Key points
- Portugal runs the Beveridge model: a universal, tax-financed National Health Service (NHS) providing free care at the point of use to all residents, including asylum seekers and migrants awaiting regularisation.
- General practitioners act as gatekeepers, with primary care organised in Family Health Units; in 2024 the former Regional Health Administrations were extinguished and Local Health Units integrating primary and hospital care were rolled out across the country.
- Care is delivered by public and private providers: private providers absorb nearly half of all health expenditure, and services such as haemodialysis, laboratory and radiology tests, endoscopies and rehabilitation are 85–100% privately supplied.
- The public share of spending is thin: only 62% of health spending came from public sources in 2023, the third-lowest share in the EU after Greece and Latvia, and households paid 29.3% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database).
- Life expectancy at birth was 82.5 years in 2023, and health spending was 10.2% of GDP in 2024 (OECD Health at a Glance 2025).
Direct answer: Portugal runs the Beveridge model: a universal, tax-financed National Health Service (NHS) providing free care at the point of use to all residents, including asylum seekers and migrants awaiting regularisation. General practitioners act as gatekeepers, with primary care organised in Family Health Units. Care is delivered by public and private providers: private providers absorb nearly half of all health expenditure, and services such as haemodialysis, laboratory and radiology tests, endoscopies and rehabilitation are 85–100% privately supplied. The public share of spending is thin: only 62% of health spending came from public sources in 2023, and households paid 29.3% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database), mostly on medicines and dental care. Life expectancy at birth was 82.5 years in 2023 — and healthy life expectancy 69.8 years — and health spending was 10.2% of GDP in 2024 (OECD Health at a Glance 2025; WHO Global Health Estimates, October 2026).
At a glance
| Item | Detail |
|---|---|
| Model | Beveridge — national health service (NHS) |
| Who pays | General taxation, through the NHS; occupation-based schemes and voluntary health insurance supplement it, and the public share was only 62% of health spending in 2023 |
| Who delivers | Public and private providers: Local Health Units integrating primary and hospital care, Family Health Units for primary care, and private providers contracted by the NHS for services that are 85–100% privately supplied |
| What is free at the point of use | NHS care for all residents, including asylum seekers and migrants awaiting regularisation; patients pay high cost-sharing on medicines and for services with limited public coverage, such as dental care |
| Life expectancy at birth | 82.5 years (2023, OECD Health at a Glance 2025) |
| Health spending | 10.2% of GDP (2024, OECD Health at a Glance 2025) |
| Source for the model and coverage | State of Health in the EU: Country Health Profile 2025: Portugal (OECD and European Observatory on Health Systems and Policies) |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
Portugal’s National Health Service is a universal, tax-financed system providing free care at the point of use to all residents, including asylum seekers and migrants awaiting regularisation. It is highly centralised: the Ministry of Health oversees planning, regulation and supervision through bodies such as the Directorate-General of Health and the NHS Executive Board, established in 2021. In 2024, the former Regional Health Administrations were extinguished and Local Health Units that integrate primary and hospital care were rolled out across the country, now under national coordination from the NHS Executive Board. The 2024 reform also introduced capitation funding for Local Health Units, based on new risk-adjustment tools.
General practitioners act as gatekeepers within the NHS, with primary care mostly organised in Family Health Units. After the 2023–25 conversion of all non-incentivised model-A Family Health Units, nearly all of them now operate under performance-linked remuneration (model B). Outside the NHS, coverage is supplemented by occupation-based schemes and voluntary health insurance, and services are delivered by both public and private providers. The workforce is ageing and stretched: one third of NHS specialists and one fifth of nurses are now 55 years or older, overtime surged to 19.8 million hours in 2022 — 51% more than in 2018 — and the NHS physician workforce grew 39% between 2010 and 2023 to just over 32,000, with the nursing workforce rising 31% to about 51,000.
Who pays, and what people pay
General taxation pays for the NHS, but the public share is thin: only 62% of current health spending came from public sources in 2023 — the third-lowest share in the EU after Greece and Latvia — and mandatory prepayment covered 62% of spending (OECD Health at a Glance 2025). What patients pay is heavy: out-of-pocket payments accounted for 29.3% of total health spending in 2023, almost twice the EU average, mainly because of high cost-sharing for medicines and limited public coverage for services such as dental care. Voluntary health insurance covered almost 3.7 million people, around one third of the population, in 2022 and represented 9% of total spending in 2023, the third-highest share after Slovenia and Ireland. Enrolment of over 600,000 people to voluntary health insurance since 2021 reflects persistent shortages of general practitioners and long waiting times: 43% of people enrol because of difficulties in accessing NHS services and 25% to reduce waiting times.
What is free, and what is not
Free at the point of use: NHS care for all residents, including asylum seekers and migrants awaiting regularisation. What is not free is the margin, and it is wide: high cost-sharing on medicines, limited public coverage for dental care, and waiting times that push many people to pay for faster access — around half of all voluntary health insurance policies are contracted by employers as part of workers’ benefits packages. Prevention is underfunded too: spending on prevention accounted for just 2.3% of health expenditure in 2023, roughly half the EU average of 4.0%. The spending mix is outpatient-heavy: 45% of current health expenditure went on outpatient services in 2023, the highest share in the EU and well above the 28% average, which helps keep avoidable hospital admissions low.
How it compares
Portugal spends 10.2% of GDP on health — above the OECD average of 9.3% — and $5,212 per person, below the OECD average of $5,967 (USD PPP, 2024). Its life expectancy of 82.5 years is 1.4 years above the OECD average of 81.1 years (OECD Health at a Glance 2025), and Portugal is one of the nine OECD countries that spend less than the average but achieve higher life expectancy than the average. Its distinguishing feature is the gap between a universal promise and a thin public purse: a National Health Service that is free at the point of use, yet households pay 29.3% of health spending out of pocket — and Portugal also has 5.8 doctors per 1,000 people, the second-highest figure in the OECD table after Greece (6.6), though the OECD notes the Portuguese count is of licensed doctors, including retirees and others not currently practising, so it overstates practising numbers. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
Is Portuguese healthcare free?
NHS care is free at the point of use for all residents, including asylum seekers and migrants awaiting regularisation — but patients pay high cost-sharing on medicines, and public coverage for services such as dental care is limited.
What are Family Health Units?
The teams that organise primary care in Portugal: general practitioners act as gatekeepers, and nearly all Family Health Units now operate under performance-linked remuneration (model B) after the 2023–25 conversion.
Why do so many people in Portugal buy private health insurance?
Voluntary health insurance covered almost 3.7 million people, around a third of the population, in 2022: 43% of people enrol because of difficulties accessing NHS services and 25% to reduce waiting times, and enrolment has risen by over 600,000 people since 2021.