Qualifying For Free Health Care Under The Portuguese Health Service.
If you are resident on Madeira, you are entitled to make use of the health service and enjoy the same benefits & standards of health care as a portuguese citizen with doctors & health centres. However, in order to obtain residency it has been necessary in the past to demonstrate that you already have medical protection in this respect, but you will be told this when you apply for residency at the Serviço de Estrangeiros e Fronteiras in the Loja da Cidadão, in Funchal. If you use the website link above you can click a button to see the english language version.
Once you have residency, any need for health and medical insurance becomes optional, as you can then apply for your medical registration and ‘health card’. Depending on your working circumstances, you may also need to show that you are registered with your local social security office (Segurança Social) and pay national insurance contributions.
There are cases where applicants have gone to their local health centre and been issued a ‘health card’ showing no more than their passport, and have seen a doctor that same day.
Anyway, however you manage it you will end up with a card called the ‘Cartão De Utente’, which will hold medical information about you on its magnetic strip, or you may be issued with a substitute document. Once you have registered you are covered (even if you have been issued with a temporary document), and you can then seek help or treatment from registered doctors at any of the health centres or hospitals on Madeira. The card will also entitle the owner to discounts on prescription medicines.
If you are unable to obtain the registration, particularly if you are waiting for your residency permit, then you will need to have a medical insurance policy to cover you. As a traveller, you can use the European Health Insurance card (formerly the E111) obtained in your own county, or use your travel insurance policy to deal with any emergencies, and in addition, some countries like the UK have reciprocal agreements with Portugal for assistance and treatment of each others citizens. This will cover any emergency treatments in health centres and hospitals.
Health Care Standards
Unless there is something to compare with, it’s hard to make comparisons, but feedback from people who have used the Portuguese health service has been pretty positive in all respects. Of course each hospital or health centre has good days and bad days, but the bad days are apparently few and far between, and it is fair to say that Madeira provides a very satisfactory medical service, that would compare well with the top european countries.
However, Madeira is a small island, and health problems of very specialised natures may not be familiar to the doctors here, or they may not have the equipment, hospitals or facilities to deal with particular specialist problems. In this case, if you are properly registered in the health care system of Portugal, you may be sent to the mainland to receive consultations or treatment, with nearly everything organised and paid for, including a meal allowance (€18 per day). Flights will be prepaid, but taxis to the airport will not be fully reimbursed for example (75%). If going to the mainland, you have an option to take a companion to help you as necessary. Normally an administrative and help contact is provided in your city of destination, so you can phone at any time for advice and support.
Doctors on Madeira may be reluctant to send foreigners to Portugal, so if necessary you should insist, and as a last resort complain.
Of course some things are done differently than elsewhere, and there have been adverse comments about food quality, hygiene issues, and lack of privacy..
How The Health System Functions
The hospitals on the island are located in Funchal, but major towns have their own Health Care facilities, and even some smaller towns have some facilities, known as the ‘Centro de Saude’. The health centre, depending on the size, will have a number of medical staff (médico/a = doctor, and enfermeiro/a = nurse). If you are making a routine visit, or are well enough to travel yourself, then you should go to your nearest ‘Centro de Saúde’ and report to the reception (if there is one), needing only to take your ‘Cartão de Utente’. If you don’t have one, take your European Health Insurance Card, or your health insurance policy, and also your passport (and Residency Permit if you have one). If you don’t have any protection, it is likely you will have to pay for any treatment.
You will need to wait until a doctor is available to see you, and if he cannot treat you, then it may be that you will be referred or transferred immediately to a hospital. Most doctors speak english very well, so a good dialogue should be possible. The doctor may give you a prescription to obtain medicine, which you will need to take to a chemist. If you need a repeat prescription, ask the receptionist at the ‘Centro de Saúde’, if possible show a copy of the previous certificate.
In the larger ‘Centro de Saude’, you will find facilities to deal with accidents and emergencies as well as the more routine problems and illnesses, and doctors will be available for longer hours.
