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How the U.K. NHS charges overseas visitors for NHS hospital care

skorts

By skorts
in Health and Medicine

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skorts Advanced Member

skorts

Posted
Posted

In case anyone is interested, here is a useful summary, “How the NHS charges overseas visitors for NHS hospital care” (published 1 August 2018):

 

https://www.gov.uk/government/publications/how-the-nhs-charges-overseas-visitors-for-nhs-hospital-care/how-the-nhs-charges-overseas-visitors-for-nhs-hospital-care

 

Key sections from this document are:

 

1. Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April 2015 affect visitors and former UK residents differently, depending on where they now live.

 

Treatment in A&E departments and at GP surgeries remains free for all.

 

2. People living outside the EEA

 

People who live outside the EEA, including former UK residents, should now make sure they are covered by personal health insurance, unless an exemption applies to them. Anyone who does not have insurance will be charged at 150% of the NHS national tariff for any care they receive.

 

The key thing seems to be “free” secondary NHS Care will only be provided to U.K citizens, based on them being U.K. resident (there are exceptions for ex-service personnel etc).

 

Definition of U.K. resident used by the NHS:

 

UK residents: people who are "ordinarily resident" in the UK. Being ordinarily resident currently means people living here lawfully, voluntarily and for a settled purpose as part of the regular order of life for the time being. The Charging Regulations currently do not apply to people who are ordinarily resident in the UK.

 

3. Returning to the UK to settle

 

Citizens who return to the UK on a settled basis will be classed as ordinarily resident, and will be eligible for free NHS care immediately.

 

There is a legal obligation placed on all NHS Hospitals to establish a patients eligibility for “free” NHS Hospital care and to recover any charges due accordingly.

 

 

 

 

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wgdanson Silver Member

wgdanson

Posted
Posted

So you get care if you are 'ordinarily resident'. And if you return 'on a settled basis' you will be classed as 'ordinarily resident', so get your health care. I do not say FREE cos I have paid for it all of my working life. Oh sorry, it is NOT dependant on my paying UK taxes, National Insurance contributions etc, so I must pay 150%.

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Jip99 Platinum Member

Jip99

Posted
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Posted
6 minutes ago, Badrabbit said:

Even though I hold a British passport on returning to the UK I would be charged 150% above the tariff of the NHS yet an immigrant can go there and get it free, something wrong somewhere!!!

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See post #2

 

Only a dumbass would have to pay 150%.

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Badrabbit Gold Member

Badrabbit

Posted
Posted

I've not lived in the UK for the last 10 yrs, if I return for a month without personal insurance and needed treatment I would be charged 150% above the tariff the NHS charges, fortunately I have no intention of returning, can only see one dumbass with your post!

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Jip99 Platinum Member

Jip99

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Posted
11 minutes ago, Badrabbit said:

I've not lived in the UK for the last 10 yrs, if I return for a month without personal insurance and needed treatment I would be charged 150% above the tariff the NHS charges, fortunately I have no intention of returning, can only see one dumbass with your post!

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app
 

 

I just popped back for hernia treatment after 12 years in Thailand.

 

I didn’t pay a Penny......... because I am not a dumbass.

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Badrabbit Gold Member

Badrabbit

Posted
Posted
  I just popped back for hernia treatment after 12 years in Thailand.

 

I didn’t pay a Penny......... because I am not a dumbass.

 

Well tel us how you did not pay a penny? I'm sure many would like to know.Are you still resident there but not live there? Have you paid NIS all your life? Explain?

 

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Jip99 Platinum Member

Jip99

Posted
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Posted
2 minutes ago, Badrabbit said:

Well tel us how you did not pay a penny? I'm sure many would like to know.

Are you still resident there but not live there? Have you paid NIS alm your life? Explain?

 

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app

 

 

 

 

I am UK NON-resident, but retain a UK address.

