Does GV enable use of Healthcare without living

In the Golden Visa guide :Portugal Golden Visa Guide: Pros & Cons in 2024 – Nomad Gate, it says:
“What are the advantages of the Golden Visa in Portugal?
In short, you can:

4. Access the Portuguese healthcare and education system (on the same basis as Portuguese citizens)
…”

Question: Can someone with GV access Portuguese public health services without spending 183+ days in Portugal?

So - yes and no. You’re able to get an SNS number which enables you to use the public health care system by right of having a residence card. However in order for the SNS to pay for your expenses, you are supposed to be living at an address in Portugal.

If you’re just passing through now and then on a GV you’ll likely have to pay out of pocket for health care. That said, these are orders of magnitude less than costs in the US, likely even less than your co-pay with many American health insurers.

You can take out a private health insurance plan, however. Regardless of how much time you spend in Portugal or not. https://mgen.pt is an excellent choice of low cost insurance without many hassles, in the neighbourhood of €100 per month per person. If you’re planning to spend time regularly in PT and use the health system a lot, this could be worth it.

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To clarify, Portuguese citizens’ health expenses are generally only covered while living in Portugal.

I’m not 100% certain what the case would be for a GV-holder not actually living in Portugal. On the one hand you are a legal resident, but on the other you’re usually not a tax resident.

I’d be somewhat surprised whether the law distinguishes based on whether you are tax resident or not, but it’s not something I’ve dug into.

According to this it seems that having a Portuguese address on file is required for costs to be covered, however it does not specify whether it needs to be registered as your “primary residence” or not. The primary vs secondary residence distinction is relevant for your tax residency status.

Maybe someone else here have first-hand experience of how it works in practice?

This is an interesting question for those of us with residency, without property, and who don’t live in the country full time.

I’m a non-tax resident but I am registered with SNS (which I did in 2021 to get a EU digital Covid certificate). I don’t have a permanent residential address in Portugal. The address on my ARI card is my lawyer’s office in Lisbon, which so far has been an acceptable address for all government interactions. The SNS was happy to use that for registration.

The rules listed on government sites say that for your healthcare to be covered under SNS, you need an ID doc, a NIF, an address in Portugal, and a valid residence permit. Notably, it does not say you need to be living permanently at an address in Portugal or that you need to be a tax resident at the time of treatment.

I haven’t tried seeing a public doctor in Portugal yet but it is worth noting that for GV renewal purposes SEF used to accept SNS registration to be “proof of adequate health insurance”.

Portuguese citizens living abroad are still covered. The government announced some changes from 1 Jan that mean they can attempt to recoup costs from private insurance if available, but failing that, SNS coverage applies to citizens even if your residential and fiscal addresses are outside Portugal.

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Indeed, it seems I was mistaken. Most countries I’m familiar with don’t operate like that, and even my Portuguese wife was unaware that she’d be covered in Portugal other than with the EHIC.

I find this article from SNS a bit more clear on the topic:

https://www.sns.gov.pt/noticias/2023/12/13/emigrantes-com-pleno-acesso-ao-sns/

So essentially, as a Portuguese emigrant, they’ll try to charge your home country or insurance for the care you receive in Portugal. But if they’re unsuccessful at that you still wouldn’t be held liable for the costs.

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Speaking of EHIC…
“ The card exists because the right to health care in the European Union is based on the country of legal residence, not the country of citizenship. Therefore, a passport is not enough to receive health care. It is however possible that a photo ID document is asked for, since the European Health Insurance Card does not contain a photo.”

So my take is that if GV holders have right to Portuguese healthcare via their residency card, they’d also be eligible for EHIC.

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Got it, thanks for that clarification. Still not clear what that means for non-tax resident ARI holders. Hopefully someone has personal experience to share.