Portugal faces higher-than-average catastrophic health spending in Europe, primarily impacting the poorest households and driven by outpatient medicine costs. Despite universal access based on residence and a relatively comprehensive benefits package, coverage gaps remain, including limited access to publicly funded dental care and medical products. Challenges also include long waiting times for primary care, specialists, and elective surgery; heavy co-payments without automatic exemptions for low-income groups; and no cap on co-payments, which exacerbates financial burdens for vulnerable populations.