Portugal’s health system is predominantly tax-financed and provides universal coverage through the National Health Service (NHS), which operates alongside health subsystems serving specific groups. Despite comprehensive care delivered by both public and private providers with GPs acting as gatekeepers, out-of-pocket spending reached 30% of total health expenditure in 2022—twice the EU average—mainly due to cost-sharing for outpatient services and pharmaceuticals. Recent reforms have prioritized restructuring the NHS, strengthening primary and integrated care, expanding primary care centres and oral health voucher systems, and progressively abolishing flat-rate user charges to enhance accessibility.