Portugal Health Insurance Market (2025 - 2033)

Portugal Health Insurance Market Trends

The Portugal health insurance market size in terms of Gross Written Premium (GWP), was estimated at USD 5.84 billion in 2024 and is expected to grow at a CAGR of 9.51% from 2025 to 2033. The Portugal health insurance market size in terms of New Business Premium (NBP), was estimated at USD 425.47 million in 2024 and is expected to grow at a CAGR of 9.73% from 2025 to 2033.

The key growth drivers include increasing demand for private insurance due to limitations in the public healthcare system, an ageing population with rising chronic disease prevalence, employer-sponsored health plans and tax incentives, and digital innovation in insurance distribution and claims processing. Furthermore, improved regulatory clarity and modernization are also contributing to market growth. In 2024, ASF ((Autoridade de Supervisão de Seguros e Fundos de Pensões) introduced comprehensive regulations covering ICT and cloud outsourcing, anti-money laundering and counter-terrorism financing (AML/CFT) controls, non-discrimination requirements, and enhanced disclosure obligations for insurers. As part of these efforts, measures were implemented to standardize health plan comparability-enhancing transparency around coverage details, premium structures, and policy conditions. These regulatory developments are aimed at helping consumers make more informed decisions, thereby increasing trust and participation in the health insurance market.

Furthermore, rising private healthcare costs and persistently high out-of-pocket expenditures are driving market growth.

Source: WorldoMeter

Between 2018 and 2023, private healthcare expenditure increased from USD 6.26 million to USD 10.28 million, indicating growing consumer reliance on private services for faster access and higher-quality care. At the same time, out-of-pocket healthcare spending remained consistently high, rising from USD 6.81 billion in 2018 to USD 8.35 billion in 2023. This reflects a significant financial burden on households and highlights a growing need for financial protection through health protection plans.

In addition, lengthy waiting times in Portugal’s public healthcare system have become a key factor driving the market growth. Although the Serviço Nacional de Saúde (SNS) provides universal coverage, it continues to struggle with staff shortages and infrastructure constraints, resulting in substantial delays for patients seeking both emergency and elective care. According to Euronews published in 2025, patients in several public hospitals including those in Lisbon, Coimbra, and Portimão faced wait times of more than nine hours in emergency departments, with Portimão Hospital reporting delays of up to 13 hours for urgent cases. In addition, the Portugal News highlighted a continued rise in surgical waiting lists, noting that the number of patients waiting for surgery increased from 235,000 in 2022 to 265,000 in 2023, with average wait times rising from 2.9 to 3.1 months.

In this context, private health protection plans are increasingly seen as both a financial safeguard and a practical solution for timely access to care. While insurance does not improve the performance of the public system, it enables individuals to bypass long delays by seeking treatment in private facilities where waiting times are significantly shorter. This shift in patient behavior, particularly among those who can afford to pay for faster access, is strengthening demand for private medical protection plans. As delays persist in the public sector, insurance is being repositioned as a necessary means of ensuring timely, efficient, and higher-quality healthcare, strengthening its role in Portugal’s evolving healthcare landscape.

Moreover, the increasing integration of health protection plans into employee benefit packages, supported by favorable tax incentives, is playing a significant role in driving the growth of the private medical insurance market. According to Benifex report published in 2025, approximately 85% of employers in Portugal include private health insurance in their employee benefits packages, reflecting its position as a core component of modern compensation strategies. In addition, as per the Playroll report published in 2025, Portugal employers are actively incorporating health protection plans into their compensation frameworks to attract skilled professionals and to differentiate themselves within the job market. These developments point to a broader transformation in the role of private health insurance, from an optional benefit to a strategic necessity, contributing significantly to the ongoing expansion and strengthening of the medical insurance sector in Portugal.

Furthermore, digitalization and innovation are becoming central to the evolution of Portugal’s health insurance market, enhancing both operational efficiency for insurers and the experience of policyholders. According to EY report, insurers are implementing digital tools such as claim processing automation, cloud-based platforms, and AI-powered analytics to streamline underwriting and service delivery, resulting in faster processing times and increased transparency for customers. Moreover, the country’s telemedicine landscape is also expanding, with Tracxn reporting more than 45 active telemedicine companies in Portugal. These include Knok and Kinetikos, which reflect the growing adoption of remote care solutions.

