Exclusion From Free British Nhs Treatment For Returning Ex-pats

[crazydrummerpauly]

This is my first posting, and i would not be surprised to be told that my query has been already dealt with on this forum, but i have not been able to find a comprehensive and definitive, up-to-date answer to my question.

Only recently i discovered the rule that denies free NHS treatment (excepting emergencies) to returning UK citizens who have been out of the UK for just 3 MONTHS. I do realise that in a day-to-day way, someone visiting their GP when back in the UK simply tells of a health problem, and the GP just gets on with it without inquiring as to where their registered patient has been since they last saw them...but that's not the legal situation as far as i can make out. I should say that as someone still in mild shock at learning about this unjust rule, i have a kind of Meldrew "I don't believe it" block to fully absorbing the facts. An updated memo from the UK Department of Health notes that discussions have been ongoing aimed at extending the allowed period away from 3 to 6 months - big deal. Given that any number of traveller-type websites recommend that ex-pats in a 'less-developed' country with a serious illness should always fly straight back to their home country for treament, the UK 3 or 6-month rule makes all that advice highly dubious for returning Brits ? Has anyone got a) the up-to-date legal position on this ? ; had real experience, or know of anyone who has had experience of being actually refused NHS treament because they were 'away' too long ? ; c) knowledge of whether it makes any difference if a Brit maintains a real Address in the UK whilst living abroad ? ; d) information about to what extent the various government agencies have or are planning to have a unified computer-system which would actually bring up one's travel dates on the screen that every GP now stares at during/instead of every consultation ?

To sum-up: just how SERIOUS is this, and how worried should Brits be ? ( or any other nationalities with free health service ).

Correction: Free ? If only - it is the idea that a person could pay into National Insurance for 45 years and then be denied NHS care after being abroad for only THREE MONTHS that takes my breath away....why isn't this a national scandal ?

Always end with a joke they say: It is precisely this tyrannical assault on our rights that pushes my blood pressure to a level that will require immediate repatriation to dear old Blighty where i can test my lying skills to avoid paying for the treatment i thought i had already paid for all my working life. Ha.

[Pushit]

Flame on

[MB1]

Below is from Citizens Advice, it may help...

http://www.adviceguide.org.uk/index/family...from_abroad.htm

Who can receive all NHS treatment free of charge

Some people from abroad can receive all NHS hospital treatment free of charge. If you are entitled to free NHS hospital treatment, your spouse, civil partner and dependent child(ren) will also be able to receive free treatment, but only if they live with you permanently in the UK.

You can receive free NHS hospital treatment if you:-

Have been living legally in the UK for at least 12 months when you seek treatment, and did not come to the UK for private medical treatment. Temporary absences from the UK of up to three months are ignored.

Have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse.

Have come to the UK to work, either as an employee or self-employed person. This does not include people on short business trips.

Normally work in the UK, but are temporarily working abroad, have at least 10 years continuous residence in the UK, and have been abroad for less than 5. However, if you are studying abroad you are not entitled to free NHS treatment.

Are receiving a UK war disablement pension or war widows’ pension.

Are a UK state pensioner who spends up to six months a year living in another European Economic Area (EEA) state, but are not a resident of that state.

Are working in another EEA country, or in Switzerland, but are paying compulsory UK national insurance contributions.

Edited May 7, 2010 by MB1

[Thongkorn]

I suppose its like Insurance , once you stop paying you are not covered.

[Pdaz]

The guys complaining about this are prolly the same ones who voted for Labour.. You're pension get's frozen too once you are an 'expat'... thanks Gordon... As you say pay NI for 40 odd years then get shafted if you decide to reside overseas...

[MB1]

Yeah your right your pension does get frozen if your an expat living in a country without a reciprocal agreement, but come on lets not blame Gordon for this one eh, reciprocal agreements have been ongoing for years, infact starting in 1948, the UK entered into reciprocal agreements with over 30 countries which allowed for payment of pension increases..

[Bagwan]

The guys complaining about this are prolly the same ones who voted for Labour.. You're pension get's frozen too once you are an 'expat'... thanks Gordon... As you say pay NI for 40 odd years then get shafted if you decide to reside overseas...

And you are being shafted by the very same people that made living in the UK very uncomfortable thus providing the motivation to move on to greener pastures.

[bifftastic]

The guys complaining about this are prolly the same ones who voted for Labour.. You're pension get's frozen too once you are an 'expat'... thanks Gordon... As you say pay NI for 40 odd years then get shafted if you decide to reside overseas...

If it wasn't for the Labour party there wouldn't be any NHS at all, keep voting Tory, as long as you can pay you'll be fine and stuff everyone else. This time they won't be able to decimate our manufacturing sector, there's none left from the last time the asset-stripping, utility privatising, council house selling, poll tax introducing, daily mail reading yuppie wanke_rs were in power.

