International Health Insurance in Portugal
International private medical insurance — IPMI — is health cover written for people whose lives are not confined to one country. It is not the same product as a Portuguese private health plan, it costs more, and for a good number of residents here the Portuguese plan is the better answer. This page sets out where the difference actually matters.
What international health insurance actually covers
An IPMI contract is built around a cover area rather than a single national provider network. You choose the geography — Europe, worldwide excluding the United States, or worldwide — and treatment is eligible anywhere inside it, at any recognised provider, rather than only inside an insurer's Portuguese network. That is the structural difference from which almost every other difference follows.
The core of a plan is normally in-patient and day-patient treatment: hospital accommodation, surgery, anaesthetics, intensive care, diagnostics performed as part of an admission, and the specialists involved. Out-patient cover — consultations, imaging, laboratory tests, physiotherapy — is usually a separate module, sometimes optional, sometimes with its own annual limit and its own excess. Cancer treatment, maternity, mental health, dental, optical, routine health screening, chronic-condition management, evacuation and repatriation, and a second-medical-opinion service are all typically modules or sub-limits rather than a single undifferentiated pot of money.
Two features tend to matter more in practice than the headline annual limit. The first is pre-authorisation and direct settlement: for planned in-patient treatment the insurer confirms eligibility in advance and settles with the hospital, so a five-figure admission does not have to pass through your own bank account first. The second is portability: the contract is designed to follow you if your country of residence changes, which a domestic policy is not.
What IPMI does not do is replace public healthcare or make you independent of it. Portuguese residents remain entitled to register with the SNS, and emergency care in Portugal will in practice usually run through the public system regardless of what private cover you hold. Nor is any of this automatic: everything above is subject to medical underwriting, to the plan and modules selected, and to the policy terms, limits and exclusions actually issued.
International vs Portuguese private health insurance
Both products are private health insurance and both are sold in Portugal, but they are engineered for different problems. The table below compares them on the seven points that separate them in practice. Details vary between insurers and between plans within the same insurer — treat this as the shape of the difference, not as policy wording.
| Point of comparison | International (IPMI) | Portuguese private health insurance |
|---|---|---|
| Geographic scope | Defined by a cover area you select — for example Europe, worldwide excluding the USA, or worldwide. Eligible treatment is covered anywhere inside that area. | Built around a Portuguese provider network. Cover outside Portugal is normally limited to emergencies while travelling, and usually capped in duration and amount. |
| Direct settlement | Pre-authorised in-patient and day-patient treatment is generally settled directly with the hospital, in multiple countries. Out-patient costs are often paid by the member and reimbursed. | Direct settlement inside the insurer's network, which is where the product is strongest. Outside the network you pay and claim reimbursement, at a lower percentage where the plan allows it at all. |
| Medical underwriting vs waiting periods | Typically full medical underwriting: each applicant declares their history and the insurer sets individual terms, which may include specific exclusions, loadings or a moratorium on named conditions. | Typically a shorter health questionnaire combined with contractual waiting periods. Pre-existing conditions are usually excluded by the policy terms rather than individually priced. |
| Portability when you move country | Designed to continue across a change of residence: the cover area is amended and continuous medical history is normally preserved, subject to the insurer's rules and to availability in the new country. | Tied to residence in Portugal. Moving abroad generally ends the contract, and a new policy elsewhere means new underwriting and fresh waiting periods. |
| Annual limits | High overall annual limits, with some plans placing no monetary ceiling on the core in-patient benefit. Individual benefits still carry their own sub-limits. | An annual capital per insured person, modest by comparison, with sub-limits per benefit and often per medical act. |
| Premium progression with age | Age-banded and exposed to medical inflation across the whole cover area. Premiums rise with age and can rise steeply at older ages; a worldwide area including the USA is the most expensive. | Also age-banded and rising with age, from a materially lower starting premium. Several insurers restrict new applications above a given age. |
| Claims in English | Documentation, member portals, helplines and claims handling are built for an international membership and normally operate in English as standard. | Policy wording, claim forms and provider paperwork are in Portuguese. English-language service depends on the insurer and is rarely a contractual entitlement. |
The honest summary: if you live in Portugal, expect to be treated in Portugal and would use a private hospital in Lisbon, Porto or the Algarve, a Portuguese plan usually gives you more cover per euro. IPMI earns its premium when the treatment, the residence or the family is genuinely spread across borders. We work through that comparison in detail in Portuguese health insurance vs international health insurance.
