UK expats going to the UK for medical treatment beware........

[xylophone]

I always thought that if I was a UK citizen I could return to the UK for a medical procedure, however it appears that is not the case?

A friend of a friend has just returned to the UK because he has been diagnosed with a spot on his lung (quite possibly lung cancer) this from a hospital in Thailand, so he decided to return to the UK to get it treated.

His doctor of old (given he has not visited him in over 10 years) would not take him on as a patient because he had been out of the country for those years. He tried elsewhere to get treatment and was eventually asked to go in for an interview with immigration, who questioned him at length about how long he had been out of the country, where he had lived etc etc.

Initially they said that the laws had changed and that he could not get medical treatment unless he had proof that he had left Thailand for good and was going to stay in the UK. Fortunately he was able to provide a letter from the landlord here in Thailand is that said he had cancelled his rental, and also a letter from a friend who had "bought his furniture".

One suggestion they had was that if he stayed in the UK for three months, then they may be able to accommodate him, but with a condition such as his, speed is of the essence.

Eventually they condescended and he now has an appointment with the specialist.

For me the frightening thing about it is that the laws seem to have changed quite markedly, if I understand correctly what has happened, yet it would appear that immigrants from the EU who have never lived in the UK and who have never worked there, can actually come and not only get housing and other benefits, but also free medical treatment – – it just does not seem to make sense.

If anyone knows any more about this, then please post it for the benefit of other UK expats.

[brewsterbudgen]

I thought the law had recently changed in that anyone with paid up NI contributions is entitled to NHS treatment regardless of how long they've been away from the UK?

I've lived and worked in Thailand for 10 years, but if I were to lose my job I'd have to return immediately to the UK (unless I want to be a "tourist" in Thailand). I fully expect to use the NHS if I need major medical treatment.

[partington]

No this is not the case. There is currently no entitlement to NHS care based on the amount of contributions that you have made, although there are some discussions on making entitlement available to pensioners who have made sufficient contributions.

Instead of being based on contributions made, the NHS is a residence-based health care system.

So as soon as you can prove you are actually resident in the UK you are entitled to free health care. As soon as you become officially non-resident, you are no longer entitled -it's that simple. This is why if you move back permanently you are entitled to health care immediately, but you must be able to show you are not just visiting. This is also why migrant workers from EU countries are eligible for NHS care as soon as they become resident in the UK for work purposes.

Entitlement to free NHS health care is explained on the UK government site -

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

Here is a quote from this site:
"If you need hospital treatment during your stay in the UK, ensure you can provide evidence that you are entitled to free treatment. For ordinary residents, this means showing that you are lawfully and properly settled in the UK (for example, showing a passport/visa plus rental agreements, utility bill, etc)."

Edited March 6, 2015 by partington

[brewsterbudgen]

No this is not the case. There is currently no entitlement to NHS care based on the amount of contributions that you have made, although there are some discussions on making entitlement available to pensioners who have made sufficient contributions.

Instead of being based on contributions made, the NHS is a residence-based health care system.

So as soon as you can prove you are actually resident in the UK you are entitled to free health care. As soon as you become officially non-resident, you are no longer entitled -it's that simple. This is why if you move back permanently you are entitled to health care immediately, but you must be able to show you are not just visiting. This is also why migrant workers from EU countries are eligible for NHS care as soon as they become resident in the UK for work purposes.

Entitlement to free NHS health care is explained on the UK government site -

http://www.nhs.uk/NH...s-services.aspx.

Here is a quote from this site:

"If you need hospital treatment during your stay in the UK, ensure you can provide evidence that you are entitled to free treatment. For ordinary residents, this means showing that you are lawfully and properly settled in the UK (for example, showing a passport/visa plus rental agreements, utility bill, etc)."

Cheers. I've been teaching abroad and have never applied for non-resident status. I fully expect to move back when I finish teaching, although as I'm very settled out here it might not be for another 20 years!

