Two ways to become the employer

A Portuguese law firm’s guidance for foreign companies describes two routes. A company with no local subsidiary can register as a foreign employer with the tax and social security authorities, and from then on it carries the same duties as a Portuguese employer. The alternative is an employer of record registered as the legal employer.

The second route has a weak spot. Portuguese press coverage points out that Portuguese labour law does not define the EOR model. Press reports say that in July 2026 the Porto Labour Court ruled unlawful the dismissal of a worker hired through an employer of record who worked only for a US client, because the grounds given were too generic, and ordered reinstatement or compensation. Our page on health coverage for EOR employees and contractors abroad sets out the routes, contractors included, in general terms.

The SNS and the user number

Public care comes from the Serviço Nacional de Saúde (SNS), the national health service. The gov.pt guide for migrants says any foreign national legally resident in Portugal can get an SNS user number, the número de utente, assigned on a first visit to a public health unit.

The number on its own is not enough for the SNS to cover costs. The guide says the record must also hold an identity document, a Portuguese tax number (NIF), a full Portuguese address and a valid residence permit, with some legal exceptions. Foreigners can request their tax, social security and health numbers online through gov.pt or its app, or at an Espaço Cidadão service point.

With the number in place, the person registers at the health centre (centro de saúde) for the area where they live. Someone living in another municipality for a while for work or study can register there for up to 12 months.

Family doctors, SNS 24 and user charges

Primary care runs through family health units (Unidades de Saúde Familiar, USF), where each patient is assigned a family doctor, the médico de família, supported by nurses and other staff.

User charges (taxas moderadoras) were removed from almost all SNS services on 1 June 2022. They still apply to a hospital emergency visit that was not referred through a health centre or the SNS 24 phone line and that does not end in admission.

What the employer must pay and insure

Under the general regime, the official Segurança Social rate table lists contributions of 23.75% from the employer and 11% from the worker, 34.75% in total. Those rates fund social security benefits and are not a separate health insurance premium. The table is undated, so check the current figure before you budget.

The second duty is insurance against work accidents. Lei 98/2009 (article 79) requires the employer to transfer liability for workplace accidents to an insurer authorised to write that cover, and having no policy, or too little cover, is penalised. A global health plan does not satisfy this requirement; the policy has to be work-accident insurance from an authorised insurer.

How employer-paid health insurance is taxed

Portuguese employers do offer staff health insurance, the seguro de saúde, as a benefit. As a rule the premiums the employer pays count as employment income (category A) for the employee under article 2(3)(b) of the IRS Code, according to a Tax Authority binding ruling.

The exception is cover of a general character, meaning insurance offered to all employees on equal terms (IRS Code article 2-A), which is left out of taxable income. Portugal’s Order of Certified Accountants notes that where there is only one beneficiary, the Tax Authority tends to find the general character missing, so the insurance tends to be taxed. For a US company whose only Portuguese employee is the one being covered, that is the situation the accountants describe.

International plans and insurers from elsewhere in the EU

None of the employer’s legal duties is a health plan, so an international plan would be a benefit the company chooses to add. It does not take the place of SNS access, the social security contributions or the work-accident policy.

On who may provide cover, the general rules of insurance activity (Decreto-Lei 94-B/98 and later rules) let insurers based in other EU member states cover risks in Portugal under the freedom to provide services. The supervisor is the Autoridade de Supervisão de Seguros e Fundos de Pensões (ASF). The position of an insurer from outside the EU is a separate question. Check it, together with the hiring route and the tax on any premium, with a local adviser or tax professional in Portugal.

Getting an introduction for your Portugal hire

Mithril1 can put you in touch with a benefits partner that handles international and remote-team health coverage. Send us the details through the quote form on this page: the district your employee lives in, your headcount there and in other countries, any family members to include, and whether you hire as a registered foreign employer or through an EOR. We pass it to the partner, and the partner and the insurer decide eligibility, plans and pricing.

The international health insurance overview links each country guide, and employee benefits for small businesses is the starting point for the benefits section.

A few useful answers

Common questions

Does an employee in Portugal need private insurance to use the SNS?

No. Access to the SNS rests on legal residence and a complete user record: a user number plus an identity document, a Portuguese tax number, a full address and a valid residence permit, with some legal exceptions.

Is employer-paid health insurance taxed when only one employee is covered?

It tends to be. Premiums count as employment income unless the cover is offered to all employees on equal terms, and the Order of Certified Accountants notes that with a single beneficiary the Tax Authority tends to treat that condition as unmet.

Does a health plan meet Portugal's work-accident insurance rule?

No. Lei 98/2009 requires the employer to transfer liability for workplace accidents to an insurer authorised to write that cover, which is a separate policy from health insurance.

Is an employer of record recognised in Portuguese labour law?

Portuguese press coverage notes that the EOR model is not set out in the labour law. In July 2026 the Porto Labour Court found an EOR worker’s dismissal unlawful and ordered reinstatement or compensation.

Can an insurer from another EU country cover someone in Portugal?

Yes. Under the freedom to provide services set out in the general rules of insurance activity, insurers based in other EU member states can cover risks in Portugal.

International Health Insurance for Remote Employees in Portugal