Who it is designed for
Four profiles account for most of the IPMI enquiries we receive. If you do not recognise yourself in one of them, the domestic market is the sensible place to start.
Expats who split time between countries
If you spend part of the year in Portugal and part somewhere else — a property in the UK, family in Germany, work in the Gulf — a Portuguese policy covers you properly for only part of your year. Under IPMI both halves sit inside the same cover area, on one contract, with one medical history and one renewal date. This is also the profile most often caught out by domestic policies that require habitual residence in Portugal, or that limit travel cover to a fixed number of consecutive days abroad.
Residents who want treatment outside Portugal
Some residents want the option of being treated in their home country, or at a specific centre abroad for a specific condition. A domestic policy will not fund that; a worldwide or Europe-wide plan can, within its limits, and with pre-authorisation. The same logic covers evacuation and repatriation, which matters more if you live somewhere with a longer road to a tertiary hospital than Lisbon or Porto.
Companies with internationally mobile staff
An employer with people in several countries can place them on a single group IPMI scheme, with one set of benefits, one renewal and one point of contact, instead of a domestic policy per jurisdiction. Group terms are usually more accommodating on medical history than individual underwriting, and cover can normally be extended to dependants. This is also the route for Portuguese companies posting employees abroad, where a domestic health plan stops being fit for purpose the moment the posting starts.
Applicants who need proof of cover for a residence visa
Portuguese consulates and AIMA ask for evidence of health cover as part of most residence routes. An international policy produces a certificate in English showing the insured persons, the dates, the insurer and the benefits, which is often easier to submit than a Portuguese schedule that has to be explained. It is not the only acceptable option — local policies are accepted too — and the requirement is set by the authority handling your file, not by the insurer. We set out what each route asks for in health insurance requirements for Portuguese residence visas and across the visa and residence insurance hub.
Allianz Care through Adler & Rochefort
Adler & Rochefort holds an appointment from Allianz Partners to distribute its international health range, marketed as Allianz Care, to clients in Portugal. That appointment is what allows us to quote, place and administer IPMI here — in the Portuguese market the number of intermediaries able to do so is small, because IPMI is a specialist line distributed through a limited network rather than a product every agency carries.
The appointment does not change what we are. Ownizo, Unipessoal Lda. is an insurance broker registered with the ASF under no. 425591790/3, and we continue to compare the Portuguese market — Allianz, Médis, APRIL, AdvanceCare and others — for anyone whose need is domestic. We are not a tied agent of Allianz and we do not present Allianz Care as the right answer by default. What the appointment adds is one more product line, for the cases where a domestic policy genuinely does not fit.
What we do
Establish whether IPMI or a Portuguese plan fits your situation, quote the cover areas and modules that are relevant, explain the underwriting outcome in plain English, and handle issuance, certificates and claims as your point of contact afterwards.
What we do not do
Promise acceptance, cover, a limit or a price before the insurer has underwritten the risk. Terms, loadings, exclusions and premium are the insurer's decision, and the policy wording is what governs any claim.
How we are paid
By commission from the insurer, included in the premium. We charge no fee for a quotation or for the comparison, and no fee for handling a claim.
What you need to request a quotation
An IPMI quotation is individually underwritten, so it needs more than an age and a postcode. Sending the following through the quotation request form lets us go to the insurer once, with a complete file, rather than three times with corrections.
Individuals and families
- Full name and date of birth of every person to be insured, including children.
- Address — the address in Portugal, or the address that will be used once you arrive.
- Contact telephone number.
- E-mail address, which is where the policy documents and member details are sent.
- IBAN, for the premium payment mandate.
- Identification document for each adult — passport, citizen card or residence permit.
It also helps to tell us the cover area you have in mind, whether out-patient and dental are needed, and whether anyone to be insured has a medical history worth discussing before we approach the insurer. Nothing you send commits you to anything, and no document guarantees acceptance.
Companies
- Código de certidão permanente — the permanent commercial certificate access code, from which we take the company's legal details.
- Beneficial owner details, as recorded in the central register (RCBE).
- Employee list with full names, dates of birth and country of assignment for everyone to be included, and whether dependants are to be covered.
- Billing details — invoicing address and IBAN for the premium.
Group schemes are quoted on the census as a whole, so the employee list is the document that determines the terms. If the population is expected to change during the year, tell us at the outset.
