Medical Evacuation to Portugal for PALOP Patients: How the Junta Médica Process Works

Key Takeaways: If a doctor at home can’t treat you, Portugal has committed by treaty to take your case, but only through your own government first. Angola, Cabo Verde, Guiné-Bissau, São Tomé e Príncipe and Moçambique each have a bilateral health-cooperation agreement with Portugal, signed between 1977 and 1992 and still active, that lets a national medical board refer patients needing unavailable-at-home specialist treatment to Portuguese public hospitals. It runs government-to-government: your country’s Ministry of Health approves the case, your embassy in Lisbon forwards it, and Portugal’s Directorate-General of Health (DGS) accepts it and books the hospital. There’s no patient-side online application. The visa itself is free for the patient and one companion, but annual quotas exist per country, and three of the five nations have been treated well above theirs in recent years.

This guide explains the actual circuit, what each step requires, what it costs and, just as important, where the public information runs out and you need to confirm directly with your own health ministry or embassy.

What Is Portugal’s Junta Médica Programme, Exactly?

It’s a set of five separate bilateral treaties between Portugal and Angola, Cabo Verde, Guiné-Bissau, São Tomé e Príncipe and Moçambique, signed in the years right after independence and never repealed. Angola’s runs under Lei n.º 6/79 and Decreto do Governo n.º 39/84; Cabo Verde’s under Decreto n.º 24/77 and Decreto n.º 129/80; Guiné-Bissau’s under Decreto n.º 44/92; São Tomé e Príncipe’s under Decreto n.º 25/77; and Moçambique’s under Decreto do Governo n.º 35/84. Each commits Portugal to treat patients from that country when the treatment they need isn’t available at home, and each spells out an annual number of cases (the “quota”) the two governments have agreed to plan around.

The mechanics of how a case is supposed to move through the system were laid out by Portugal’s Direção-Geral da Saúde (DGS) in Circular Normativa n.º 04/DCI, dated 16 April 2004 and still cited as in force. That circular, aimed at hospital administrators rather than the public, describes a national medical board in the patient’s home country reviewing the treating physician’s evacuation proposal, the country’s Minister of Health signing off, the case going to that country’s embassy in Lisbon, and the embassy forwarding it to DGS with a formal request for acceptance. DGS then coordinates which public hospital takes the case.

Here’s the honest caveat: we could not find a current, public-facing Portuguese explainer aimed at patients themselves. The old page on this exact topic from the Alto Comissariado para as Migrações (ACM) has been taken down: it now redirects to a “site disabled” notice pointing to Portugal’s web archive. The only primary text we found describing the process is that 2004 circular, written for hospital staff. That doesn’t mean the programme stopped; DGS’s own country pages (cited below) and multiple embassies’ active pages confirm it’s still running. It does mean you should treat any very specific procedural claim — including some of the detail below — as “how it has been described to work,” and confirm the exact steps for your case with your own Ministry of Health or your embassy in Lisbon before you count on a particular timeline.

Who Qualifies, and Who Actually Files the Request?

You don’t. Not directly, anyway. This isn’t a programme where a patient fills out a form on a Portuguese website: the request has to originate with your own country’s health system.

The circuit, as described by the DGS circular and corroborated by embassy and DGS country pages, runs in this order:

1. Your treating physician in your home country determines the treatment isn’t available locally and drafts a clinical proposal for evacuation.
2. Your country’s national medical board (junta médica) reviews the proposal and the underlying medical file, and decides whether to approve it.
3. Your country’s Ministry of Health signs off on the approved case.
4. Your embassy in Lisbon receives the case and forwards it, with the supporting documentation, to Portugal’s DGS.
5. DGS reviews and accepts the case, and coordinates an appointment with the relevant Portuguese public hospital.
6. You (and, if approved, a companion) apply for the corresponding Portuguese visa at your nearest Portuguese consulate, using the medical-board certification and appointment confirmation DGS’s acceptance generates.

Guiné-Bissau’s embassy in Lisbon is the most transparent of the five about its side of this, publishing a dedicated Department of Health and Social Support (Rua de Alcolena, Nº 17A, 1400-004 Lisboa) that handles scheduling, airport reception, hospital coordination and, in genuine hardship cases, help with accommodation for already-evacuated patients, plus a post-arrival patient-registration form. We did not find equivalent public step-by-step pages from Angola’s, Cabo Verde’s, São Tomé e Príncipe’s or Moçambique’s embassies in Lisbon; if you’re applying from one of those four countries, your Ministry of Health at home and your embassy’s consular section are the right places to ask what their current intake process looks like.

The Visa: What Portugal Actually Requires Once Your Case Is Accepted

Once DGS has accepted your case, the entry document you need is Portugal’s Visto de Estada Temporária para Tratamento Médico, a national visa for stays under a year, valid for the length of your treatment and for multiple entries. Per Portugal’s own consular visa portal, the file for a cooperation-agreement patient needs:

• A completed application form, valid passport, and two recent passport photos
• Proof of return transport
• Travel insurance covering medical costs and repatriation
• A criminal record certificate from your country of nationality or residence
• A medical report and confirmation of admission from the treating Portuguese hospital
• Your medical board certification and appointment confirmation (“comprovativo da Junta Médica e marcação da consulta”): this is the document that proves your case actually went through the process above

For patients evacuated under a cooperation agreement specifically, there’s one meaningful shortcut: the usual proof of financial means and accommodation can instead be a declaration from your embassy in Lisbon guaranteeing those conditions, rather than your own bank statements or a lease.