[citizen33]

Here is a bit more about the change in allowable absence from 3 months to 6 months.

http://www.theyworkforyou.com/wms/?id=2009-07-20d.96WS.0

[MB1]

Here is a bit more about the change in allowable absence from 3 months to 6 months.

http://www.theyworkforyou.com/wms/?id=2009-07-20d.96WS.0

Which is still only a "PROPOSAL" to my knowledge, even if it's passed though you'll still need to be residing substansively in the UK, I'd say it's a fair proposal due to people travelling abroad for longer periods than 3 months, will it happen though ?, things are tight money wise at the moment and a new Government might just scrap the idea..

[sleepyjohn]

There is something relevant in the rule for both NHS treatment and non-indexed pensions.

Once you are out of the UK you are not paying indirect taxes which are a pretty big form of income for the state.

I'm not saying it makes it fair and even, but it has meaning for the country.

In practical terms, if you have a medical problem presumably you go back and just act like you're not going anywhere. And maybe you're not. And maybe you are......

[motorhead]

Interesting post. I asked my NHS Consultant what the position is. She told me it is up to the doctor/consultant whether their hospital will treat an 'expat' or not. (You cant be an expat in Thailand, only a guest. I never call myself an expat). Mind you, if you are an illegal immigrant or bogus asylum seeker there is no question that you will not be treated-and hey, these people haven't paid a penny into the NHS!

[sarahsbloke]

Have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad

This is the rule you quote, if confronted.

"........ I just moved back, pound too weak to live abroad any more."

Edited May 10, 2010 by sarahsbloke

[Konini]

We left UK for Australia in 1987. Last year in England I had to visit a GP and my husband had to go to Accident and Emergency. Both the GP and hospital still had us on the computer system at our old address - well, some data entry operator had entered us onto a computer system in the intervening years as none of it was computerized back then. We explained to both that we didn't live in England now, and they just changed the address to my mum's.

On the other side though, I had a cousin who moved to Spain and a couple of years ago she brought her 2 kids back to see the same GP she's had since birth to get some vaccinations. The doctor refused as he believed that the family were not resident in England and therefore not entitled to treatment. Her brother also lives in Spain and makes a trip back once every month to pick up his wheelbarrow full of prescription medications for various ailments. Same GP, maybe he doesn't suspect anything about him living in Spain. The medication he takes must cost an absolute fortune, and I personally think it's wrong for him to do it - a couple of his illnesses means that he pays nothing at all. The taxpayers pick up the bill. The cigarette run pays for his airfares, he just has the inconvenience of having a couple of days in England and having to find someone to buy the ciggies from him - not very difficult with the prices the way they are in England. One night down the pub and the whole lot are gone.

Maybe we just got lucky, although I think UK has a reciprocal thing going with Aus anyway, where we are still 'officially' resident and pay tax.

GP's aside, as bad as the NHS is I can't see them ever turning ANYONE away from A&E no matter where they come from.

Just my 10 baht's worth.

[Birdy]

I thought that keeping a house in the UK and paying NI contributions was the best way to ensure that you could get treatment if you had to return .

Seems I am wrong

Can expats get NHS treatment, who pays for it, what about needing medical insurance abroad? Your NHS and health insurance questions answered!

Report filed under: Health Abroad » Keeping Healthy Abroad

Mon, January 19, 2009 - 1:55 pm EET

Living Abroad, Medical Insurance and Getting NHS TreatmentA recent case involving an expatriate British woman living in Turkey who sought treatment under the NHS has highlighted the fact that, once you move abroad and make your permanent residence somewhere outside the UK, you lose your automatic right to free care and treatment under the NHS.

However, other expats have experienced a different scenario and some expatriate forums suggest ways in which Brits can get around government rulings that ban the free treatment for non-resident Britons…

So in this article we’ll be looking at living abroad, medical insurance and getting NHS treatment so that if you’re already living abroad or you’re thinking of retiring overseas or working away from home, you’ll know what your entitlement is, what your own financial liabilities and obligations are, and where you can turn if you do find you need treatment and care.

A recent judicial review of one’s entitlement to NHS treatment took place after a failed asylum seeker in the UK was given free care under the NHS system. The findings of this review are relevant to expatriate Britons because they state the following: -

“All patients, regardless of their status or nationality are subject to the same basic screening process and should be asked the following question about their residential status as part of the hospital registration procedure:

• Where have you lived for the last 12 months?

• Can you show that you have the right to live here?

A person who has not been living in the UK for the last 12 months is subject to the NHS (Charges to Overseas Visitors) Regulations and can therefore expect to be asked further questions such as,

• On what date did you arrive in the UK?

