Education and Solidarity Network

MGEN Portugal: offering solidarity-based health coverage on a market dominated by commercial insurance companies

Romain Chave
December 19, 2016

MGEN established MGEN-Portugal in 2011 in order to provide mutualist services in Portugal. The aim was to offer solidarity based health cover on a market dominated by commercial health insurance companies.

MGEN is regulated by the French Mutual Society Code (Code de la Mutualité) which prohibits any medical selection on entry via the use of a medical questionnaire. MGEN, contrary to the capitalist insurers on the Portuguese market, therefore offers mutual and supportive health plans: without a medical questionnaire on registering, therefore no selection of patients based on their state of health, without excluding applications with pre-existing diseases, without excluding serious diseases, such as HIV or cancer, without excluding the first year of cover for maternity, without excluding older people and without cancelling in the event of an increased accident rate.

By proposing a solidarity based healthcare insurance, MGEN is speaking to the biggest number and contributes to the improvement of access to health care.

In order to restrict anti-selection and therefore massive opportunist subscriptions and to restrict to all those refused by the insurance companies, MGEN has put measures in place allowing them to guarantee a sustainable future for supportive health plans:

  • reduction in the level of care charges in the first year, particularly for dentistry and maternity
  • access for subscribers to a wide network of care throughout the country (hospital establishments, health centres, health professionals…) at negotiated and preferential prices. A network which constitutes a real advantage for MGEN subscribers since it reduces the amount to be paid and for MGEN, it constitutes a way of managing the cost of care and expenses.

The MGEN health offer was originally developed in partnership with Portuguese education unions, FNE and FENPROF and autonomous unions. Today, MGEN health coverage has expanded to two other sectors: businesses and not-for-profit organisations. Since September the DECO, biggest Portuguese consumer association, following in-depth comparative studies conducted by the Portuguese health insurance market, has recommended the MGEN plans as the health coverage with the best quality/price ratio.

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