In addition, as per the Startup Portugal Ecosystem Report (2024), Portugal had a total of 4,073 startups by the conclusion of 2023, with around 8.45 percent of them operating in the medical sector. Meanwhile, funding from the European Union’s Recovery and Resilience Plan includes an allocation of USD 346.8 million aimed explicitly at the digital health transition and the modernization of the public health system. Moreover, there is a funding of USD 2.9 million dedicated to fostering digital innovation in HealthTech through the DigiHealthPT program and USD 104.0 million earmarked for advancing innovations in the medical sector. These developments are helping insurers to integrate digital health services, such as teleconsultations and wellness apps, into their coverage offerings, improving service accessibility and customer engagement.

Market Concentration & Characteristics

The chart below illustrates the relationship between industry concentration, industry characteristics, and industry participants. The x-axis represents the level of industry concentration, ranging from low to high. The y-axis represents various industry characteristics, including industry competition, degree of innovation, impact of regulations, level of partnership & collaboration activities, and geographic expansion. The Portugal health insurance markets operate under a highly competitive structure.

The degree of innovation in market is steadily increasing, driven by growing investments in digital transformation, collaborations with healthtech startups, and evolving consumer expectations. Insurers are incorporating advanced technologies such as artificial intelligence for risk assessment, automation for claims management, and mobile applications for customer engagement. The integration of telemedicine and digital wellness platforms into medical protection plans offerings has become more widespread, especially after the pandemic accelerated demand for remote healthcare solutions.

Several key market players are devising business growth strategies in the form of mergers and acquisitions. Through M&A activity, these companies can expand their business geographies. In 2024, Grupo Ageas Portugal expanded its presence in the medical insurance market by acquiring One Clinics. The acquisition aligned with the strategy of its Médis brand to build a more integrated healthcare ecosystem. It allowed the insurer to offer new services such as Médis Light and Médis Dental, aimed at providing faster and more affordable care.

Regulation plays a significant role in shaping Portugal’s health insurance market by promoting transparency, consistency, and operational security. In 2024, the Insurance and Pension Funds Supervisory Authority (ASF) introduced a series of regulatory updates covering areas such as information and communication technology outsourcing, anti-money laundering and counter-terrorist financing controls, non-discrimination mandates, and enhanced disclosure requirements. These measures have influenced how insurers manage digital systems, data privacy, and customer communications. In addition, ASF implemented a standard medical insurance framework that establishes common policy features, including defined coverage elements, capital limits, and copayment conditions.

Several market players are expanding their business by entering new geographical regions to strengthen their market position and expand their product portfolio. In 2024, Caesara Insurance Group, a strategic partner of Mapfre in Spain, expanded into the Portuguese market by launching EMax Insurance with a new headquarters in Lisbon. This geographic expansion marked the group's entry into Portugal’s medical protection plans space, introducing a localized portfolio of insurance products, including medical coverage.

Insurance Type Insights

The insurance type segment comprises of public and private. Public insurance is further cross segmented into corporate policy and retail policy. The public segment dominated the market in 2024 and accounted for the largest revenue share of 72.62% and is also anticipated to register the fastest growth rate over the forecast period.

The public health insurance segment in Portugal continues to expand, supported by the government’s sustained efforts to strengthen the Serviço Nacional de Saúde (SNS). According to OECD report, public financing accounted for only 63.2% of total health expenditure in Portugal in 2021, considerably below the EU average of 81.1%. Despite this, the Serviço Nacional de Saúde (SNS) remains the primary source of medical coverage, and the Portuguese government continues to strengthen it through significant reforms. Furthermore, OECD also noted that the Portuguese government had implemented major reforms to reduce financial barriers, including the removal of user charges for primary care services and diagnostic tests by 2022, aiming to improve access and increase reliance on the public system. These actions collectively reflect a policy-driven commitment to reducing financial burdens, reinforcing public trust in the SNS, and propelling the long-term growth of Portugal’s public health insurance segment.

Private segment in Portugal health insurance industry is anticipated to register a significant growth over the forecast period. driven by increasing demand for faster and more personalized healthcare services, particularly in urban regions where public healthcare waiting times remain a concern. Many individuals are turning to private medical protection plans as a complement to the public system, drawn by the promise of faster access to specialists, higher-quality care, and a broader choice of healthcare providers. The expansion of employer-sponsored medical plans is also contributing to this trend, as companies increasingly offer private insurance to enhance employee benefits.

Moreover, the growing availability of digital health services such as telemedicine, wellness apps, and preventive care programs has further strengthened the value proposition of private medical protection plans in Portugal’s evolving healthcare environment. In addition, private medical protection plans allows policyholders to select personalized coverage options, including dental, optical, and alternative medicine treatments. This flexibility makes private medical insurance an attractive alternative for those seeking more comprehensive and tailored healthcare solutions.