• What is the basis for your stay in the UK?

Patients who are unable to provide answers to these questions, or whose answers indicate that they may not be eligible for free hospital treatment should be referred to the NHS trust’s Overseas Visitors Manager, who will conduct a full interview with the patient to establish whether he/she is chargeable. However, immediately necessary treatment should never be delayed or withheld because of doubts about the patient’s chargeable status or his/her ability to pay.”

From this one can ascertain that anyone who has been non-resident in the UK for a year or more loses their right to automatic free treatment on the NHS. They will however still be treated, but they are liable for charges for their treatment. This is in line with the case of the expatriate Briton referred to in the first paragraph of this article. She had been living in Turkey for 5 years and had returned to the UK for essential treatment for liver and heart problems – she received the treatment but was charged for it. Many feel that this is an unfair situation as the woman in question, and her husband, had worked all their lives in the UK and had made National Insurance contributions during that period of time. However, fair or unfair, the ruling stands – once you become permanently non-resident in the UK you are no longer entitled to free treatment under the NHS. This loss of entitlement is understood to come into effect 12 months after you leave.

On some expat forums where people have posed the question about getting around this, suggestions have been made ranging from maintaining an address in the UK to declaring yourself a resident again in order to receive treatment. However, particularly with the latter suggestion, this can have negative knock on effects such as affecting a person’s tax status. Our advice therefore is as follows – understand the government’s rules and guidelines and accept that there are no easy or legitimate ways around them, and prepare yourself accordingly.

Depending on your status, age and where you move to live abroad it could be that there is a reciprocal agreement in place that will allow you to be treated for free under your new country’s state healthcare system. This is usually only the case for Britons over the retirement age who retire within the EU. For all others it comes down to a question of health insurance. So, before you think about moving abroad, retiring to the sun or going and working away from home, you need to look into the level of health insurance you will need. You will have to factor in the cost for this insurance on an ongoing basis – unless you want to risk it and face paying for any treatment you receive either abroad or if you return ‘home’ to Great Britain.

If you’re moving to a nation with basic medical facilities, it could be that your health insurance will need to include provision for repatriation to Great Britain and for paying for NHS care. Look carefully into what level of cover you need, and get that in place – because this is your health we’re talking about, without it you’re no good to anyone!

What is your thought on this?

Private health insurance is OK now but what about people that retire abroad and are older, say 75+ .Would the private companies insure them and at what price!

Edited May 14, 2010 by Birdy

[Thongkorn]

I thought that your National Insurance was for your pension mainly.As I have posted before that once you stop paying, Your Insurance runs out, And not only that you have not contributed to the UK Economy for how ever long. The NHS is not a bottomless pit. You would never be refused medical care. The government is looking to save money so I think there will be a few more changes yet, Maybe you will get a bill for self inflicted aliments and injury's ie smokers, Drink related accidents obese the list can go on,

[Penkoprod]

The words missing in the OP are "non emergency" when referring to treatment

By that, i mean you cant just get off a plane after living outside the country for a time, walk into a hospital in UK and say " i need new hip replacement"........or whatever.

Quite how you might explain how you managed to get on that plane, and travel for 12 or more hours, with an illness that was deemed "emergency" is yet another barrier to overcome. Anddont forget, there is a world of difference between treatment and cure. For instance, a week in a hospital bed monitoring a heart condition and giving of a few pills is treatment. it wont CURE the condition.

There are many other such banana skins waiting to trip the unwary UK expat up when he finds he has to return home, for whatever reason. And not just his NHS entitlement, either !!!!!!

Penkoprod

[offset]

I thought that your National Insurance was for your pension mainly.As I have posted before that once you stop paying, Your Insurance runs out, And not only that you have not contributed to the UK Economy for how ever long. The NHS is not a bottomless pit. You would never be refused medical care. The government is looking to save money so I think there will be a few more changes yet, Maybe you will get a bill for self inflicted aliments and injury's ie smokers, Drink related accidents obese the list can go on,

You are not covered even though you are paying tax in the UK people that carry on paying UK tax for what ever reasons although they contribute to the UK economy are not covered by the NHS

[Mossfinn]

Helpful Info

[crazydrummerpauly]

Hi all,

i'm confused - could this posting be 'merged' with my previous one dealing with the same issue >>>

Exclusion From Free British Nhs Treatment For Returning Ex-pats, NHS denied after 3 months abroad

Ok, is this how the 2 posts link up : Basically, you have to be living IN the UK for 12 months before you

are eligible for free NHS treatment; BUT, if you are travelling for even 1 day over 3 MONTHS during that

12-month period, you would have to start trying to build up the 12-month qualifying period all over again ?