Related reading
Portuguese vs international cover
Which one you actually need, including the cases where a Portuguese policy is the better decision. Read the comparison
Residence visa requirements
What consulates and AIMA accept as proof of health cover on the D7, D8, Golden Visa and family reunification routes. Read the guide
Health insurance in Portugal
The full guide to the domestic market: insurers, networks, waiting periods and what a family policy involves. Read the guide
SNS vs private insurance
Whether residents need both, and what the public system does and does not do for you. Read the article
Pre-existing conditions
How a declared condition is treated under domestic and international underwriting. Read the article
Children at school abroad
Where family cover breaks down when a child studies in another country, and how international cover handles it. Read the article
Frequently asked questions
What is the difference between international health insurance and a Portuguese health plan?
A Portuguese plan is built around an insurer's network of clinics and hospitals in Portugal, with an annual capital per person and emergency-only cover abroad. An international plan is built around a cover area you choose, with higher limits, direct settlement for pre-authorised hospital treatment in several countries, and the ability to continue if you move country. The international product costs more, and for a resident who expects to be treated in Portugal the domestic plan is often better value.
Does an international policy satisfy the health insurance requirement for a Portuguese residence visa?
An IPMI certificate is generally suitable evidence, and its English wording tends to be straightforward for a consulate to read. It is not the only acceptable option — Portuguese policies are accepted on these routes as well. The requirement is set by the consulate or by AIMA for your particular file, so the sequence that works is to confirm the checklist for your process and then arrange cover whose certificate matches it.
Can I keep the policy if I leave Portugal?
Portability is the point of the product. On a change of residence the cover area is normally amended rather than the contract replaced, so the medical history you were underwritten on is preserved. It is subject to the insurer's rules and to the plan being available in the new country — some jurisdictions restrict what a foreign insurer may write locally — so confirm the position before you move, not after.
Will pre-existing conditions be covered?
Not automatically, and not on any basis we can confirm in advance. IPMI is individually underwritten: you declare your medical history and the insurer decides the terms, which may include cover as standard, a premium loading, a specific exclusion, or a moratorium under which a condition becomes eligible only after a period without treatment. Declaring everything is what protects the claim — an undeclared condition is the most common reason a claim is refused.
Do I still have access to the SNS if I take out international cover?
Yes. Private insurance of any kind sits alongside the public system; it does not replace it and taking it out does not affect your entitlement as a legal resident to register with the SNS and use it. In practice most residents with private cover still use the public system for emergencies. There is more on how the two fit together in our article on SNS versus private insurance.
How much does international health insurance cost in Portugal?
We do not publish premium tables, because an IPMI premium depends on the ages of the people insured, the cover area, the modules selected, the excess and the underwriting outcome. As an order of magnitude it is a multiple of a comparable Portuguese plan, and a worldwide area including the United States is the most expensive option there is. The only figure that means anything is the quotation issued on your own details.
Are you a tied Allianz agent?
No. Ownizo, Unipessoal Lda. is an insurance broker registered with the ASF under no. 425591790/3. We hold an appointment from Allianz Partners that allows us to distribute Allianz Care international cover in Portugal, and we continue to compare the domestic market for clients whose need is local. Where a Portuguese policy is the better fit, that is what we recommend.
Can a company insure staff based in different countries on one policy?
Yes — that is the standard use of a group international scheme. One contract, one benefit table, one renewal date, with employees in different countries and dependants included where the employer chooses. Group underwriting is usually more accommodating on medical history than individual applications. Terms depend on the size and composition of the population, so the employee census is the first thing the insurer will ask for.
Adler & Rochefort is the commercial brand of Ownizo, Unipessoal Lda., an insurance broker registered with the Autoridade de Supervisão de Seguros e Fundos de Pensões (ASF) under no. 425591790/3, authorised to carry on insurance mediation in the life and non-life branches. We hold an appointment from Allianz Partners for the distribution of international private medical insurance in Portugal and are not a tied agent of any insurer. This page is general information, not advice on a specific case, and it is not an offer of insurance. Acceptance, cover, limits, exclusions and premium are determined by the insurer following medical underwriting and are governed exclusively by the policy conditions issued. Nothing here guarantees that cover will be offered or that any particular claim will be paid.
Request an
IPMI quotation
Send us the details of everyone to be insured and the cover area you have in mind. We will tell you whether international or Portuguese cover fits the situation before we quote, and come back in writing.