Most private health insurance in Portugal is individually underwritten: a medical questionnaire, an assessment of your history, and a decision that can mean a loading, an exclusion, or a decline. MGEN, a mutual provider, works differently — membership rather than individual risk-selection. That difference is genuinely useful for some people and irrelevant for others, and the honest version includes the trade-off, not just the access.
No questionnaire, because nothing is being individually assessed
Conventional insurers price and accept each application on that person's own declared history. MGEN's route runs on membership: there is no medical questionnaire at application and no individual assessment of your risk, because nothing is being individually assessed in the first place. That is also why it does not exclude a pre-existing condition outright the way a conventional decline or exclusion would.
The trade-off: a 365-day waiting period
Nothing is free. A pre-existing condition is covered once a waiting period of 365 days from the start of cover has elapsed — not excluded permanently, but not paid for in year one either. Anyone comparing this route to a conventional policy needs to hold both facts at once: broader acceptance, and a full year before the condition that motivated the search is actually covered.
Where the mechanism has to sit
A health product that accepts everyone — no medical questionnaire, no age limit, no pre-existing condition excluded outright — has made a design choice, not found a loophole. Anti-selection, people joining because they already know they will claim, has to be managed somewhere or the product cannot function at any price. It is managed through the questionnaire, or the age limit, or the exclusions, or the waiting periods. Take the first three off the table and the fourth is where it goes. MGEN takes the first three off the table and puts the mechanism in the waiting period: 365 days before a pre-existing condition is paid for. That is a coherent way to build the product, not a defect it is hiding.
The question worth asking of any policy that advertises acceptance without limits — not this one specifically — is where its own version of that mechanism actually sits. A lenient-looking questionnaire can sit in front of a long exclusion period. A headline of "no waiting period" can sit behind a stricter declaration requirement or a narrower definition of what counts as pre-existing. The mechanism does not disappear because a particular page does not mention it; it moves to wherever the reader did not think to look. Reading a proposal well means finding where it sits before signing, not assuming the absence of one door means there is no door at all.
Our own position on this one: if a 365-day wait makes this route wrong for a specific situation — a condition that needs treatment sooner, a move that cannot wait out the year — we would rather say so before the policy is placed than have it discovered six months into it.
Age: the other door this route keeps open
Conventional insurers apply a maximum entry age for a new individual policy. Because MGEN's acceptance runs on membership rather than individual risk-selection, that age barrier does not operate the same way here — which is why this route comes up most often for two overlapping groups: someone who has already been declined or excluded on medical grounds, and someone arriving in Portugal later in life who has aged past a conventional insurer's entry cut-off. For the second group specifically, the practical question is rarely "which policy is cheaper" — it is often "which route will accept me at all."
Acceptance, not price, is the actual comparison
This is deliberately not a premium comparison. Adler & Rochefort does not rank insurers on price, and the honest way to place MGEN alongside a conventional insurer is by what each will accept, not by which costs less. Someone who would clear conventional underwriting without a loading has no obvious reason to take on a 365-day waiting period. Someone who would be declined, excluded on the specific condition, or priced out by age is looking at a genuinely different question, and acceptance is the variable that actually decides it.
Moving to Portugal with an existing condition
The practical sequence for someone relocating with a known condition: establish whether a conventional insurer will accept the case at all, on what terms, and at what age cut-off; if the answer is a decline, an exclusion of the condition itself, or an age barrier, the membership-based route becomes the live option, with the 365-day clock starting from when cover actually begins — which is a reason to start that clock as early as practical, not to wait until the condition becomes active again.
What we actually do here
We explain both routes against the specific situation — declared history, age, what a conventional insurer's underwriting is likely to do with it — and set out what each route accepts and on what timeline, in writing, before any application goes in.
Declined, excluded, or past the age cut-off?
Tell us your situation and we will set out, in writing, what each route would actually accept — and on what timeline.
Adler & Rochefort is a commercial brand of Ownizo, Unipessoal Lda., registered with the Portuguese Insurance and Pension Funds Supervisory Authority (ASF) under no. 425591790/3. General information only, not personalised advice; acceptance terms, waiting periods and cover details are confirmed in writing against the specific application, not guaranteed by this page.
More on this subject: Pre-existing conditions and Portuguese health cover · International health insurance in Portugal · Declined for health cover: what is left · Private health cover at 70 and 75 · Acceptance, not price: four routes compared · Waiting periods, product by product · Moving to Portugal with a chronic condition