UK NHS Care for Expats

[Muhendis]

So. The differences between Domiciled and Residence seem to be as between Tax and National insurance. As I mentioned, the white paper talks of neither but refers to expats. Could you post a link which refers to the UK Govt. guidelines to which your statement "the other was a guarantee of benefits to people over the age of 65" refers. I am not aware of this and, if true, it would be useful to me.

[uptheos]

This is a copy of part of the UK Govt. white paper for expats that are over retirement age:

• 12. Expatriate UK citizens who move to reside abroad currently lose their entitlement to free
• NHS treatment. They regain this if they return to live in the UK permanently but usually not
• when returning to visit. In line with the principle that everybody makes a fair contribution, we
• propose to confirm the entitlement of any person who has previously paid at least seven
• years of National Insurance contributions.

This clearly implies that you don't get it today except by lying. The rules will be changing in in line with the white paper in 2014.

At the moment NOBODY (pensioner, student and any other criteria you care to think of) who is domiciled outside of the UK is entitled to NHS treatment in the UK except as an emergency admission.

In other words;

If you are visiting the UK and are involved in an accident or perhaps have a heart attack then you will be treated because that is an unforeseen emergency.

If, on the other hand, you visit the UK and go to a doctor requesting treatment for a hearing problem that is clearly not an accident and you must pay.

That is the way the law stands at the moment. As others have said there are ways of circumventing the law but that is between you and your conscience.

Please read the copy of my earlier post and try to understand that this will change but not until next year and then only for those that have paid more than seven years NIC. This means it will not be related to your age but instead it will be related to how much you have contributed over the years to the National Insurance Scheme in the UK.

This is good news for those with long standing ailments that would normally be treated by a doctor and/or in a hospital. It may be less costly to pay for the flight and accommodation to the UK and get your free treatment rather than pay for treatment in your country of residence.

I'm sorry to keep disagreeing with you but what you've written is incorrect.

Domicile and residency are two totally different things, residency can easily be changed whereas domicile is very difficult to change, as Lord Denning, Master of the Rolls put it, "domicile is not a raincoat that can be discarded at will"!

But residency is a different matter, we can choose our residency and can easily change it, if for example a UK citizen who has been resident in Thailand for the past ten years for example, decides to return to the UK to become permanently UK resident once again, they are once again entitled to free NHS care from the day they arrive. Similiarly, anyone over the age 65 is also entitled to complete and free NHS care by virtue of their age.

Bingo!!

[Muhendis]

This is a copy of part of the UK Govt. white paper for expats that are over retirement age:

• 12. Expatriate UK citizens who move to reside abroad currently lose their entitlement to free
• NHS treatment. They regain this if they return to live in the UK permanently but usually not
• when returning to visit. In line with the principle that everybody makes a fair contribution, we
• propose to confirm the entitlement of any person who has previously paid at least seven
• years of National Insurance contributions.

This clearly implies that you don't get it today except by lying. The rules will be changing in in line with the white paper in 2014.

At the moment NOBODY (pensioner, student and any other criteria you care to think of) who is domiciled outside of the UK is entitled to NHS treatment in the UK except as an emergency admission.

In other words;

If you are visiting the UK and are involved in an accident or perhaps have a heart attack then you will be treated because that is an unforeseen emergency.

If, on the other hand, you visit the UK and go to a doctor requesting treatment for a hearing problem that is clearly not an accident and you must pay.

That is the way the law stands at the moment. As others have said there are ways of circumventing the law but that is between you and your conscience.

Please read the copy of my earlier post and try to understand that this will change but not until next year and then only for those that have paid more than seven years NIC. This means it will not be related to your age but instead it will be related to how much you have contributed over the years to the National Insurance Scheme in the UK.

This is good news for those with long standing ailments that would normally be treated by a doctor and/or in a hospital. It may be less costly to pay for the flight and accommodation to the UK and get your free treatment rather than pay for treatment in your country of residence.