 

I have paid 50+ years’ NICs and have no intention of every paying a NHS surcharge.

 

My doctor and surgeon have no interest in where I reside.

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simoh1490 Senior Member

simoh1490

Posted
Posted
8 minutes ago, Jip99 said:

 

I just popped back for hernia treatment after 12 years in Thailand.

 

I didn’t pay a Penny......... because I am not a dumbass.

So you lied and you scammed the system? The NHS is a residency based system and by your own admission you haven't been UK resident for the past 12 years, there can be no other possible explanation.

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malagateddy Senior Member

malagateddy

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Posted
Guy not lived in the UK for 12yrs but goes back for help by having a false address probably parents or mate etc sounds very dishonest to me!!!

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app


Sounds like someone who has "paid his dues " through his working life thought things through and used his intelligent brain[emoji6]

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wgdanson Silver Member

wgdanson

Posted
Posted
3 hours ago, Badrabbit said:

Guy not lived in the UK for 12yrs but goes back for help by having a false address probably parents or mate etc sounds very dishonest to me!!!

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app
 

But you did say in No3 that there's something wrong somewhere. It IS against the law, but the law is (sometimes) an ass, a badass !

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simoh1490 Senior Member

simoh1490

Posted
Posted
32 minutes ago, wgdanson said:

Of course it is against the rules, but how many of you out there would go back for free treatment if you had to?

A fair point....yes I would, or rather I might but there again I live there six months each year so technically I am UK resident - I do think however that six months in and six months out is abou the limit, twelve months out though is a stretch too far.

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ivor bigun Gold Member

ivor bigun

Posted
Posted
Guy not lived in the UK for 12yrs but goes back for help by having a false address probably parents or mate etc sounds very dishonest to me!!!

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Personally i think its the govt that are dishonest,so anyone who paid in all his working life and is then treated so badly,can afford to be a little "dishonest" .

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Badrabbit Gold Member

Badrabbit

Posted
Posted
Personally i think its the govt that are dishonest,so anyone who paid in all his working life and is then treated so badly,can afford to be a little "dishonest" .

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It's the government's fault for allowing people who have not returned to the UK for many years to all of a sudden return to use the NHS, incredible that he admitted to doing that, he said "it didn't cost me one penny" well the return flight home was certainly more than a penny the plumb lol

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Pilotman Ruby Member

Pilotman

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Posted
On 11/29/2018 at 2:52 PM, Jip99 said:

 

I just popped back for hernia treatment after 12 years in Thailand.

 

I didn’t pay a Penny......... because I am not a dumbass.

well said mate.  Others have been the architect of their own misfortune.   

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simoh1490 Senior Member

simoh1490

Posted
Posted

When the NHS was founded in 1948 it was done so on the basis of free health care for everyone, it wasn't explicitly stated at the time but this was for people in the UK. In later years it became necessary to be explicit about who could use the system, this was because people from other countries, people who didn't live in the UK, started to abuse the system and it became overloaded as a result. Even later still the system started to be abused by British people who had left the UK, returning after several years or in old age, solely in order to take advantage of free health care. Somewhere along the line it became necessary to make clear that eligibility for free NHS treatment is determined by residency and this is pretty much in line with its remit when it was first started back in 1948, in that respect eligibility rules have not changed although they have been made more explicit.

 

The definition of residency was a little murky but has now been broadly defined as being UK resident for at least six months each year, and/or, returning to the UK in order to live there on a permanent and settled basis - separate rules apply to armed forces personnel.

 

National Insurance contributions (NIC's) help towards payment for certain UK benefits including Jobseeker Allowance, Maternity Pay, Incapacity Benefit etc etc although I'm not sure the complete list of these benefits was ever precisely defined at the outset. What is clear however is that NIC's were not introduced in order to pay for the NHS albeit in today's world some money from NIC's is used to pay for some NHS facilities: "National Insurance contributions are paid into the various National Insurance Funds after deduction of monies specifically allocated to the National Health Services (NHS). However, a small percentage is transferred from the funds to the NHS from certain of the smaller sub-classes. Thus the four NHS organisations are partially funded from NI contributions but not from the NI Fund.[9".

