If you fall ill in the Algarve this year, the care you need will still be there — but the paperwork around who pays for it could change. A new bill in Portugal's Parliament wants to tighten access to the national health service (SNS) for foreigners who don't live in the country, and it's being driven largely by figures from the country's biggest holiday region.
The proposal, Bill 786/XVII/2, was submitted on September 25 by PSD and CDS-PP MPs, among them Algarve deputy Cristóvão Norte. Its core idea: non-residents, including anyone staying in Portugal irregularly, would have to either pay for treatment themselves or prove that someone else — a travel insurer, another state, or another legally responsible party — will pick up the tab. Hospitals would gain tools to identify who owes what, and could demand a guarantee or advance payment in some cases. Crucially, emergency, urgent and life-saving care would always be provided first, with the billing sorted out afterwards.
Why now? An audit by Portugal's health inspectorate IGAS found €1,234,358 in invoices for emergency care given to foreign non-residents in the Algarve across 2023 and 2024 still unpaid. Over the same two years, emergency department visits by non-resident foreigners at ULS Algarve rose 7.8%, from 17,736 to 19,111. With millions of visitors a year, the Algarve feels the gap between treating people and recovering the money more than anywhere else in the country.
"Anyone who needs emergency, urgent and vital care must be treated. That is not in question," Norte has said, arguing the real problem is ensuring the bill lands with whoever is responsible — which is often an insurer or a foreign health system, not necessarily the patient.
For travellers, the practical takeaway is straightforward even before this law passes: make sure your travel insurance covers medical treatment in Portugal, and carry the details with you. EU/EEA visitors can currently use a European Health Insurance Card (EHIC) for state healthcare on the same terms as locals, and that arrangement isn't what this bill targets — it's aimed at people with no residency status and no clear payer. Britons and other non-EU visitors have long been expected to pay or claim through insurers, and this push simply aims to make those bills actually get collected.
The bill is at an early stage, so holidaymakers shouldn't expect changes overnight. But if you're heading to the Algarve, the direction of travel is clear: Portugal's most visited region wants tourists to keep using its hospitals when they need to — it just wants the invoices paid.