I'm sorry to keep disagreeing with you but what you've written is incorrect.

Domicile and residency are two totally different things, residency can easily be changed whereas domicile is very difficult to change, as Lord Denning, Master of the Rolls put it, "domicile is not a raincoat that can be discarded at will"!

But residency is a different matter, we can choose our residency and can easily change it, if for example a UK citizen who has been resident in Thailand for the past ten years for example, decides to return to the UK to become permanently UK resident once again, they are once again entitled to free NHS care from the day they arrive. Similiarly, anyone over the age 65 is also entitled to complete and free NHS care by virtue of their age.

Bingo!!

Not yet but getting there....

[chiang mai]

So. The differences between Domiciled and Residence seem to be as between Tax and National insurance. As I mentioned, the white paper talks of neither but refers to expats. Could you post a link which refers to the UK Govt. guidelines to which your statement "the other was a guarantee of benefits to people over the age of 65" refers. I am not aware of this and, if true, it would be useful to me.

Once again, domicile and residence cross boundaries and confuse the subject, the introduction of the term "expat" into the governement white paper is fairly recent but apropriate since it doesn't muddy the water of NHS elligibility with tax affairs.

You'll forgive me for not spending too much time searching for the definitive governement view on this topic, I've been down the same road many times on TV over the years hence a search of this site may be yield some results. Alternatively a web search on the subject produces lots of avenues to explore, here's one that is only anecdotal but will get you started::

"Expats of state pension age who have lived in the UK for a continuous period of 10 years remain entitled to some cover even if they permanently live abroad. Expats living within the European Economic Area are also entitled to subsidised health care".

http://www.telegraph.co.uk/health/expathealth/10303008/Brits-abroad-could-have-rights-to-free-NHS-treatment-restored.html

[chiang mai]

This is a copy of part of the UK Govt. white paper for expats that are over retirement age:

• 12. Expatriate UK citizens who move to reside abroad currently lose their entitlement to free
• NHS treatment. They regain this if they return to live in the UK permanently but usually not
• when returning to visit. In line with the principle that everybody makes a fair contribution, we
• propose to confirm the entitlement of any person who has previously paid at least seven
• years of National Insurance contributions.

This clearly implies that you don't get it today except by lying. The rules will be changing in in line with the white paper in 2014.

At the moment NOBODY (pensioner, student and any other criteria you care to think of) who is domiciled outside of the UK is entitled to NHS treatment in the UK except as an emergency admission.

In other words;

If you are visiting the UK and are involved in an accident or perhaps have a heart attack then you will be treated because that is an unforeseen emergency.

If, on the other hand, you visit the UK and go to a doctor requesting treatment for a hearing problem that is clearly not an accident and you must pay.

That is the way the law stands at the moment. As others have said there are ways of circumventing the law but that is between you and your conscience.

Please read the copy of my earlier post and try to understand that this will change but not until next year and then only for those that have paid more than seven years NIC. This means it will not be related to your age but instead it will be related to how much you have contributed over the years to the National Insurance Scheme in the UK.

This is good news for those with long standing ailments that would normally be treated by a doctor and/or in a hospital. It may be less costly to pay for the flight and accommodation to the UK and get your free treatment rather than pay for treatment in your country of residence.

I'm sorry to keep disagreeing with you but what you've written is incorrect.

Domicile and residency are two totally different things, residency can easily be changed whereas domicile is very difficult to change, as Lord Denning, Master of the Rolls put it, "domicile is not a raincoat that can be discarded at will"!

But residency is a different matter, we can choose our residency and can easily change it, if for example a UK citizen who has been resident in Thailand for the past ten years for example, decides to return to the UK to become permanently UK resident once again, they are once again entitled to free NHS care from the day they arrive. Similiarly, anyone over the age 65 is also entitled to complete and free NHS care by virtue of their age.

