If you are thinking of having a baby and want the birth covered by private health insurance in Portugal, you need to take out the policy before you become pregnant. The maternity waiting period is usually between 240 and 365 days, and if the baby arrives before that period ends, the birth is generally not covered. Here is how it works, and what to do if you are already expecting.

What the maternity waiting period is

A waiting period (carência) is the time that must pass from the start of the policy before a particular cover begins. For childbirth it is longer than for other covers, precisely so that people do not take out insurance only once they know they are pregnant.

In the Portuguese market, the maternity waiting period is usually between 240 and 365 days, depending on the policy. In most cases what matters is that the waiting period has ended by the date of the birth. Some policies add further conditions, so always check the particular conditions of your policy.

Doing the maths

A pregnancy lasts around 40 weeks, or roughly 280 days. That means:

If the waiting period is 365 days, the policy needs to start several months before conception. In practice, if you sign up today, allow around three months before you start trying for a baby.
Even with a shorter waiting period, closer to 240 days, the safest rule is the same: sign up before you are pregnant, because many policies treat a pregnancy that already exists when you join as a pre-existing condition.
Premature births happen. If the baby arrives a few weeks early and the waiting period has not yet ended, the birth may not be covered. Leave yourself some margin.

A practical example

Anna and Rui want to start trying for a baby at the beginning of next year. They take out health insurance in September, with a 365-day maternity waiting period that ends the following September.

If Anna becomes pregnant in January, the baby is due in October. The waiting period ended in September, so the birth should, in principle, be covered.
If the baby arrives three weeks early, in mid-September, it may be only days from the end of the waiting period. That is exactly the situation you want some margin to avoid.
Had they signed up only in December, an October birth would not be covered.

The example shows why “a few months before” is not always enough. Count the waiting period from the policy start date and compare it with the likely due date.

My advice is simple: if children are part of your plans for the next two or three years, sort out the insurance now.

What if you are already pregnant?

If you became pregnant before taking out the policy, or before the waiting period ended, the birth is most likely not going to be paid by the insurer. But you still have options.

The Portuguese National Health Service (SNS) covers pregnancy and birth. Pregnant women and women who have just given birth are exempt from SNS user charges (taxas moderadoras). If you are registered with the SNS, antenatal care at your health centre and the birth in a public hospital cost you nothing.
Your policy is still useful for everything else. Consultations, tests and other covers unrelated to the pregnancy work normally once their own waiting periods have passed.
Think about the baby now. Even if the birth itself is not covered, it can be important for the baby to join the policy from birth. The rules vary, so it is worth talking to me before the due date.
Do not switch policies midway. If your waiting period is already running, moving to another insurer normally resets the clock to zero.

It is not just the waiting period: what to check before signing

Completing the waiting period is the first condition, but not the only one. Before choosing a policy, check:

The maternity limit (plafond de parto): the maximum the insurer will pay. A private birth can cost several thousand euros, and a low limit leaves you to pay the difference.
The co-payment (copagamento): the fixed amount you pay at a network hospital, and whether it differs between a natural birth and a caesarean.
Complications: whether complications of pregnancy and birth are covered, and which limit those costs come out of.
The newborn: whether the baby can join without a medical questionnaire or waiting periods, within what deadline, and whether congenital conditions (present at birth) are covered.

These details are clearly set out in the pre-contractual information document and should be checked before you sign up.

Frequently asked questions

If I change insurer, do I lose the waiting time already served?

You may lose it if you are in the first year of the contract. For policies that have been in force for more than one year, it is possible to transfer without waiting periods, subject to certain rules, including equivalent sums insured. I can confirm this if you send me a copy of your policy’s Particular Conditions (Condições Particulares).

Is the waiting period the same for a natural birth and a caesarean?

In most policies, yes: the waiting period applies to childbirth in general. What usually differs is the co-payment and the final cost. Check your conditions.

If my policy does not cover the birth, what will I pay in a public hospital?

Nothing, if you are registered with the SNS. Pregnant women are exempt from SNS user charges, and giving birth in a public hospital is free for the family.

If you are planning a family, now is the right time to talk. I will review your situation with no obligation: request your health insurance review here.

Sources

General information only. It does not replace reading your policy conditions or personalised advice.