For instance, below is the product offered by Zurich, a private insurer:

Policy Type Insights

The corporate policy segment dominated the market in 2024 and accounted for the largest revenue share of 82.78%. The corporate policy segment in Portugal is driven by the increasing adoption of employee benefit packages by businesses aiming to attract and retain skilled talent in a competitive labor market. Companies recognize health insurance as a key component of their human resources strategy, offering group medical policies that provide comprehensive coverage, streamlined administration, and cost savings compared to individual plans. These policies often include additional benefits such as mental health support, preventive screenings, and telehealth services, making them an attractive offering for both employers and employees. Moreover, the tax advantages associated with employer-provided medical coverage further incentivize businesses to invest in corporate medical insurance, supporting the expansion of this segment.

Retail policy segment in Portugal’s health insurance market is anticipated to register significant growth over the forecast period, supported by evolving consumer behavior, changing household healthcare spending patterns, and a broader shift toward personalized medical solutions. A key driver is the rising demand for modular insurance products that allow individuals to build their own coverage packages by selecting services such as outpatient care, alternative therapies, dental plans, and specialist consultations. According to the OECD’s Portugal Country Health Profile 2023, Portugal households contributed nearly 29 percent of total health expenditure through out-of-pocket payments, which is almost double the EU average of 14.6 percent. This high level of private spending is encouraging individuals to seek more predictable and comprehensive medical coverage through retail insurance. Insurers are increasingly adopting flexible pricing models and subscription-based medical plans to cater to varied income groups, particularly younger demographics who prioritize affordability and digital convenience.

Private Health Insurance Market (GWP), by Distribution Channel Insights

The agents segment dominated the market in 2024 and accounted for the largest revenue share of 51.13%. The agents segment continues to grow as insurers rely on dedicated sales representatives to build direct relationships with clients, particularly in regional and suburban areas where digital reach may be limited. Insurance agents, often tied to a single provider, serve as brand ambassadors who promote specific medical plans while offering personalized consultations and post-sale services. Their in-depth understanding of the insurer’s product portfolio allows them to explain complex coverage details, facilitate enrollment, and support clients throughout the policy lifecycle. This one-on-one approach builds customer loyalty and trust, especially among older populations or individuals seeking straightforward guidance, which in turn contributes to higher policy conversion rates and long-term retention. According to the ASSOCIAÇÃO PORTUGUESA DE SEGURADORES report, agents accounted for approximately 65.2 percent of Portugal’s health insurance premium volume in 2022, highlighting their continued dominance in distribution. A prime example is Tranquilidade, which operates through more than 1,800 retail outlets, supported by a robust network of around 1,400 multi-brand agents and 80 brokers, enabling it to serve clients across both urban and rural regions.

Broker segment in Portugal health insurance industry is anticipated to register a fastest growth over the forecast period, driven by consumer demand for impartial advice and multi-insurer comparisons. Brokers operate independently and are not tied to a single provider, giving them the flexibility to present clients with a broader range of policy options based on their specific healthcare needs and budget. This neutrality makes brokers especially valuable for self-employed professionals, SMEs, and clients with complex health profiles who seek customized coverage. Although, according to the ASSOCIAÇÃO PORTUGUESA DE SEGURADORES report, brokers contributed a smaller share of 12.7 percent of private health insurance premiums in 2022, their value lies in tailored advisory services and regulatory alignment. The Portuguese Insurance and Pension Funds Supervisory Authority (ASF) enforces the Insurance Distribution Directive (IDD), which mandates that brokers consider a wide range of contracts and act in the best interests of clients. As insurers aim to extend their reach, many are partnering with experienced broker networks to expand both in urban centers and underserved rural areas.

Key Portugal Health Insurance Company Insights

Key participants in the Portugal health insurance market are focusing on devising innovative business growth strategies in the form of product/service portfolio expansions, partnerships & collaborations, mergers & acquisitions, and business footprint expansions.

Recent Developments

• In April 2024, Luz Saúde, in partnership with Portuguese insurtech Habit, launched LUZ ON PRIME, an annual subscription card designed for Hospital da Luz clients. The service provides 24/7 access to clinical services, a dedicated LUZ 360° customer manager, family doctor consultations (in-person and via video), essential diagnostics such as ECGs, home healthcare, urgent case triage via video, and transport to urgent care when necessary. The subscription is also tailored for corporate clients, enhancing employee healthcare access through continuous medical support from Hospital da Luz professionals.

• In June 2024, Médis acquired One Clinics (specializing in physiotherapy and rehabilitation) and launched digital tools such as the Médis Active app, healthcare marketplace, and loyalty platform to improve client engagement.

Portugal Health Insurance in Terms of GWP Market