Expat Brits Excluded From National Health Service

[Mobi]

There was a letter in today's Pattaya Today which effectively said that under new rules, any British citizen who was out of the UK for 2 years or more would lose their entitlement to free cover in the UK health service, if they went back to get medical treatment.

This apparently would even apply to retired people (UK pensioners) who had previously paid tax and national insurance contributions.

It was suggested that the yardstick is whether the expat has maintained an address in the UK, and more importantly, was he/she still on the list of a UK GP? If not, he/she would lose the cover.

Theoretically, seriously ill people, and stretcher cases could be refused admission back to the UK.

Can anyone throw any light on this? Thanks.

Edited May 16, 2006 by Mobi D'Ark

[GuestHouse]

Theoretically, seriously ill people, and stretcher cases could be refused admission back to the UK.

Can anyone throw any light on this? Thanks

.

There is some truth in this and there is some BS too.

Healthcare in the UK is provided on the basis of NEED and at the POINT OF NEED.

ANYONE can walk into any doctor's surgery anywhere in the UK and demand treatment under the NHS.

Which is exactly the way it should be and another reason not to knock the UK.

Just to clear that issue of how you pay for NHS treatment.

You do not pay taxes for NHS cover, you pay national insurance and UK Pensions INCLUDE National Insurance Payments. So if you are in receipt of your UK State Pension you are covered.

If You have been living overseas for more than two years AND have not kept your National Insurance Payments up to date, (Not a problem for pensioners) you should, in theory, be presented with a bill for your health care in the UK, but you WILL NOT be denied treatment.

As for denying you the right to fly to the UK if you are ill and going to the UK to receive medical treatment. The UK government cannot deny UK citizens entry to the UK on any basis what-so-ever.

It is right there in Magna Carta "You shall come and go without let or hinderence"

So, in summary.

You are entitled to Health Care if you are in the UK, you cannot be denied entry to the UK. If you have not kept your national insurance stamps uptodate you may be presented with a bill (But never denied treatment) and if you are a UK State pensioner your national insurance is paid for you.

Now back to where you read about this.

There wasn't by chance and advertisement for private health care on the very next page was there?

[Mobi]

Theoretically, seriously ill people, and stretcher cases could be refused admission back to the UK.

Can anyone throw any light on this? Thanks

.

There is some truth in this and there is some BS too.

Healthcare in the UK is provided on the basis of NEED and at the POINT OF NEED.

ANYONE can walk into any doctor's surgery anywhere in the UK and demand treatment under the NHS.

Which is exactly the way it should be and another reason not to knock the UK.

Just to clear that issue of how you pay for NHS treatment.

You do not pay taxes for NHS cover, you pay national insurance and UK Pensions INCLUDE National Insurance Payments. So if you are in receipt of your UK State Pension you are covered.

If You have been living overseas for more than two years AND have not kept your National Insurance Payments up to date, (Not a problem for pensioners) you should, in theory, be presented with a bill for your health care in the UK, but you WILL NOT be denied treatment.

As for denying you the right to fly to the UK if you are ill and going to the UK to receive medical treatment. The UK government cannot deny UK citizens entry to the UK on any basis what-so-ever.

It is right there in Magna Carta "You shall come and go without let or hinderence"

So, in summary.

You are entitled to Health Care if you are in the UK, you cannot be denied entry to the UK. If you have not kept your national insurance stamps uptodate you may be presented with a bill (But never denied treatment) and if you are a UK State pensioner your national insurance is paid for you.

Now back to where you read about this.

There wasn't by chance and advertisement for private health care on the very next page was there?

Thanks for that info - it has cleared up some confusuion in my mind.

I think the letter was genuine - in fact written by a 67 year old man, who presumably is a Uk pensioner. The editor, in his reply, did not say anything about pensioners being entitled to treatment, and also said nothing about national insuarnace contributions nneeding to be kept up. He just said that it depended on a Uk address and a UK GP. There are no private care ads in the paper.