 

https://en.wikipedia.org/wiki/National_Insurance

 

The bottom line of the above is that eligibility for free NHS treatment, outside of emergency treatment, is intended for UK residents who live in the UK for at least six months each year, not for those who simply paid NIC's for X years, not for those who own homes or pay Council or income tax in the UK and not for those who are merely UK citizens. If people don't meet the above criteria they are scamming the system and are part of the problem, part of the reason why the NHS is under stress. If people have found effective workarounds to help disguise their residency then good for them, well done, just don't try and pretend however that doing that is an acceptable part of the way the NHS is designed to operate.

 

 

 

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Badrabbit Gold Member

Badrabbit

Posted
Posted
When the NHS was founded in 1948 it was done so on the basis of free health care for everyone, it wasn't explicitly stated at the time but this was for people in the UK. In later years it became necessary to be explicit about who could use the system, this was because people from other countries, people who didn't live in the UK, started to abuse the system and it became overloaded as a result. Even later still the system started to be abused by British people who had left the UK, returning after several years or in old age, solely in order to take advantage of free health care. Somewhere along the line it became necessary to make clear that eligibility for free NHS treatment is determined by residency and this is pretty much in line with its remit when it was first started back in 1948, in that respect eligibility rules have not changed although they have been made more explicit.

 

The definition of residency was a little murky but has now been broadly defined as being UK resident for at least six months each year, and/or, returning to the UK in order to live there on a permanent and settled basis - separate rules apply to armed forces personnel.

 

National Insurance contributions (NIC's) help towards payment for certain UK benefits including Jobseeker Allowance, Maternity Pay, Incapacity Benefit etc etc although I'm not sure the complete list of these benefits was ever precisely defined at the outset. What is clear however is that NIC's were not introduced in order to pay for the NHS albeit in today's world some money from NIC's is used to pay for some NHS facilities: "National Insurance contributions are paid into the various National Insurance Funds after deduction of monies specifically allocated to the National Health Services (NHS). However, a small percentage is transferred from the funds to the NHS from certain of the smaller sub-classes. Thus the four NHS organisations are partially funded from NI contributions but not from the NI Fund.[9".

 

https://en.wikipedia.org/wiki/National_Insurance

 

The bottom line of the above is that eligibility for free NHS treatment, outside of emergency treatment, is intended for UK residents who live in the UK for at least six months each year, not for those who simply paid NIC's for X years, not for those who own homes or pay Council or income tax in the UK and not for those who are merely UK citizens. If people don't meet the above criteria they are scamming the system and are part of the problem, part of the reason why the NHS is under stress. If people have found effective workarounds to help disguise their residency then good for them, well done, just don't try and pretend however that doing that is an acceptable part of the way the NHS is designed to operate.

 

 

 

Dishonest scroungers are everywhere!!!

 

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app

 

 

 

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Jip99 Platinum Member

Jip99

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Posted (edited)
4 hours ago, Badrabbit said:

Dishonest scroungers are everywhere!!!

 

Sent from my SM-G610F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

45 years of NIC's and ongoing tax payments don't make me a scounger..

 

 

 

But keep trolling by all means...

Edited by Jip99
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Jip99 Platinum Member

Jip99

Posted
Posted
15 hours ago, Badrabbit said:

I "it didn't cost me one penny" well the return flight home was certainly more than a penny the plumb lol

 

 

 

Yep, it certainly was.

 

 

But as I managed to coincide it with business, my company paid it. 

 

Plumb ?   LOL      beats a dumbass in my book....

