Key Takeaways: The S1 form is a certificate issued by the UK that makes the UK pay for your healthcare in Portugal, so you can use the national health service (SNS) like a Portuguese resident. UK State Pension recipients are the main group who qualify. You apply through NHSBSA, then register the S1 at a Segurança Social office and your local centro de saúde to get a número de utente. You still pay user fees, and dental care is usually not covered.

If you receive a UK State Pension and live in Portugal, the S1 is the document that moves your healthcare from “visitor” to “resident”. It does not replace your right to live in Portugal, and it does not replace private cover for everything the SNS leaves out. This guide covers who qualifies, how to apply, how to register in Portugal, what you pay, and the mistakes that cause delays. For the wider picture of how the system works, see healthcare in Portugal for expats.

Who qualifies for an S1 in Portugal?

You qualify if the UK is responsible for your healthcare under the rules for people living in the EU, which in practice means you receive a UK State Pension or certain other exportable UK benefits. The S1 also covers Switzerland, Norway, Iceland and Liechtenstein, which have separate timing rules for moves made between 2021 and 2023.

The main routes are:

  • UK State Pension recipients. You must be receiving the pension. If you also receive a pension from the country you moved to, you may not qualify, because that country becomes responsible for your care. If you receive pensions from several eligible countries, the one where you paid contributions longest may be responsible.
  • Exportable benefit holders. Some UK benefits qualify, but Disability Living Allowance, PIP, Carer’s Allowance and Attendance Allowance do not. Maternity Allowance or some bereavement benefits may. If you already hold an S1 based on an exportable benefit, you stay covered while you receive that benefit, and time-limited S1s can be renewed.
  • Posted workers. The S1 is arranged through HMRC.
  • Frontier workers. HMRC decides.

The same mechanism exists for pensioners from other EU countries: an S1 (or the equivalent certificate) issued by that country’s pension institution. If that is you, ask your own pension institution how to apply, because the process differs by country. The rest of this guide describes the UK route.

How do you get the S1 form from the UK?

You request it from NHS Overseas Healthcare Services, run by NHSBSA, online or by phone. Have your details ready before you start, because the application asks for them.

  1. Confirm you are receiving your UK State Pension (or another qualifying benefit) and that you have no pension from Portugal that would change which country is responsible.
  2. Gather the information requested: your name, the names and dates of birth of any dependants, your National Insurance number, your residential address and move date in Portugal, an email address, the destination country, your nationality, and details of any EU, EEA or Swiss pensions.
  3. Apply online through NHSBSA, or call NHS Overseas Healthcare Services on +44 (0)191 218 1999 (Monday to Friday 8am to 6pm, Saturday 9am to 3pm, per GOV.UK).
  4. Wait for approval. If you gave an email address, you are sent a download link. Otherwise the S1 is posted. You can ask for delivery to a UK address if you need the document for visa purposes.

Dependants can be listed on the S1. If a replacement S1 is sent to a dependant’s address, they must register that one too.

How do you register your S1 in Portugal, step by step?

You register the S1 at a Segurança Social office, then at your local centro de saúde, and you leave with a número de utente de saúde. GOV.UK gives that order, but local offices sometimes run it differently, so confirm with yours before you travel.

  1. Go to any Segurança Social office (a Centro Distrital da Segurança Social) and register the S1.
  2. Go to your local centro de saúde and register there.
  3. Receive your número de utente de saúde. This is your ID for all state healthcare, on the same basis as a Portuguese citizen.

Bring:

  • your S1 (and a copy to leave with the health centre)
  • a valid passport
  • your residence certificate or permit
  • your NIF, in case it is asked for

A social security number (NISS) is not required to register for healthcare. For the registration side in more detail, see how SNS registration and the utente number work.

If your registration is delayed and you need urgent treatment, call Overseas Healthcare Services on +44 191 218 1999. Do not try to register for or use Portuguese healthcare with an EHIC or GHIC while you are resident.

What does the S1 cover, and what do you still pay?

The S1 gives you access to state healthcare in Portugal on the same basis as Portuguese citizens, which means the same user fees (taxas moderadoras), not free care. GOV.UK’s examples are €5 for a GP appointment and €15 for A&E.

You also pay something toward prescribed medicines. Exemptions are mentioned for pregnant people, children under 12 and unemployed people. Fees and exemption rules are set in Portugal and can change, so check at your health centre.

Dental care is usually not covered by the SNS. See dental care in Portugal for expats for how people handle that.

S1, GHIC or EHIC, and private insurance: which do you need?

The S1 is for living in Portugal; a GHIC or EHIC is for visits; private insurance fills the gaps. They do different jobs, and holding one does not cancel the need to think about the others.

  • S1. Your healthcare as a resident, paid for by the UK. Register it once you arrive.
  • GHIC or EHIC. Stop using any existing card and return it once you hold an S1. After registering the S1, you can apply for a new UK-issued GHIC or EHIC for visits to eligible countries.
  • Private insurance. Worth considering for what the SNS does not cover, such as dental, and where you want a route that does not depend on the public system. See best health insurance for expats in Portugal for options.

Visiting the UK is a separate question. If you moved to Portugal before 1 January 2021, you can use NHS services free when visiting. If you moved on or after that date, you no longer get free NHS care on visits and should have travel insurance. GOV.UK also notes that a Portuguese-issued EHIC covers necessary care during visits; confirm the current terms before you rely on it.

What mistakes should you avoid with an S1 in Portugal?

The common problems are timing and paperwork, not eligibility. These are the ones worth avoiding:

  • Arriving without the S1. The certificate comes from the UK, and approval takes time. Apply before you move if your address and move date are settled, and ask for a UK delivery address if the visa process needs the document.
  • Assuming the S1 replaces residency. You still need legal residence in Portugal, such as a D7 or an EU registration. See the D7 visa guide or retiring in Portugal for the residence side.
  • Using a GHIC or EHIC after you move. Once you are resident, it is the S1 that applies.
  • Skipping the copy. Keep a copy of the S1 to show the health centre.
  • Assuming a benefit qualifies. DLA, PIP, Carer’s Allowance and Attendance Allowance do not.
  • Registering for healthcare before you have residence documents. You need your residence certificate or permit at the Segurança Social office.

If you are still planning the move, moving to Portugal from the UK covers the wider checklist.

What happens when your situation changes?

You must tell NHS Overseas Healthcare Services about changes to your address or circumstances. The S1 is tied to the reason you qualified, so changes to that reason can affect it.

Things worth reporting or checking:

  • A new address, in Portugal or elsewhere.
  • Starting a pension from Portugal, which may make Portugal responsible for your care instead of the UK.
  • Dependants’ details, including any replacement S1 sent to their address, which they must register.
  • A time-limited S1 nearing its end date, which can be renewed.
  • Your benefit changing, since an S1 based on an exportable benefit lasts while you receive it.

Rules and phone lines change, so check the NHSBSA S1 FAQ and the GOV.UK Portugal healthcare guidance before you act.

This article is for general informational purposes only and is not legal or medical advice. Eligibility depends on your individual circumstances; confirm details with NHS Overseas Healthcare Services and your local Segurança Social office.