Now my situatioin, if you wouldn't mind clarifying. My nic contributions will cease when I am 60, and I will be entitled to a slightly reduced Uk pension when I am 65. How will this effect me if I want to go back for medical treatment (a) between the ages of 60 and 65 (no pension) and after 65, when I will be a Uk pensioner?

Thanks.

[briley]

If you read the UK government web site it actually says you stop being entitled to free NHS treatment if you are out of the UK for 6 months.

But if you return you are entitled to treatment from the day you arrive if you say you are intending to move back to living in the UK.

So if you don't mind a little lie there is no problems.

Added:

http://www.dh.gov.uk/PolicyAndGuidance/Int...&chk=Kgqt9s

If that link works it contains the information, and the added point that all UK ordinary residents are entitled to free NHS treatment, no mention of having to pay NI contributions - after all not everyone has to pay, only those with jobs.

(Or use "treatment under nhs free" in www.google.co.uk with pages from UK selected - it is the top link)

Edited May 16, 2006 by briley

[GuestHouse]

If your NIC payments are uptodate you will not be charged for treatment. I take it that since you say you are going to get a slightly reduced pension you have not paid all your NIC contributions.

The rule, for pensions is:

You should pay for 44 years, and you are allowed a break of five years without detriment to your pension.

If you miss more than five years your pension will be reduced accordingly and may fall the the statutory minimum of GBP25/week.

Unless you've missed a lot of years, and I presume you have not because you state 'slightly reduced pension', then it might well be worth you paying the missing contributions. When I checked it turned out I owed GBP1000, I have paid that and figure that it is a good investment in terms of the likely return and a very much better insurance.

[tolsti]

Exactly one year ago I returned to the UK. Coincidentally it was from 6 months in Thailand that I actually re-entered the UK, but having last lived in the UK some 15 years ago and since then having lived in all sorts of different countries.

I have acute renal failure and will in the relatively near future require a kidney transplant.

I found lodgings in the UK and a job and went to the surgery local to where I was living and asked for an appointment. I was asked if I had a UK medical card.... I replied that sometime in the past yes, but not with me. That's OK, if you remember who the Dr was then we'll just ask for a new one for you. Then all I had to do was provide proof of residence in the area covered by the surgery. This was accomplished by a letter from my landlord and I had my appointment and a referral to a consultant nephrologist.

I was asked if I was a British Citizen (Ishowed my passport) but at no time asked whether I had been making National Insurance payments. I did not keep up an addess in the UK nor spend any time there in 15 years.

I now see a consultant on a fairly regular basis and receive full care from my surgery as well.

My understanding is that if you are British Citizen then you are entitled to NHS treatment regardless of whethe you are making payments or not but this does seem to require your living in the country or intending to do so.

I was applying in an area close to Gatwick Airport were you would expect checks to be more thorough for 'Medical fraudsters'.

I was once Medevaccd from Moscow with kidney stones and take to A&E at Epsom general. The A&E treatment was immediate, effective and without question.... a different story when I went to a local GP (Foreign Lady) who accused me of abusing the system by getting sick somewhere else and then coming ''here for treatment''. I retorted by asking her just how long she had been in the UK... 3years was the reply..... And whose taking advantage of the system here then?...she got abusive and asked me to leave!!!

[solo siam]

How will they ever actually make this happen.

Unless things have changed recently it's not like the hospital ask for your NI number, NI card etc... before they help you. You go to a hospital and they fix you up, it may get difficult if you have to go throug health centres etc... but I cant see it being a problem.

I paid for 10 years and was never ill, how do they reconcile that with Joe bloggs wgo has paid 6 months national insurance and falls ill with an expensive to cure disease?

[Mobi]

If your NIC payments are uptodate you will not be charged for treatment. I take it that since you say you are going to get a slightly reduced pension you have not paid all your NIC contributions.

The rule, for pensions is:

You should pay for 44 years, and you are allowed a break of five years without detriment to your pension.

If you miss more than five years your pension will be reduced accordingly and may fall the the statutory minimum of GBP25/week.