[NancyL]

What the OP says is very true. So, if someone is planning to return to the UK for medical treatment, they must do their homework to prove that they've severed their ties here and don't plan to return to Thailand. This is to prevent UK citizens from going to the UK for elective procedures then coming back to their homes in Thailand.

That being said, I'm aware of cases where U.K. citizens who were elderly, infirm and quite clearly couldn't care for themselves were able to make it back to the U.K. where they were able to immediately receive appropriate care. When it's very obvious that someone won't be returning to Thailand, the U.K. system is very good at providing treatment and care for its citizens. Speaking as someone who has also assisted Americans in similar situations, I find the U.K. to be much better. And I'm a U.S. citizen.

[MaeJoMTB]

Pensioners are entitled (over 65).

People with 10 years NI payments will be entitled (after April).

People declaring they are moving back forever are entitled.

So basically if you are under 65, just lie or wait a couple of months.

[brewsterbudgen]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

[partington]

Pensioners are entitled (over 65).

People with 10 years NI payments will be entitled (after April).

People declaring they are moving back forever are entitled.

So basically if you are under 65, just lie or wait a couple of months.

The first point isn't accurate. Pensioners over 65 are not entitled to free NHS health care if they go back to the UK after becoming ill in order to get treated.

They are only entitled to free NHS hospital treatment if the illness arises during their visit, and it's an emergency, that cannot wait until they return to whatever country they are living in to be treated.

This is clearly stated on the UK NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for treatment if it becomes necessary during your stay and cannot wait until your return home. This includes any pre-existing conditions that doctors say need prompt treatment while here. Any pre-planned or routine treatment will not be free.

[...]

• Anyone receiving a UK state pension if they have lived legally in the UK for 10 continuous years or more at some point. This also covers their spouse, civil partner or child under 16 if they are travelling with them"

As to the second point, I know there was a consultation document considering making NHS treatment available to current non-residents who have 10 years or more worth of NI contributions, but I haven't seen anything to suggest this has been accepted and is about to become law, so I'd really like to see any link you have for this information (not least because it would apply to me and make my health insurance largely unnecessary!)

Third point is quite true, but at least in theory you have to be able to prove you are returning permanently.

Edited March 7, 2015 by partington

[partington]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

As far as the UK is concerned, the decision as to whether you are resident in the UK is based entirely on how many days you spend in the UK per year, and is nothing to do with any permission you may or may not have got from another country to live there.

For tax purposes you are simply considered non-resident in the UK if you are present for less than 182 days in any one year, and this is also the case in considering whether you are eligible for free NHS treatment. This is also stated on the NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

• Anyone who has lived lawfully in the UK for the 12 months prior to treatment. An absence of up to 182 days is allowed but you must have had immigration permission to be in the UK for the full 12 months"

So if you have been in the UK for less than 182 days in any one year you are considered non-resident and so not eligible for free NHS treatment. This is independent of any declaration you have made -they decide whether you are resident, not you!

However if you have 10 years of contributions and you have worked in another country for up to five years , but not longer, you are also still eligible for free NHS treatment. Unfortunately your 10 years away excludes you from this!

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

[...]

• Former UK residents of 10 continuous years or more who are now working abroad (including self employed people) for not more than five years

Edited March 7, 2015 by partington

[brewsterbudgen]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

As far as the UK is concerned, the decision as to whether you are resident in the UK is based entirely on how many days you spend in the UK per year, and is nothing to do with any permission you may or may not have got from another country to live there.

For tax purposes you are simply considered non-resident in the UK if you are present for less than 182 days in any one year, and this is also the case in considering whether you are eligible for free NHS treatment. This is also stated on the NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

• Anyone who has lived lawfully in the UK for the 12 months prior to treatment. An absence of up to 182 days is allowed but you must have had immigration permission to be in the UK for the full 12 months"

So if you have been in the UK for less than 182 days in any one year you are considered non-resident and so not eligible for free NHS treatment. This is independent of any declaration you have made -they decide whether you are resident, not you!

