A few people will know but out of nowhere I started getting medical issues after returning from Thailand in June 2025

In fact I had spent six visits to UK hospitals including Hillingdon near Heathrow after an ambulance picked me up from Heathrow. I had been suffering on the flight and crew looked after me. There was a Thai Doctor onboard who assured the crew we didnt need a diversion and I'd be ok until Heathrow...very kindly they moved me up to Business for last 6 hours of flight on Thai

Fast forward to October 2025 and I'm in local hospital in Devon....my brother and one of my sons was with me inside drawn curtains around bed (consultant had just been inside with me hence still closed)

Out of nowhere some woman enters my area calling me by name and saying "Understand you have been expecting me"

Now I aint exactly feeling too well but she looks officious so I hold off on any sarcasm along the lines of who the hell are you

Starts yakking to me saying you're not entitled to NHS free care any more (obviously I'm British) because you spend too much time out of the UK.....(no specific mention of Thailand)

Naturally I start retorting (politely) asking what are you going on about.......she produces documents I assume from Immigration office (or wherever) showing extensive visits I can hardly argue with her but I stick to the truth and point out I dont live overseas

Cue her now demanding I produce documentation clearly proving I'm normally resident in UK......i had 14 days to produce it. Bear in mind I'm in a hospital bed

I immediately say why dont you check with Prescription services for all my normal meds (which carry signature as some restriced drugs) and you'lll see I dont live overseas

She aint having it......she produces list of requirements that I have to produce. It was so ludicrous in the extreme (bear in mind I aint exactly feeling well) that I chuck it in my bag....where it stayed.

3 weeks later I get final warning. Produce or else......

Another week goes by and letter arrives with Invoice for £14,957 lol

Thinking this is ludicrous (but probably could have been avoided) I get hold of my local MP who invites me to his office and I sit with one of his case workers

They point out and asked if I had been outside of UK for more than 90 days on any one trip as this DOES lead to a requalifying period for free NHS services.

I make the point I had never been outside of UK in Asia for more than 77 days in any one trip....they write to the woman who I now know was an official recoverer of monies owed to NHS

Still didnt provide any other proof of what she originally required

In December I get the attached a cancelling of the invoice....no apology no nothing. How many people might just have paid it in the first place !

I have redacted home address

3 hours ago, Chivas said:

They point out and asked if I had been outside of UK for more than 90 days on any one trip as this DOES lead to a requalifying period for free NHS services.

Thanks for sharing. Very interesting.

16 minutes ago, topt said:

Thanks for sharing. Very interesting.

I do recall it being mentioned few years ago about the requalifying period after 90 days.....it probably goes unactioned 99% of the time though

I did think about having a pop at them at the address at bottom of invoice "for distress" lol but thought better of it. After all they got the information from somewhere in the first place. No point poking the bear so to speak just in case

I'd say that if you haven't been paying in while away from UK then you probably have to pay in to "requalify".

I do not believe that simply being British entitles one to the usual "being free at the point of use".

What the period of absence or period of lapsed payment is I do not know?

Thanks for the report, i am sure many did not know this, i did not, so those who have been out of the UK for 90 days need at a time. lose their right to free NHS treatment and have to qualify again, very interesting that they see to have access to peoples immigration records, so those people who have just given a relatives address as their own, and return months years later, can expect the same treatment, idid look it up on google and it does say if you leave the country for 90 days or more you are supposed to tell your GP and you are removed from their list, and you have to register again when ypou return, This is going to be a big issue for many planning to return to the UK for treatment.

Hope you are feeling better and all the best

2 minutes ago, VocalNeal said:

I'd say that if you haven't been paying in while away from UK then you probably have to pay in to "requalify".

I do not believe that simply being British entitles one to the usual "being free at the point of use".

What the period of absence or period of lapsed payment is I do not know?