Bingo!!

Since you mentioned it, what's a duck and a crutch?

[Muhendis]

Any comments on this may be helpful.

http://www.dailymail.co.uk/health/article-190218/Ex-pat-pensioners-denied-NHS-treatment.html

[chiang mai]

Any comments on this may be helpful.

http://www.dailymail.co.uk/health/article-190218/Ex-pat-pensioners-denied-NHS-treatment.html

It has always been the case that citizens who stay abroad for more than three months each year will loose elligibility, the green paper changed that to six months each year. But the article uses the term "pensioners" and this is misleading for reasons already stated, unless of course there has been a last minute change in the law which I seriously doubt, had that been the case there would have been wide spread publicity I'm sure.

[Muhendis]

http://www.expatmoneychannel.com/node/286

"Under the current Department of Health Regulations, anyone spending more than three months outside the UK is no longer automatically entitled to free NHS treatment," confirms Katrina Osman, broker with IHC International. "And, therefore, NHS charges may apply for any hospital treatment received. Those in receipt of UK state pensions, and who have previously lived in the UK for a continuous period of 10 years, remain entitled to some cover, although this is dependent on their current country of residence and length of time there."

This article is quite clear until you get to the bit I've highlighted in red. What is meant by "some cover" and "current country and length of time there".

[chiang mai]

http://www.expatmoneychannel.com/node/286

"Under the current Department of Health Regulations, anyone spending more than three months outside the UK is no longer automatically entitled to free NHS treatment," confirms Katrina Osman, broker with IHC International. "And, therefore, NHS charges may apply for any hospital treatment received. Those in receipt of UK state pensions, and who have previously lived in the UK for a continuous period of 10 years, remain entitled to some cover, although this is dependent on their current country of residence and length of time there."

This article is quite clear until you get to the bit I've highlighted in red. What is meant by "some cover" and "current country and length of time there".

Skip the highlighted text above and go to the screening process in the link you provided:

This screening process will include the following questions:

• 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 will be subject to the NHS charges and can 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?

Assumimg you are a British subject the correct answer will need to be "yes" and "permanent" to the two questions underlined above, after which all related problems evaporate.

[bifftastic]

Any comments on this may be helpful.

http://www.dailymail.co.uk/health/article-190218/Ex-pat-pensioners-denied-NHS-treatment.html

The only comment I have is that it is never a good idea to read the Daily Fail in the hope of gaining any useful, or accurate information.

Sometimes amusing, in a perverse kind of way, but they never let the truth get in the way of a headline.

[meatboy]

http://www.expatmoneychannel.com/node/286

"Under the current Department of Health Regulations, anyone spending more than three months outside the UK is no longer automatically entitled to free NHS treatment," confirms Katrina Osman, broker with IHC International. "And, therefore, NHS charges may apply for any hospital treatment received. Those in receipt of UK state pensions, and who have previously lived in the UK for a continuous period of 10 years, remain entitled to some cover, although this is dependent on their current country of residence and length of time there."

This article is quite clear until you get to the bit I've highlighted in red. What is meant by "some cover" and "current country and length of time there".

when they say "some cover" its the same as in the pension and benefits booklet "you may" in other words

"you wont and you will not"

[GinBoy2]

If you're registered with a Doctor in the UK and make occasional visits there's no way of stopping people from doing this.

Personally I just use the BUPA international insurance and it covers me for pretty much everything expensive everywhere in the world apart from the US.

Actually the BUPA insurance does cover me if I go back to the US, but for no more than 60 days a year, which is fine for me since I go back at Christmas and maybe one other time during the year

[Chivas]

The clear outcome reading this thread is simply do nothing if you leave the uk for short time or indefinately. Dont red flag yourself by opening your mouth.

KISS Principle.

Whilst Googling this up recently the cut off date for medical qualification is 90 days away as well not some of the extended times quoted. Out for 90 days or more and you are subject to a requalifying period.

