Portugal's public health system — the SNS, Serviço Nacional de Saúde — has taken on its patient database. Around 20 million records are subject to review — that's how many patient numbers have been issued over the entire period, including the numbers of people who have left and died. For someone who moved recently and processed their paperwork piecemeal, the review has two possible consequences. You can be dropped from the list of the family doctor that many waited months for, without finding out in time. And for an ordinary appointment, free until now, a bill may arrive — because the record is missing an address or a tax number. In this article we explain in detail what information must be filled in, how to submit the missing documents, and what to do if a bill has already been issued.
The right to be treated in the public system belongs to everyone who lives in the country. The Basic Health Law and Decreto-Lei 52/2022 classify as SNS users the Portuguese, EU citizens, citizens of third countries, stateless persons, applicants for international protection, and migrants, including those whose status is not regularized. For a foreigner without a residence permit, the SNS will pay for emergency and vital care if they bring a certificate confirming residence in the country for more than 90 days from the district administration — the Junta de Freguesia.
What exactly the SNS is checking
This concerns the national patient registry, the Registo Nacional de Utentes, which stores a record for everyone who has a patient number — número de utente. The reconciliation began in July 2026 in order to free up places on family doctors' lists and find records with missing or outdated information.
More than a million patients have already received notifications that something is missing from their record — for example, a full name or address. Approximately 262,000 people never responded to these notifications. Almost another 122,000 haven't used the system in more than five years — this group is the first to lose its place with a family doctor.
The patient number, meanwhile, is not canceled, and a person with an incomplete record still must be treated. But until the data is submitted, they pay for the appointment themselves, as the public broadcaster RTP reports.
For expats the likelihood of ending up on this list is higher. The number is often obtained during a one-off hospital visit, when the admissions clerk is satisfied with a passport and date of birth. After that the person moves out of their first rented apartment, changes their phone, renews their residence permit — and the registry keeps data from a year ago, if there was any there at all.
If you don't have a patient number yet
The número de utente is a permanent individual number that a foreigner is assigned on their first visit to a public medical facility: a hospital or a district clinic, centro de saúde. It's also issued when registering with a clinic at your place of residence. Registration gives access to a family doctor, subsidized prescriptions, and referrals to specialists.
The initial registry entry is created from a minimal set: name, sex, date of birth, citizenship, and place of birth. The number issued on this basis is unified, national, and permanent — it doesn't change if you move from Lisbon to Porto or change your status.
Those who already have an address in Portugal, a tax number (NIF), a social security number (NISS), and a número de utente can request them simultaneously at 12 Espaço Cidadão government-service centers. The combined service is available to EU citizens, those who have received or already applied for a residence permit, and applicants for and recipients of international protection. Everyone else will have to obtain the three numbers separately.
Why one number isn't enough
Having a número de utente does not in itself guarantee that the state will cover treatment costs — this is stated directly on the government portal. The number is needed so the system can identify you, and whether it pays or not depends on the completeness of your record.
The mandatory fields add up to quite a few: name, sex, date of birth, country of citizenship and country of birth, the type and number of an identity document, tax number (NIF), and residential address. A foreigner is also required to provide a document confirming the right to reside — a residence permit.
Each record is assigned to one of five categories:
Updated (registo atualizado) — all mandatory data is in place. Grants both clinic registration and the right to a family doctor.
Updated non-resident (registo atualizado não residente) — the same for Portuguese living abroad: registration exists, but no family doctor is provided.
In progress (registo em curso) — data is missing and the 180-day window for submitting it is running. Grants neither registration nor a doctor.
Incomplete (registo incompleto) — the same record after the 180 days have passed. Grants neither registration nor a doctor.
Archived (registo em histórico) — records of the deceased.
When the system asks a patient for missing data, 180 days are allowed for a response, and on the 90th day a repeat notification should arrive. The record can be corrected later too: as soon as all mandatory fields are filled in, the status switches to updated automatically, with no separate application needed for this. But until that moment, the person risks paying for treatment out of pocket.
For foreign children the requirements are gentler: up to age 18, the record is considered updated even without a NIF and residence-permit details.
How to check and update your record
You can find your identification data and your registration with a clinic and doctor in your personal account on the SNS 24 portal or the app of the same name. You can log in with the Cartão de Cidadão identity card, via the Chave Móvel Digital digital key, or with the número de utente itself. The last option requires a date of birth and a phone number that is already entered in the registry: if an old number is recorded there, you won't be able to log in this way.
The category of your record, however, can't yet be viewed in the account. From August 2026 it will be reported at any SNS facility, while displaying this information on the portal and in the app is only under development. You can also find out your category from an administrator at a clinic or hospital.
On your own, through the portal and app, you're only allowed to change your phone and email. Your name, address, NIF, document, and resident-status details can only be corrected with an in-person visit to an SNS facility. You'll need to bring your patient number, passport, NIF, proof of address in Portugal, and a valid residence permit.
The family doctor and the appointment bill
A patient now gets a family doctor under three conditions at once:
the registry record is updated;
there has been at least one SNS visit in the past five years;
there is a free place on a doctor's list in their district.
The district is managed by the ULS, Unidade Local de Saúde — the local health authority that unites hospitals and clinics.
Anyone who hasn't used the SNS in five years loses their place with a doctor. Clinic registration and the right to treatment remain if the record is updated. An exception is made for families with children: at least one adult, most often the mother or father, keeps a doctor. Until the record is updated, treatment is paid for by the patient themselves or a third party — an insurance company or the state under an international agreement. From the published documents it's unclear whether bills issued before the record was updated will be canceled.
If a bill has already been issued, you first need to correct the record: go to the clinic or ULS, submit the documents, and take away confirmation with a date. Then, with this confirmation, ask the ULS to review the basis on which the bill was issued.
Checklist: what to check and do
Get a patient number if you still don't have one.
Log in to SNS 24 and open the section with identification data.
Verify your address, phone, email, and clinic registration.
Update your phone and email yourself if they're out of date.
Go to your clinic and ask which category your record has been assigned to — it isn't visible in the account.
Submit the documents missing from your record to the same place.
Keep the confirmation of the update — you'll need it if it comes to a dispute over a bill.