Yes you're probably right

Out of interest and I forgot to put in opening post. Whilst still on the aircraft in flight the senior flight attendant having been involved approached me again and warned me that if the Ambulance attended "airside" and comes underneath the aircraft the service is not free and you will get invoiced

I queried that by saying "really" as I suspect most reading this are ! Asking if there was a way around it he said yes "are you able to walk"......I said yes for sure. I was bit wobbly on my feet but he said if you can get to immigration area go straight to one of the desks and ask for medical assistance once passport scanned in. As you're now "landside" there is no ambulance charge

I did as instructed and had Heathrow medical services with me within minutes. 2 minutes later they called for ambulance and I was on my way to Hillingdon hospital and they got bag off the carousel in interim

24 minutes ago, howerde said:

Thanks for the report, i am sure many did not know this, i did not, so those who have been out of the UK for 90 days need at a time. lose their right to free NHS treatment and have to qualify again, very interesting that they see to have access to peoples immigration records, so those people who have just given a relatives address as their own, and return months years later, can expect the same treatment, idid look it up on google and it does say if you leave the country for 90 days or more you are supposed to tell your GP and you are removed from their list, and you have to register again when ypou return, This is going to be a big issue for many planning to return to the UK for treatment.

Hope you are feeling better and all the best

Yes I'm 90% better thanks......I had so many different issues including Liver KIdneys Heart (all out of nowhere) plus plenty of other stuff

They have all been sorted bar the Atrial fibrillation on my heart......i had an Ecocardigram on 24th December and cardiology are still prevaricating over what medication is required......I have the hospital ringing me this Friday 27th February so hopefully final part of jigsaw completed

As regards immigration records no idea where they obtained info from but if your passport is scanned on exit and entry from UK its in the system somewhere

How did she know you'd been out the country too much? usually they don't track who is leaving

2 minutes ago, scubascuba3 said:

How did she know you'd been out the country too much? usually they don't track who is leaving

I read she had his travel records, i remember last year thousands of families lost their child benefits as their travel records showed their children leaving the UK but the system did not log them in on their return, the first the knew about it was when the benifits stopped

It would seem this has now been actioned by the NHS if you look at the NHS guidlines it states that you should tell your GP and you are taken off the list if leaving for more than 90days, when you return to be a resident you re register, the question have they been taking people off the lists who have maybe been gone years?.

I expect it will not be long before some find their pensions frozen based on their immigration records

No matter how long you've been away from the UK, if you return permanently you are entitled to full NHS treatment.

4 minutes ago, brewsterbudgen said:

No matter how long you've been away from the UK, if you return permanently you are entitled to full NHS treatment.

Yes true, the link below shows what you have to provide to get free health care

https://www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk

21 minutes ago, scubascuba3 said:

How did she know you'd been out the country too much? usually they don't track who is leaving

Scuba the minute your passport is scanned on flights cruises etc etc it leaves a trace obviously

Who has access to it I dont know but I have no doubt Government computing systems "talk" to each other electronically

9 minutes ago, brewsterbudgen said:

No matter how long you've been away from the UK, if you return permanently you are entitled to full NHS treatment.

The contact address is on the bottom of that invoice via Email

Send an Email asking what the situation is albeit dont quote the amount of invoice as doubtless they could track it back to me lol not that I've done anything wrong as it turned out

1 hour ago, VocalNeal said:

I'd say that if you haven't been paying in while away from UK then you probably have to pay in to "requalify".

I do not believe that simply being British entitles one to the usual "being free at the point of use".

What the period of absence or period of lapsed payment is I do not know?

there is no paying for nhs coverage, its partly funded by National insurance payment, which once you reach retirement age you no longer pay, nhs is free at the point of use for uk citizens

1 hour ago, steve187 said:

nhs is free at the point of use for uk citizens

Define UK citizens as based on the preceding posts that isn't always true as most people understand it.......