[diggledunc]

I haven't read all the posts on this as so many were mis-informed.

If you want the definite rules on this go to the Department of Health website.

Yes there are people who are/have been treated BUT some of the rules are still being applied in a discretionary manner by individual surgeries.

After reading DoH website a person needs to look at their own position and see how they stand and whether or not they can get round the rules by keeping their head below the parapet.

Quite simply if you live over here you can't rely on any free healthcare from UK and any you do get after patching up at say A&E could in theory be charged for.

Please read and judge for yourself rather than relying on anecdotes I think better to know the facts and then you know how to play the game.

[sms747]

I haven't read all the posts on this as so many were mis-informed.

Yours happens to be one of mis informed ones, if you don't know what you are talking about it's better not to add to the confusion

[GinBoy2]

i'm American, so sorry for feeling the need to comment on all this. But why, if you live in Thailand would you even worry about UK health insurance? Covering yourself here under the best BUPA policy here is dirt cheap, certainly as cheap, if not cheaper than an airfare back to LHR. Private Thai hospitals rank up there with the best I've experienced back in the States. Out patient care is equally cheap as are prescription drugs. So maybe you guys have some emotional attachment to be treated in a British hospital, but I'm in a cultural befuddlement!

[ukrules]

i'm American, so sorry for feeling the need to comment on all this. But why, if you live in Thailand would you even worry about UK health insurance? Covering yourself here under the best BUPA policy here is dirt cheap, certainly as cheap, if not cheaper than an airfare back to LHR. Private Thai hospitals rank up there with the best I've experienced back in the States. Out patient care is equally cheap as are prescription drugs. So maybe you guys have some emotional attachment to be treated in a British hospital, but I'm in a cultural befuddlement!

Well that all depends on how old you are when you first take out the policy doesn't it.

[chiang mai]

i'm American, so sorry for feeling the need to comment on all this. But why, if you live in Thailand would you even worry about UK health insurance? Covering yourself here under the best BUPA policy here is dirt cheap, certainly as cheap, if not cheaper than an airfare back to LHR. Private Thai hospitals rank up there with the best I've experienced back in the States. Out patient care is equally cheap as are prescription drugs. So maybe you guys have some emotional attachment to be treated in a British hospital, but I'm in a cultural befuddlement!

The problem is that there are many UK expats in Thailand who are over age 65 and have been here for some time, they are on fixed income and if they are insurable at all (which most are not by virtue of age), the cost is very high.

[Muhendis]

i'm American, so sorry for feeling the need to comment on all this. But why, if you live in Thailand would you even worry about UK health insurance? Covering yourself here under the best BUPA policy here is dirt cheap, certainly as cheap, if not cheaper than an airfare back to LHR. Private Thai hospitals rank up there with the best I've experienced back in the States. Out patient care is equally cheap as are prescription drugs. So maybe you guys have some emotional attachment to be treated in a British hospital, but I'm in a cultural befuddlement!

The problem is that there are many UK expats in Thailand who are over age 65 and have been here for some time, they are on fixed income and if they are insurable at all (which most are not by virtue of age), the cost is very high.

I would also add that probably all of those UK expats have paid into the national health insurance scheme for 40 or more years and don't need to contribute once they get to retirement age. It is considered by the UK government that, by the age of 65, (I know the retirement age is changed now) they have contributed enough. However it is considered grossly unfair that because a fully paid up citizen chooses to retire in a country other than the UK he/she should no longer be entitled to NHS treatment that has been paid for already.

[diggledunc]

i'm American, so sorry for feeling the need to comment on all this. But why, if you live in Thailand would you even worry about UK health insurance? Covering yourself here under the best BUPA policy here is dirt cheap, certainly as cheap, if not cheaper than an airfare back to LHR. Private Thai hospitals rank up there with the best I've experienced back in the States. Out patient care is equally cheap as are prescription drugs. So maybe you guys have some emotional attachment to be treated in a British hospital, but I'm in a cultural befuddlement!