Unless you've missed a lot of years, and I presume you have not because you state 'slightly reduced pension', then it might well be worth you paying the missing contributions. When I checked it turned out I owed GBP1000, I have paid that and figure that it is a good investment in terms of the likely return and a very much better insurance.

Thanks guesthouse. I've just found a pension forecast I received last year. I will have made 34 out of the 44 qualifying years when I am 60, next month. I will get approx 77% of the basic pension, and they have told me that if I continue to pay contributions until I am 65, I will get 91 % of the basic pension - that's the max they will give me. A back of the envelope calculation shows that if I pay for another 5 years, it will increase my pension by around 670 pounds per annum , based on last year's basic pension rate. Any idea what the contribution rate is, as it will have to come out of my pocket - not sure if I will end up ahead?

I will also get pre 1997 additional pension, and post 1997 additional pension, in all amounting to 72 quid per week. I've no idea what this is, but I'll take anything they give me. Will the amount of the additional pension in any way affect the basic pension? Its all so bloody confusing, which is why I put the forecast away last year without reading it too closely - gave me a headache.

Thanks again

[Guest endure]

Lots of good info here:

http://www.pension.gov.uk/

[GuestHouse]

Mobi.

Ask the pensions office for a statement of missing contributions, it may be that you can pay back past contributions instead of paying after 60 years old.

The advantage of this is that past contributions are paid at the PAST RATE - That has to be a bargain.

I'm not sure what the current rates are but I think around 400 a year. At that rate, five years comes out at 2000 and you'd make that back in a little over three years.

Moreover, if you are married to a younger wife, she gets a pension at the increased rate for the rest of her natural...

I think its a bargain. If your finances are going to be low during retirement then I think its worth paying because small extras will help.

The reason I say its a great insurance is where else can you get that kind of return (return your full investment every three years)? Live past 68, and I hope you do, and you are imediately in the black, every single month from then on.

[Prakanong2005]

I can remember a documentary about the Health Service on BBC and there was indeed a case of a guy just off the plane from Thailand who checked into a local hospital to Heathrow for treatment.

Ther woman whose role it was to get money out of patients not entitled to free treatment was onto him like a moth to a light.

If he had gone to a hospital away from there I bet he would have had a much better chance - registering with you GP will in all likliehood get around most.

I even think registering with a GP is one of the factors the Dole and the Tax office take into account as to your back being resident in the UK again from abroad - it certainly was with me back in 2000.

Edited May 16, 2006 by Prakanong2005

[Mobi]

Thank you Guesthouse, Prakanong and others for all you good advice and information.

My finances are not that low, but every little helps, as you say, and who knows what may happen somewhere down the line.

On re-reading the letter I received last year, it actually states: "Medical treatment under the National health Service ios only available in the UK and you must be living here to receive it." Nothing about being away for 2 years or more, or anything else about having made contributions etc.

I think you're right Parkanong, as long as they don't wheel you off the plane, and you use a bit of sense, you should be OK. If I ever have a death threatening illness that I want treated in the UK, I will try to get there well ahead of the stretcher - if not, I'll take my chances out here.

[terdsak_12]

When I went to blighty at X'mas with my Thai missus, she had a serious asthma attack due to the change in weather, she was rushed to hospital in an ambulance, treated in A&E, given a new inhailler thingy, and sent on her way. No questions of where she's from, money etc. First class if you ask me.

[briley]

One error to clear up - you can only pay NI contribution up to 6 years back, and only the last 2 years are at the rate for that year, over 2 years old and you pay this years (normally higher) rate.

(Exception for the period in the late 1990's when a computer error occured and these payments are due at the then rate until 2008 or 2009)

As an extra if UK resident and unemployed/not paying NI contributions then from age 60-65 (think actually years you are 59-64) you get your NI contributions credited free.

AFAIK if you don't actually tell them you're non-resident and they see no contributions then you automatically get the credits.

[phusingpete]

Mobi.

Ask the pensions office for a statement of missing contributions, it may be that you can pay back past contributions instead of paying after 60 years old.

The advantage of this is that past contributions are paid at the PAST RATE - That has to be a bargain.

