The Portuguese Insurance and Pension Funds Supervisory Authority issued Circular No. 6/2025 setting out “standard terms” for health insurance, aiming to make products easier for consumers to understand and compare by promoting a comparable option across insurers operating the disease line in Portugal. Adoption of the standard terms is voluntary, and insurers remain free to offer additional cover, but participating firms are expected to follow specific disclosure practices. Insurers that choose to comply are expected to make available a health insurance option matching the annexed standard terms, provide the information needed to understand key features such as provider networks, and, where additional covers are offered, present premium information in a way that enables comparison with the standard package by separating the premium attributable to the standard cover from any incremental premium. Products meeting the template must be explicitly identified as such in pre-contractual and contractual documentation, while insurers that do not offer a fully compliant option should not refer to the standard terms. The template includes four coverages with defined capital limits (hospitalisation, outpatient care, preventive medicine and extended-coverage diseases) and sets parameters on entry age policy, continued cover without exclusion based on age, territorial scope including certain short European travel (up to 60 days) for accident or emergency care evidenced by a medical report, and exclusions aligned with common market practice that can be varied by agreement. For monitoring, insurers must report to the ASF twice yearly on whether they offer a product meeting all standard terms, including in-force contracts and insured persons and total premiums collected for the standard coverages, with the first report due for the second half of 2025. After each reporting cycle, the ASF will publish the insurers offering a fully compliant product and will issue an evaluation report after two reports.
Portuguese Insurance Regulator (ASF) 2025-07-07
Portuguese Insurance and Pension Funds Supervisory Authority sets voluntary standard terms for health insurance and requires semi-annual reporting
The Portuguese Insurance and Pension Funds Supervisory Authority (ASF) issued Circular No. 6/2025, introducing voluntary "standard terms" for health insurance to enhance consumer understanding and comparability. Insurers adopting these terms must offer a health insurance option matching the annexed standards, disclose key features, and separate premiums for standard and additional covers. Insurers must report compliance to the ASF biannually, with the ASF publishing compliant insurers and issuing evaluation reports.