Cheers. After all, in what situations must moderating fees be paid?

Dand in general, in Portugal, the payment of moderating fees by users when accessing hospital emergency services, without prior referral by the National Health Service (SNS), according to the information available on the Health Regulatory Entity (ERS) website. 

SNS reference: What is it? 

In practice, “hospital reference takes place through the SNS 24 Line or through the health centers“.

“ Access to the Health Line 24 is made by telephone number 808 24 24 24 and should be used in acute or urgent situations, but without immediate risk of life. Health 24 will screen, advise and refer patients to the most appropriate health unit. The reference can also be made by the Health Center”, explains the ERS. 

The blog Jump, from Santander, explains that the logic of moderating rates has changed over the past year, and today the scenario is as follows: “There are no moderating rates in consultations at health centers, scheduled hospital visits, prescribed exams, surgeries and hospitalizations; the collection of moderating rates remains only in unreferenced hospital emergencies and without hospitalization“. 

It means that the only situation where moderating fees are currently charged is in the hospital emergencies: “It’s the only context where taxes stay. Only pay moderating rate if it goes directly to the urgency, without reference of SNS 24, health center or INEM and this episode does not result in hospitalization”.

Who is exempt from paying moderating fees? 

Still according to the ERS free from payment of moderating fees, users who are in one of the situations provided for in the law:

1. Pregnant and pregnant;
2. Minors;
3. Incapacities of 60% or more;
4. Persons in a situation of economic impairment, as well as those dependent on their household;
5. Benevolent blood donors;
6. Living donors of cells, tissues and organs;
7. Fire department;
8. Transplanted patients;
9. Military and former military personnel of the Armed Forces who, by virtue of the provision of military service, are permanently incapacitated.
10. Unemployed persons registered at the Employment Centre and their spouses and dependents. The unemployment benefit received shall be equal to or less than 1,5 of the IAS (in 2026 it is EUR 805,70). In the case of a temporary situation or of a duration of less than one year, they may not prove their condition of economic insufficiency as provided for in the law;
11. Young people in the process of promoting and protecting the running of terms on a committee to protect children and young people or in court;
12. Young people who are in compliance with:
    inpatient protection measure;
    precautionary custody measure in an educational centre;
    precautionary custody measure in a public or private institution;
13. Young people integrated into any of the host social responses, if the guardianship or exercise of parental responsibilities is granted to the institution where the child is integrated, by judicial decision in civil protection proceedings.
14. Asylum seekers and refugees and their spouses or assimilates and direct descendants.
15. Patients in the context of voluntary termination of pregnancy (GVI).
16. Victims of forest fires in Continental Portugal, between 17 and 24 June 2017; 15 and 16 October 2017, and between 3 and 10 August 2018, in the municipalities identified by the law.