I don’t know specifically but as Portugal is in the EU it will be essentially led by that. In Europe most private medial insurance tends to try and not cover chronic disease of which of course PsA is. So it’s under the public health system where chronic disease are more likely to be covered.
I would research private medical insurance in Portugal and see whether chronic diseases are covered and interrogate the providers on their coverage of it. And there might be a significant bar to any any coverage of a pre-existing condition anyway. I wouldn’t be searching for the meds as much as how you can access them. Portugal will be able to provide biologics, most especially the more standard ones such as humira, enbrel and cosentyx. More easily in the bigger cities than rurally according to ex pat websites (after a quick google search).
Again there are likely to be protocols your wife will need to jump through in order to qualify for biologics, whether via insurance (if pre-existing conditions are covered) or the public system. It does appear it’s only the USA that prescribes these as a matter of choice. The rest of the world aapears to demand protocols are adhered to first and often when moving countries and health systems like this the patient has to start again on the protocol as often happens here in the UK when Americans move over. They sometimes aren’t automatically kept on the same biologic as they were in the USA but must instead plod through our NICE protocol all over again to qualify for the prescription of biologics.
I’m Irish and often daydream of going home to Ireland. What stops me though is that there I would be unlikely to be able to avail of the same standard of care and access to meds as I do in the UK. I wouldn’t qualify under private medical insurance for it and the Irish public health system isn’t as wealthy for funding purposes as the NHS is. So access would be harder for my biologic. Plus there are far more specifically PsA experienced rheumys in the UK than Ireland and I happen to be exceptionally privileged to be cared for by one of the most experienced PsA rheumys in the UK under the NHS. So frankly I’m in the best place presently for the best care available between both countries for my PsA. And that remains a priority for me.
Best of luck though and what a great adventure to be considering.