The problem is that there are many UK expats in Thailand who are over age 65 and have been here for some time, they are on fixed income and if they are insurable at all (which most are not by virtue of age), the cost is very high.

I would also add that probably all of those UK expats have paid into the national health insurance scheme for 40 or more years and don't need to contribute once they get to retirement age. It is considered by the UK government that, by the age of 65, (I know the retirement age is changed now) they have contributed enough. However it is considered grossly unfair that because a fully paid up citizen chooses to retire in a country other than the UK he/she should no longer be entitled to NHS treatment that has been paid for already.

I agree with you. Many of the UK expats here will however have been and will be paying UK tax on the pensions they have and are living off over here. It's not as though no contribution to the UK is being made. It's not possible to do QROPS with all pensions.

I would consider that puts UK expats in a different category to the Lagos shuttle patients referred to in the article. Maybe I am wrong but the Dr seems to lump all together as a problem.

[motoguzzibob]

I am late to this discussion and so apologise. I hope that one of you knowledgeable types will clear this up. I was made aware of the 91 consecutive days or 181 days in any 12 months (which some folks say is not the case). I have trawled through all (I think) postings and it appears to be a very grey area, It seems that so long as you have an NI and/or NHS number and especially if you are already registered with a doctor, you can duck under the radar. However, I also read that there was a white paper this year which states the law will be changed with the suggestion that anyone who had paid NI contributions for at least 12 years will always be eligible. I also checked it out a while back;

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/268632/Sustaining_services__ensuring_fairness_-_Government_response_to_consultation_-_Equality_Analysis.pdf

On page 6 there is this statement:

Expatriates (irrespective of nationality)

Expatriates visiting the UK will be immediately entitled to free NHS services if they have previously made the required contribution to the UK (yet to be determined). The specific qualifying criteria will need to be developed but the intention is to make legislative changes in 2014 to this effect.

This has not yet moved forward! Why do I say that, you ask? Because today I asked my UK doctor for a 6 months prescription and he refused asking why and he said you are not entitled to more than 3 months if you out of the country and will have to re-register on your return. I told him that I was coming back for Christmas and we get another 3 months then - which is very inconvenient, but better than dying from heart problems! I tried to reason with him telling him about the white paper, but he refused to acknowledge that and said it wasn't a law. I rang the NHS help line and she knew nothing but then came back with the 90 day law and after discussion changed it to "probably" 6 months. I said what happens if it's more than 6 months? She said I would have to re-register. How long would I have to wait? She said you have to prove that you have moved back. I said I have a house here, is that proof? Yes. In other words, in my case, all things staying as they are, I can go away for any length of time! I am over 65 and so entitled to free prescriptions as I think over 60, you are?

However, I can't get more than 3 months from my doctor - change surgery? May find the same problem.

Please can anyone tell me (Contrary to my doctor and the NHS helpline) if the white paper was passed, becoming law because I would love to wave a copy in front of my bloody awkward doctor! I would need a website quote, of course. I agree that this is morally wrong as is the state pension not allowed inflation increases. However, governments aren't interested in morals and most of the public think people like me are just rich bastards who don't deserve any help. I have an average pension for the record as do a lot of retired folk in Thailand.

[i claudius]

My doctor gives me 6 months at a time no problem

[motoguzzibob]

My doctor gives me 6 months at a time no problem

Don't suppose you live on the South coast!!!!!!?????

[i claudius]

My doctor gives me 6 months at a time no problem

Don't suppose you live on the South coast!!!!!!?????

l

Live here in Thailand my doc knows

[motoguzzibob]

My doctor gives me 6 months at a time no problem

Don't suppose you live on the South coast!!!!!!?????

l

Live here in Thailand my doc knows

That confirms what I think about bloody awkward doctor!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!