Since 2004 the UK has moved to a more sophisticated approach to checks by starting to collect Advance Passenger Information (API) for both inbound and outbound air passengers. API includes the passenger’s full name, nationality, date of birth, gender and travel document number, type and country of issue.

https://www.gov.uk/government/publications/exit-checks-on-passengers-leaving-the-uk/exit-checks-fact-sheet#:

26 minutes ago, vinny41 said:

Since 2004 the UK has moved to a more sophisticated approach to checks by starting to collect Advance Passenger Information (API) for both inbound and outbound air passengers. API includes the passenger’s full name, nationality, date of birth, gender and travel document number, type and country of issue.

https://www.gov.uk/government/publications/exit-checks-on-passengers-leaving-the-uk/exit-checks-fact-sheet#:

But still there are pensioners on this forum that think the government doesn't know about them lying about where they live

I have PR in Thailand and rarely go back to UK, but I still have a UK address in addition to my Thai address. I've also paid enough NI over the years to not to continue with payments.

I'm aware that if I make a trip back to UK I would not qualify for NHS treatment, but my current medical insurance should cover major issues anyway.

But my understanding is if I moved back to the UK, I would re-qualify for NHS?

So if you've been in Thailand for an extended period, could you just move back to UK?

17 minutes ago, CallumWK said:

But still there are pensioners on this forum that think the government doesn't know about them lying about where they live

Yes exactly....all HMRC or DWP etc etc need to do is ascertain where the very last usage of passport was utilised and they know what country you are in......They may not know exact location but country they certainly do

3 hours ago, howerde said:

so those who have been out of the UK for 90 days need at a time. lose their right to free NHS treatment

AI search

NHS hospital treatment is based on "ordinary residence," not just citizenship. If you live outside the UK for more than 3 months (or 6 months for some pensioners), you may lose eligibility for free care and be charged 150% of the tariff. Emergency A&E remains free, but inpatient/outpatient care is charged unless exemptions apply.

GOV.UK +4

Key Details on NHS Eligibility:

• Residence Rule: To access free, non-emergency NHS care, you must be "ordinarily resident" in the UK.

• Time Away Threshold: Generally, being out of the UK for over 3 months (or 6 months for pensioners in the EEA) triggers a, risk of losing free care.

• Exceptions: You may still be entitled to free care if you:

  • Are working abroad for less than 5 years and previously lived in the UK for 10 continuous years.

  • Are a civil servant/military serving abroad.

  • Are a UK state pensioner living in an EEA country (or Switzerland).

• What is Still Free: Emergency treatment in an A&E department is free. However, this does not extend to emergency services that require admission to a ward or follow-up care.

• Charges: Non-residents can be charged 150% of the NHS national tariff for hospital treatment.

  GOV.UK +5

Recommendation: If you are living abroad, you should take out private health or travel insurance to cover potential medical costs in the UK.

^ ^

Yep there you go....

Passenger name record (PNR) data is information collected by airlines and other passenger service operators as part of their normal course of business and includes information required to complete and process a booking.

This may include information such as:

• dates of travel and travel itinerary

• ticket information

• contact details like address and phone number

• travel agent

• payment information

• seat number and baggage information

https://www.gov.uk/government/publications/passenger-name-record-data/passenger-name-record-data

Website states PNR data may be transferred by the PIU to:

• a UK competent authority

6 hours ago, Kinnock said:

But my understanding is if I moved back to the UK, I would re-qualify for NHS?

So if you've been in Thailand for an extended period, could you just move back to UK?

Yes, if you can satisfy the relevant NHS Trust that you have returned permanently you are immediately eligible for free NHS care.

There’s no qualifying period but you maybe asked to provide evidence that you have severed ties overseas, sold or cancelled a lease on a property for instance.

Some conditions are not charged, emergency treatment in Casualty for instance and visits to GP surgery.