PLEASE - can anybody set down the last word on this topic ?

( Please read my previous post and all the reponses to it first.)

[crazydrummerpauly]

Interesting to read views of UK folks living in Egypt on the same topic ( look out for the

comments about the GP who thought it would be a 'human rights' issue if the rule was

actually followed...) >>>

http://www.luxor4u.com/forum/viewtopic.php?t=13862

Whatever the logic of the original civil-servant/politician thinking on this ruling, one thing's

for sure: It was never debated in a truly democratic way with opportunities for public

opinion to be in the mix.... I wonder why not ?....

[Sheryl]

2 related threads have been merged

[crazydrummerpauly]

Could this be merged with yet another new post on this issue ? >>> The Nhs And Uk Ex-pats

(just posted by CHIANGMAI)

[chiang mai]

Hi all,

i'm confused - could this posting be 'merged' with my previous one dealing with the same issue >>>

Exclusion From Free British Nhs Treatment For Returning Ex-pats, NHS denied after 3 months abroad

Ok, is this how the 2 posts link up : Basically, you have to be living IN the UK for 12 months before you

are eligible for free NHS treatment; BUT, if you are travelling for even 1 day over 3 MONTHS during that

12-month period, you would have to start trying to build up the 12-month qualifying period all over again ?

PLEASE - can anybody set down the last word on this topic ?

( Please read my previous post and all the reponses to it first.)

My apologies for posting a new thread on this same subject, my motivation to do so came from a visa related thread and I hadn't spotted this one.

I think we can all see from the extract of the discussion document that I posted separately that the intention is to allow UK subjects to have free and unfettered acess to NHS care, within certain guidelines and surely we must all be able to agree that there must be some parameters. As things stand presently the bar is set at three months outside of the UK and now proposals offer to increase this to six months, that seems fair and reasonable to me and in keeping with the HMRC guideline whereby 180 days is the cut off point for UK residency. Perhaps you feel that having paid into a system for so many years that you now have an inherrent right to acces that system for life, ditto the UK pension system, personally I don't.

I accept that times have changed and that changes now need to be made because of prior abuse, abuse that is not too different from some of the things you have described! It's funny isn't it, here we are with the country being mired in debt and needing to cut budgets and expense and to reduce excessive salaries, yet when a proposal surfaces to do just that, those affected jump up and down and say not me, another NIMBY attitude that simply isn't helpful to solving the problem, MHO.

Put this another way, if a person is in a position and of an age to retire to Thailand then power to their elbow. But if all of that involves use of a free medical system, instead of buying helath insurance in the country where they have retired, that's false accounting and worse.

[mommysboy]

Hi all,

i'm confused - could this posting be 'merged' with my previous one dealing with the same issue >>>

Exclusion From Free British Nhs Treatment For Returning Ex-pats, NHS denied after 3 months abroad

Ok, is this how the 2 posts link up : Basically, you have to be living IN the UK for 12 months before you

are eligible for free NHS treatment; BUT, if you are travelling for even 1 day over 3 MONTHS during that

12-month period, you would have to start trying to build up the 12-month qualifying period all over again ?

PLEASE - can anybody set down the last word on this topic ?

( Please read my previous post and all the reponses to it first.)

My apologies for posting a new thread on this same subject, my motivation to do so came from a visa related thread and I hadn't spotted this one.

I think we can all see from the extract of the discussion document that I posted separately that the intention is to allow UK subjects to have free and unfettered acess to NHS care, within certain guidelines and surely we must all be able to agree that there must be some parameters. As things stand presently the bar is set at three months outside of the UK and now proposals offer to increase this to six months, that seems fair and reasonable to me and in keeping with the HMRC guideline whereby 180 days is the cut off point for UK residency. Perhaps you feel that having paid into a system for so many years that you now have an inherrent right to acces that system for life, ditto the UK pension system, personally I don't.

I accept that times have changed and that changes now need to be made because of prior abuse, abuse that is not too different from some of the things you have described! It's funny isn't it, here we are with the country being mired in debt and needing to cut budgets and expense and to reduce excessive salaries, yet when a proposal surfaces to do just that, those affected jump up and down and say not me, another NIMBY attitude that simply isn't helpful to solving the problem, MHO.

Put this another way, if a person is in a position and of an age to retire to Thailand then power to their elbow. But if all of that involves use of a free medical system, instead of buying helath insurance in the country where they have retired, that's false accounting and worse.

Most people don't let on they are living abroad and thus the ruling has no effect.

Personally I get health insurance in Thailand, it's really good unless you get ill!

I don't think the rule has ever really been enforced, but have heard of the odd case involving a pensioner airlifted back to Blitey.