I'm not sure what the current rates are but I think around 400 a year. At that rate, five years comes out at 2000 and you'd make that back in a little over three years.

Moreover, if you are married to a younger wife, she gets a pension at the increased rate for the rest of her natural...

I think its a bargain. If your finances are going to be low during retirement then I think its worth paying because small extras will help.

The reason I say its a great insurance is where else can you get that kind of return (return your full investment every three years)? Live past 68, and I hope you do, and you are imediately in the black, every single month from then on.

Hi guesthouse re-"Moreover, if you are married to a younger wife, she gets a pension at the increased rate for the rest of her natural.".. Does this apply to a Thai wife who has not lived in the UK and therefore does not have a National Insurance no?. My TW is much younger than I and I have been thinking about ways of ensuring her financial security after my demise, although I hope this is some way off. I am also receiving a teachers pension from the UK and know I had been paying contributions for widows benefit so perhaps she would also be entitled to some pension from them. This would be really great for her. I suppose I should contact them on my next visit to England, but any info. would be appreciated.cheers

[Mobi]

One error to clear up - you can only pay NI contribution up to 6 years back, and only the last 2 years are at the rate for that year, over 2 years old and you pay this years (normally higher) rate.

(Exception for the period in the late 1990's when a computer error occured and these payments are due at the then rate until 2008 or 2009)

As an extra if UK resident and unemployed/not paying NI contributions then from age 60-65 (think actually years you are 59-64) you get your NI contributions credited free.

AFAIK if you don't actually tell them you're non-resident and they see no contributions then you automatically get the credits.

The trouble that I, or my then financial advisor last year, already told them I was living in Thailand. I suppose I could tell them I am now back in the UK, but that would be an outright lie, and in any event, I wouldn't want to do anything to effect my non resident status for tax purposes - this is far more important than 2,000 pounds worth of contributions. I know these departments never talk to each other - but there's always a first time.

I appreciate what you say, terdsak about no one checking anything before they treat you. Through the years I've had afew Thais treated on the national health who were only visitors, and had never paid any contributions. In fact I know a few Aussies who have had extensive treatment, after just being in the Uk on business, and could have well afforded to pay but were not asked for anything.

However, when all's said and done, there must have been some grain of truth in that letter - ie maybe a recent change in some of the rules, and if you follow the Uk news and the bashing the health service gets every day, it's only a matter of time before the politicians home in on expats and foreigners going there for free treatment and tightening the rules accordingly. So its as well to know what the rules really are, and keep an eye on any future changes, if like me you hope to be around for a few years yet, and obviously, as we grow older, we may be in greater need of medical care.

[monsieurhappy]

Hi guesthouse re-"Moreover, if you are married to a younger wife, she gets a pension at the increased rate for the rest of her natural.".. Does this apply to a Thai wife who has not lived in the UK and therefore does not have a National Insurance no?. My TW is much younger than I and I have been thinking about ways of ensuring her financial security after my demise, although I hope this is some way off. I am also receiving a teachers pension from the UK and know I had been paying contributions for widows benefit so perhaps she would also be entitled to some pension from them. This would be really great for her. I suppose I should contact them on my next visit to England, but any info. would be appreciated.cheers

I have always been under the impression that if you are married when you are 65 you would get a larger state pension than a single person but I don't seem to be able to find anything that substantiates this. There is something however ( married couples allowance ) that allows someone who was born before 1935 to claim extra tax allowance. Does anyone know for sure if the UK state pension is increased for married people when the wife ( Thai ) has never been to the UK or in my case only for a couple of years? My wife does have a UK NI no. but only worked there for less than 3 years.

[Digger]

My understanding is that emergency treatment will remain free for any British Citizen even under these latest changes, however where they are being more carefull is for non emergency treatments preumably like a cataract operation, which is not I assume life threatening in the same way that a burst appendix is.

I would very much doubt anybody is going to question you for emergency treatment or life threatening stuff.

Presumably they are also trying to cut down on the amount of people who live abroad and elect to come back to the UK for expensive treatment.