A family member can apply separately for a companion visa to accompany you, using the same cooperation-agreement framework and documentation logic. Neither visa is a route to Portuguese residency by itself; it’s tied to the treatment, not a long-term stay. If, after treatment, a family member wants to remain in Portugal longer-term for a genuinely separate reason, that has to go through its own process, such as our guide to family reunification in Portugal, rather than being extended out of the medical visa.

On cost: as of Portugal’s consular fee table (Tabela de Emolumentos Consulares, current as of February 2026), the standard processing fee for a national visa is €110, but patients travelling under a health-cooperation agreement, and their accompanying companions, are explicitly exempted from that fee. Budget separately for your own country’s exit paperwork, flights, and any costs your embassy’s hardship support doesn’t cover, since that varies by country and by case.

The Annual Quotas — and Why Three of Five Countries Already Blow Past Theirs

Each agreement sets an annual number of patients the two governments plan for. As of the most recent published breakdown we found:

Country	Annual quota	Patients treated, 2023
Cabo Verde	300/year	654
Guiné-Bissau	300/year	496
São Tomé e Príncipe	200/year	363
Angola	200/year	45
Moçambique	50/year	29

That data (reported by Observador in January 2025, drawing on official figures) also shows the pattern held over 2021–2023 as a whole: of 4,396 total patients treated across all five countries in that period, Cabo Verde accounted for 43%, Guiné-Bissau 29% and São Tomé e Príncipe 24%, while Angola and Moçambique together made up only about 5%. The average cost per patient over those three years was roughly €3,324, for a total SNS outlay near €14.6 million.

The practical takeaway: a published quota being smaller than what actually gets treated isn’t a hypothetical here, it’s the norm for three of the five countries. We haven’t found any indication that hitting the quota number automatically closes admissions for the rest of the year: the decision appears to stay with each country’s own medical board and Ministry of Health, but we also couldn’t confirm the opposite with an official statement either. If your case is time-sensitive, ask your Ministry of Health directly rather than assuming either answer.

What Happens Once You’re Admitted in Portugal

Under the cooperation agreements, patients accepted through this process are treated in the public hospital DGS assigns, under the National Health Service (SNS), Portugal’s public healthcare system, which our guide to Portuguese healthcare for expats covers in more general detail if you want the wider picture of how SNS works. This is a different track from the ordinary route residents use: a legal resident registers at a local health center and gets a permanent número de utente, as our SNS registration guide explains, whereas a cooperation-agreement patient’s care is tied specifically to the treatment DGS approved, coordinated at the hospital level rather than through neighborhood registration. If your situation changes — for example, you or a family member later becomes a Portuguese resident for an unrelated reason — the ordinary SNS registration process is the one that then applies.

Don’t Confuse This With CPLP Residency or “Estatuto de Igualdade”

This is worth stating plainly because the three things get mixed up. This health-cooperation programme, the CPLP residence permit, and the Portugal–Brazil “Estatuto de Igualdade” are three separate legal instruments with three different origins and three different sets of people they apply to:

• The health-cooperation agreements covered in this guide are bilateral decrees from 1977–1992, specific to a medical evacuation, and don’t touch immigration status.
• The CPLP residence permit is a 2025-reformed immigration route open to citizens of any CPLP member state (Angola, Brazil, Cabo Verde, Guinea-Bissau, Mozambique, São Tomé e Príncipe and others) who want to live in Portugal, requiring its own consular visa and AIMA process, unrelated to health.
• “Estatuto de Igualdade de Direitos e Deveres” comes from a specific Portugal–Brazil Treaty of Friendship and applies only to Brazilian citizens; it does not extend to Angolan, Cape Verdean, Guinean or São Tomean nationals, regardless of CPLP membership.

Being accepted for treatment under the health-cooperation programme doesn’t grant or advance any residency status, and holding CPLP residency doesn’t replace the junta médica approval you’d still need to get treatment funded under the cooperation agreement.

What We Couldn’t Verify — Confirm These Yourself

In the interest of not guessing where the record runs thin:

• How current the 2004 DGS circular’s exact procedural detail still is. It remains the only primary text we located describing the step-by-step circuit, and DGS’s own pages confirm the programme is active, but we found no more recent public procedural update superseding it.
• Whether Angola’s, Cabo Verde’s, São Tomé e Príncipe’s or Moçambique’s embassies in Lisbon publish an equivalent intake process to Guiné-Bissau’s. We didn’t find one; that doesn’t mean none exists, only that it isn’t publicly documented the way Guiné-Bissau’s is.
• Whether reaching your country’s annual quota changes anything in practice. The 2023 numbers show admissions well above quota for three countries, but we found no official statement on what, if anything, happens once a quota is reached in a given year.
• Exact visa processing times. Neither the gov.pt service pages nor the consular visa portal state a processing window for this specific visa category.

None of this should stop you from starting the process; it should just stop you from treating any secondhand timeline or procedural claim, including parts of this one, as guaranteed. Your country’s Ministry of Health and your embassy in Lisbon are the authorities who can confirm exactly where your case stands.