A & E (Urgent Care/Emergency dept). I decided to investigate and found out the following:
SNS ‘user fees’ (taxas moderadoras) will be ending in June – except in the case of people who attend A & E without being sent by official channels (i.e. a health centre or the SNS24 helpline) and do not end up being admitted to hospital. Since 2020, user fees were being progressively eliminated in consultations at health centres, tests and analyzes prescribed in the SNS, as well as in the first hospital consultations. With the new rules, the payment of follow-up hospital consultations also ends. I have one word: WOW!
I was actually invoiced in December 2022 for my Emergency room visit to Coimbra (CHUC) and charged €18. I challenged this fee by email as I was sent to the Emergency Room via the SNS Helpline. The hospital replied and waived the €18 fee. To be honest, I would not have minded one little bit paying the small bill as I find the previous costs before this new rule came into force extremely affordable.