Portuguese expats will remain “inactive” on social media and will have to pay for services in Portugal from 1 January.

Portuguese residents abroad will become “inactive” in the National Health Service (SNS) and will have to pay for treatment from 1 January 2024, under new National User Registry rules.

Several doctors working in primary health care services told Lusa that they had been told that from January 1, Portuguese people with tax addresses outside Portugal would be considered “inactive”.

This means that whenever they use the Portuguese social network, they will have to pay its cost.

Nelson Magalhães, vice-president of the USF-AN (Division of Family Health – National Association), told Lusa that the decision was conveyed to the units in a meeting held on October 2 with those in charge of the Central Directorate of the Health System. and (ACSS) and Department of Health General Services (SPMS).

We are talking about the application of the order (No. 1668/2023), which “defines the organizational rules and mechanisms for managing the National Register of Users (RNU), as well as the rules for registering citizens in the SNA and admission to primary health care. Care”.

An ACSS source told Lusa that the order stipulates that registration in a primary health care department presupposes active registration in the RNU, which “has a mandatory condition of residence in Portugal.”

Until now, Portuguese residents abroad with a Portuguese SNS user number paid a subscription fee when accessing their services, just like Portuguese residents.

From 1 January, Portuguese with tax residency abroad will have their registration “inactive”, even for those attending services.

In addition to not having a family doctor, if they have one, these users will have to bear the cost of medical care: “In case of inactive registration, except in cases of death, the condition of responsibility assumed by the citizen applies,” the order reads.

Even without explicit instructions from senior management regarding this method, primary care providers attempt to reach users in such circumstances, who react with apprehension and some anger.

“I think it’s very unfair. Although it is true that I currently live abroad, I still prefer to use medical services in Portugal as the language and familiarity make treatment easier, especially for some chronic health problems for which I have always received follow-up. care in Portugal with the same family doctor who has looked after me since childhood,” said the user, who currently lives in the Netherlands and has already been informed that she will be removed from social networks.

And she continued: “I am still Portuguese and I feel that this policy excludes me and will make it difficult for me to access healthcare.”

According to Nelson Magalhães, these are “many people who use” social networks and “don’t want to break ties with their family doctor.”

“It’s a matter of trust. People who use technology tools such as email often keep in touch with their doctor,” he said.

The biggest impact will be on users who live abroad with a family doctor in Portugal, as they will “lose that connection”, but this applies to everyone else too.

Nelson Magalhães stressed that these Portuguese expats must have a European Health Insurance Card, which allows them to receive medical care during a temporary stay in a European Union country, Iceland, Liechtenstein, Norway or Switzerland.

However, the director of the USF-AN warned about the small number of users of this card, since until today it had “never been necessary” in Portugal.

This measure, he added, should cover hundreds of Portuguese, since of the 1,750 users (per family doctor), about 100 are emigrating.

The impact will also be felt on the income of doctors, who receive depending on the number of users in their lists (Model B) and who, in order to maintain the same value, will have to include more users and, above all, people who consume more services, which will further complicate medical help”.

Another consequence, he emphasized, is the “separation of families,” since the person who emigrates no longer has the same reaction as his family.