A private or public birth in Portugal comes down mainly to one thing: what your health insurance will pay if the birth does not go to plan. With a low maternity limit, going private can be expensive, especially if the baby needs intensive care. With a high or unlimited limit within the network, private becomes a comfortable option. In the public system, the birth costs you nothing. Here are the numbers, with a focus on the Algarve.

What a private birth costs

Without insurance, giving birth in a private hospital in Portugal costs, as a rough guide:

Natural birth: from around €3,500 to €5,500.
Caesarean: from around €5,500 to €8,500.

These packages usually include the delivery suite, anaesthesia and the standard number of nights in hospital, and they assume a birth without complications. Anything beyond that is billed separately. These are indicative figures only; they vary by hospital and over time.

How insurance pays: limit and co-payment

Two terms decide how much you pay yourself:

Maternity limit (plafond or capital de parto): the maximum the insurer will pay for the birth. Some policies have low limits, in the region of €1,500 to €3,000; others have high limits or no limit at all within the network.
Co-payment (copagamento): the fixed amount you pay to the network hospital. It is often in the hundreds of euros, depending on the policy.

A simple example, with a natural birth costing €4,000:

With a €2,000 limit, the insurer pays €2,000 and the remaining €2,000 is yours to pay, on top of any co-payment the policy sets.
With a high or unlimited limit within the network, you pay only the co-payment. The insurer covers the rest.

The prices agreed between the hospital or clinic and the insurers are lower, so a normal birth without complications may be paid for, less the excess (franchise) that remains your responsibility.

The risk few people consider: neonatal intensive care

Most births go well. But some newborns need extra support, and a few need neonatal intensive care, for example because they are premature or have breathing difficulties.

In a private hospital, a day in a neonatal intensive care unit can cost more than €1,000. Ten days can add up to over €10,000, and a very premature baby may need several weeks. Again, these are indicative figures; they vary by hospital and over time.

This is where your choice of policy really matters. Before deciding, check:

Which limit the baby’s costs come out of: the mother’s maternity limit or the hospital (internamento) limit? If they come out of a low maternity limit, it will run out quickly.
Whether the baby is added to the policy from birth, and with what cover of its own.
Whether complications for the mother (for example a haemorrhage or an intensive care stay) are covered, and under which limit.

Giving birth in the public system: what you need to know

In the Portuguese National Health Service (SNS), the birth is free for the family. Pregnant women and women who have just given birth are exempt from SNS user charges (taxas moderadoras), as are children under 18. To use the SNS as a resident, you should be registered with it and have your user number (número de utente).

The SNS has experienced teams and is the network that handles the most complex cases, including very premature babies or those with serious complications. What you usually give up is some comfort: a shared room, less flexibility over visiting, less choice of team.

The Algarve in particular

In the Algarve, the SNS is organised under the Algarve Local Health Unit (ULS Algarve), which includes, among others, the public hospitals in Faro and Portimão. Faro is the largest public hospital in the region and the public reference for the most complex cases. If a newborn needs care the hospital of birth cannot provide, the team stabilises the baby and arranges a transfer to the right unit, which may be Faro or, in very specific situations, a hospital outside the region.

At present, only one private hospital in the Algarve has neonatal support, and few deliver babies in the region. But if your policy has a low maternity limit, a complication in a private hospital can become very expensive. If the baby is transferred to a public hospital, care is free for the family from admission to the SNS. Costs incurred privately before the transfer follow the rules of your policy.

How to decide

There is no single answer, but there is a sensible way to think about it:

Low maternity limit and limited savings: the public system tends to be the safer choice for your finances. You can still use your policy for consultations and scans, if it allows.
High or unlimited limit within the network: private is a comfortable option, provided you check how complications and the baby’s care are paid.
No insurance: even with savings, the cost of a complication in a private hospital is hard to predict. Public is, in most cases, the more prudent option.
High-risk pregnancy: decide with your obstetrician, putting the clinical response first.

Many families choose a mixed approach: antenatal care in the private sector, the birth in a public hospital, and the baby added to the health policy from birth.

Frequently asked questions about private or public birth

Can I have antenatal care privately and give birth in a public hospital?

Yes. You can have consultations and scans privately, through your insurance or paying yourself, and give birth in an SNS hospital.

Does the maternity limit also cover the baby?

It depends on the policy. In some, the newborn’s costs in the first few days come out of the maternity limit; in others, the baby has its own cover once added to the policy. Check the special and particular conditions of the policy. Contact me for verification.

If I am transferred from a private to a public hospital, will I pay anything?

Not at the public hospital: pregnant women and children are exempt from SNS user charges. What was spent privately before the transfer is paid according to your policy.

If you would like, I can review your current policy or put together a proposal with the birth in mind: request your health insurance review here.

Sources

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