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poohy Gold Member

poohy

Posted
Posted

I will be uk next April and will look at setting up an address (sister is very straight so maybe at mates)

Now

I will not be claiming anything

i can at a register at doctor no problem

no bank accounts been away for 22 years

 

quite simply what do i have to do and what costs incurred for mate these i will cover

wgdanson Silver Member

wgdanson

Posted
Posted (edited)
5 hours ago, simoh1490 said:

When the NHS was founded in 1948 it was done so on the basis of free health care for everyone, it wasn't explicitly stated at the time but this was for people in the UK. In later years it became necessary to be explicit about who could use the system, this was because people from other countries, people who didn't live in the UK, started to abuse the system and it became overloaded as a result. Even later still the system started to be abused by British people who had left the UK, returning after several years or in old age, solely in order to take advantage of free health care. Somewhere along the line it became necessary to make clear that eligibility for free NHS treatment is determined by residency and this is pretty much in line with its remit when it was first started back in 1948, in that respect eligibility rules have not changed although they have been made more explicit.

 

The definition of residency was a little murky but has now been broadly defined as being UK resident for at least six months each year, and/or, returning to the UK in order to live there on a permanent and settled basis - separate rules apply to armed forces personnel.

 

National Insurance contributions (NIC's) help towards payment for certain UK benefits including Jobseeker Allowance, Maternity Pay, Incapacity Benefit etc etc although I'm not sure the complete list of these benefits was ever precisely defined at the outset. What is clear however is that NIC's were not introduced in order to pay for the NHS albeit in today's world some money from NIC's is used to pay for some NHS facilities: "National Insurance contributions are paid into the various National Insurance Funds after deduction of monies specifically allocated to the National Health Services (NHS). However, a small percentage is transferred from the funds to the NHS from certain of the smaller sub-classes. Thus the four NHS organisations are partially funded from NI contributions but not from the NI Fund.[9".

 

https://en.wikipedia.org/wiki/National_Insurance

 

The bottom line of the above is that eligibility for free NHS treatment, outside of emergency treatment, is intended for UK residents who live in the UK for at least six months each year, not for those who simply paid NIC's for X years, not for those who own homes or pay Council or income tax in the UK and not for those who are merely UK citizens. If people don't meet the above criteria they are scamming the system and are part of the problem, part of the reason why the NHS is under stress. If people have found effective workarounds to help disguise their residency then good for them, well done, just don't try and pretend however that doing that is an acceptable part of the way the NHS is designed to operate.

 

 

 

Tough on those who have paid NIC all their working life, NEVER claimed any benefit whatsoever, and cannot get NHS treatment because they live abroad 182.5 days in a year, or 183 in a Leap year..

Edited by wgdanson
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simoh1490 Senior Member

simoh1490

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Posted
17 minutes ago, wgdanson said:

Tough on those who have paid NIC all their working life, NEVER claimed any benefit whatsoever, and cannot get NHS treatment because they live abroad 182.5 days in a year, or 183 in a Leap year..

Yes it is, but there again they've been lucky in that they've never needed to claim benefits.

 

I have never claimed a single benefit ever plus I've never used the NHS for anything other than routine visits to the GP from time to time, anything more extensive was always covered by private health insurance or I was living in another country under a different system. Despite those things I've paid all my taxes and lots of them, I've paid my NIC's plus I've created jobs...do I feel as though I've been cheated by not being able to get access to the NHS as an expat? Not really because those are the rules although I am miffed at the idea of having to pay 150% of the actual charges when others get the same things for free under government issued insurance policies.

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Pilotman Ruby Member

Pilotman

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Posted

I served Her Majesty for 26 years, was even shot on on her behalf and have the medals to prove it.  I also paid my taxes for a total of 56 years, with no breaks.  As far as I am concerned, the NHS, indeed the Country, owes me some consideration if I happen to get sick, regardless of where I decide to spent my days, on my 'extended holiday'.  In the sun rather than in a cold miserable  overcrowded UK. Sod the rules. 

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