UK Nationals in receipt of a UK State Pension used to be free, but that concession was cancelled during the Cameron/Clegg Coalition.

https://www.gov.uk/government/publications/nhs-cost-recovery-overseas-visitors/charging-overseas-visitors-in-england-guidance-for-providers-of-nhs-services

9 hours ago, howerde said:

https://www.gov.uk/guidance/using-the-nhs-when-you-return-to-live-in-the-uk

9 hours ago, Chivas said:

Scuba the minute your passport is scanned on flights cruises etc etc it leaves a trace obviously

Who has access to it I dont know but I have no doubt Government computing systems "talk" to each other electronically

Funny, on talk radio they still say people are not tracked leaving, seems they are wrong

5 minutes ago, scubascuba3 said:

Funny, on talk radio they still say people are not tracked leaving, seems they are wrong

Yes they’re wrong, when Embarkation Checks were stopped at airports it became the responsibility of carriers to pass on details of all passengers leaving the UK, l seem to recall that Eurostar were the first.

GOV.UK

Exit checks fact sheet

10 hours ago, Chivas said:

Yes exactly....all HMRC or DWP etc etc need to do is ascertain where the very last usage of passport was utilised and they know what country you are in......They may not know exact location but country they certainly do

question already covered

10 hours ago, Bredbury Blue said:

AI search

NHS hospital treatment is based on "ordinary residence," not just citizenship. If you live outside the UK for more than 3 months (or 6 months for some pensioners), you may lose eligibility for free care and be charged 150% of the tariff. Emergency A&E remains free, but inpatient/outpatient care is charged unless exemptions apply.

GOV.UK +4

Key Details on NHS Eligibility:

• Residence Rule: To access free, non-emergency NHS care, you must be "ordinarily resident" in the UK.

• Time Away Threshold: Generally, being out of the UK for over 3 months (or 6 months for pensioners in the EEA) triggers a, risk of losing free care.

• Exceptions: You may still be entitled to free care if you:

  • Are working abroad for less than 5 years and previously lived in the UK for 10 continuous years.

  • Are a civil servant/military serving abroad.

  • Are a UK state pensioner living in an EEA country (or Switzerland).

• What is Still Free: Emergency treatment in an A&E department is free. However, this does not extend to emergency services that require admission to a ward or follow-up care.

• Charges: Non-residents can be charged 150% of the NHS national tariff for hospital treatment.

  GOV.UK +5

Recommendation: If you are living abroad, you should take out private health or travel insurance to cover potential medical costs in the UK.

so who pays 100% of the NHS national tariff

On 2/26/2026 at 4:16 AM, theoldgit said:

Yes they’re wrong, when Embarkation Checks were stopped at airports it became the responsibility of carriers to pass on details of all passengers leaving the UK, l seem to recall that Eurostar were the first.

GOV.UK

Exit checks fact sheet

If you are not registered on the UK embassy as living in Thailand, can you renew your passport in Thailand?

On 2/26/2026 at 9:12 AM, steve187 said:

so who pays 100% of the NHS national tariff

A UK pensioner who's paid their full National Insurance (35 years for some, more complicated for others, I've paid 38 years & am told I need to pay another year to get the maximum State Pension in 7 years time), you normally wouldn't be expected to pay any further National Insurance (You can pay it if you're feeling charitable, but it gets you nothing).

Whilst NI is not covering 100% of NHS costs, it goes a long way to funding it & somebody living in the UK wouldn't be expected to pay anthing other than this, people not living in the UK can/will lose access to NHS even if they're fully paid up, it's not what you've paid, it's where you live.

I paid a the highest rate you could pay in NI from the age of 28-41 (+ bought 7 years backdated contributions & did voluntary contributions for 6 years after that) & can look forward to being charged 1.5x what any non-Brit would be charged if I needed treatment on the NHS.

Don't get me started on the "Benefits In Kind" tax I paid for a company provided BUPA policy, never used & never needed the NHS but had to pay even more tax because it was part of my package.

4 hours ago, CallumWK said:

If you are not registered on the UK embassy as living in Thailand, can you renew your passport in Thailand?

There is no facility to register with the UK Embassy if you’re resident in Thailand, that doesn’t prevent you using the, somewhat limited, services they offer. What you can do is register to receive emailed updates from the FDCO via their GOV.UK website.

If you’re resident in Thailand you can apply for passport, the UK Embassy are not involved in the process.