Private Medical Insurance
If you don’t have the entitlement to use the Portuguese Health Service free then you need to ensure you have one of the other forms of protection previously mentioned. If private medical insurance is the only option open to you, for example as a non EU citizen, then you should keep it valid and present any documents at the request of medical staff.
Private Doctors
Private Doctors and Specialists are plentiful on Madeira with over two whole pages in the yellow pages in the telephone directory under ‘Médicos’. You should enquire about the cost before you agree to have treatment done.
Ambulances
You should dial 112 if you need an ambulance in an emergency, or find a listed number here bearing in mind you may be talking to the fire brigade, who provide ambulance services. Ambulance journeys can be chargeable, so if you can find your own way it may be quicker and cheaper. Road accident attendance are normally charged to the policyholder to reclaim on their vehicle insurance.
Dentists
Dental care falls outside of the Portuguese health system, so you will always need to consult a private dentist, and their services are not cheap, a fact supported by the fact that a great many Madeirans never go to the dentist, or only in the event of an emergency. You should ask the dentist about the cost before you agree to have treatment done. You will find over 30 dentists in the yellow pages of the telephone directory listed under ‘Médicos – Dentistas’.
Opticians & Eye Care
Opticians are plentiful on the island, with a shop or more in most large towns. You need to pay for everything, as they operate outside the Portuguese health system. You will probably find them very helpful if you need a screw replacing in your glasses, but if you need to buy new glasses then you might find them comparatively expensive against prices in other countries. It is possible to have an eye test and then use the prescription to order glasses on the internet or use the same prescription in another country. Likewise, it is possible to see an optician in another country to obtain a prescription and use it on Madeira. You will also find over 20 opticians in the yellow pages of the telephone directory listed under ‘Oculistas’ and several opticians advertise in the daily paper ‘The Diário’.
Chemists / Pharmacies
Chemists / Pharmacies are well represented across the island, with around 100 listed in the yellow pages and a presence in most towns, the shops with the green cross outside. If you have a minor ailment or just need some advice, your local ‘farmácia’ may well be a good port of call, as the staff are well trained and helpful, and are able to recognise most medicinal products you may be familiar with. Chemists / pharmacies also carry large stocks of non prescription items.
Many chemists / pharmacies open in the evening, some until late at night, and there are even 24 hour chemists / pharmacies. The YELLOW PAGES directory on-line may help.
Prescriptions are issued by doctors in the health centres and hospitals, and this is taken to the pharmacy. If you have a ‘Cartão de Utente’, present that also, as it may earn you a discount on the marked price. Often the medicine prescribed may have a much cheaper generic alternative, but the pharmacist is not permitted to make a substitution. It is often worth asking for an generic alternative, as it may be available without a prescription.
Tax Concessions
Medicines and many medical expenses are tax deductable for tax payers in Portugal. Ask for and keep any receipts safe. Also medical insurance is a allowable tax deduction.
Complaints
‘ORDEM DOS MÉDICOS’ – This is the governing body covering doctors and medical facilities and specialists. You can contact them if you have a complaint about medical personnel, services and facilities on Madeira.
Complaints about public health institutions, including hospitals and health centres should be directed to the regional health administration office if they are unresolved at the point of origin.
However, you can now access an online complaints book, instead of asking for the ‘Livro de Reclamacões’, go to: Health Care Complaints Book Online
At this stage, this is only for complaints on matters of health care, but the principle is good, and hopefully it will extend to other areas. It’s certainly a lot easier than doing this in the environment where the complaint was incurred. The form is in Portuguese, but is not too hard to understand with the help of a dictionary.
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NO RESPONSIBILITY CAN BE ACCEPTED FOR THE ACCURACY OF INFORMATION SHOWN HERE, AND YOU SHOULD SEEK INDEPENDENT VERIFICATION OR PROFESSIONAL GUIDANCE. THIS PAGE WAS LAST UPDATED IN 2008.
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