However if you have 10 years of contributions and you have worked in another country for up to five years , but not longer, you are also still eligible for free NHS treatment. Unfortunately your 10 years away excludes you from this!

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

[...]

• Former UK residents of 10 continuous years or more who are now working abroad (including self employed people) for not more than five years

Thanks. That's interesting, although worrying. If I stop working in Thailand I fully intend to return permanently to the UK. I had assumed that once back home, I would be entitled to all that I was when I lived there before.

[partington]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

As far as the UK is concerned, the decision as to whether you are resident in the UK is based entirely on how many days you spend in the UK per year, and is nothing to do with any permission you may or may not have got from another country to live there.

For tax purposes you are simply considered non-resident in the UK if you are present for less than 182 days in any one year, and this is also the case in considering whether you are eligible for free NHS treatment. This is also stated on the NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

• Anyone who has lived lawfully in the UK for the 12 months prior to treatment. An absence of up to 182 days is allowed but you must have had immigration permission to be in the UK for the full 12 months"

So if you have been in the UK for less than 182 days in any one year you are considered non-resident and so not eligible for free NHS treatment. This is independent of any declaration you have made -they decide whether you are resident, not you!

However if you have 10 years of contributions and you have worked in another country for up to five years , but not longer, you are also still eligible for free NHS treatment. Unfortunately your 10 years away excludes you from this!

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

[...]

• Former UK residents of 10 continuous years or more who are now working abroad (including self employed people) for not more than five years

Thanks. That's interesting, although worrying. If I stop working in Thailand I fully intend to return permanently to the UK. I had assumed that once back home, I would be entitled to all that I was when I lived there before.

You will be , that's the point!

As soon as you become permanently resident again in the UK you become entitled to free NHS care.

You only have to prove you are permanently resident (and probably many places won't check). As the website says, this can be simply done by "showing that you are lawfully and properly settled in the UK (for example, showing a passport/visa plus rental agreements, utility bill, etc)".

This means even if you haven't been in the UK for more than 182 days in the last year, if you can prove you have come back for good, (and are not just visiting to get free treatment) you are entitled straightaway.

[xylophone]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

As far as the UK is concerned, the decision as to whether you are resident in the UK is based entirely on how many days you spend in the UK per year, and is nothing to do with any permission you may or may not have got from another country to live there.

For tax purposes you are simply considered non-resident in the UK if you are present for less than 182 days in any one year, and this is also the case in considering whether you are eligible for free NHS treatment. This is also stated on the NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

• Anyone who has lived lawfully in the UK for the 12 months prior to treatment. An absence of up to 182 days is allowed but you must have had immigration permission to be in the UK for the full 12 months"

So if you have been in the UK for less than 182 days in any one year you are considered non-resident and so not eligible for free NHS treatment. This is independent of any declaration you have made -they decide whether you are resident, not you!

However if you have 10 years of contributions and you have worked in another country for up to five years , but not longer, you are also still eligible for free NHS treatment. Unfortunately your 10 years away excludes you from this!

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

[...]

• Former UK residents of 10 continuous years or more who are now working abroad (including self employed people) for not more than five years

Thanks. That's interesting, although worrying. If I stop working in Thailand I fully intend to return permanently to the UK. I had assumed that once back home, I would be entitled to all that I was when I lived there before.

You will be , that's the point!

As soon as you become permanently resident again in the UK you become entitled to free NHS care.

You only have to prove you are permanently resident (and probably many places won't check). As the website says, this can be simply done by "showing that you are lawfully and properly settled in the UK (for example, showing a passport/visa plus rental agreements, utility bill, etc)".

This means even if you haven't been in the UK for more than 182 days in the last year, if you can prove you have come back for good, (and are not just visiting to get free treatment) you are entitled straightaway.

Great info on this subject, many thanks Partington.

[Ghoulst Writer]

when your time comes it is simpler to just die

[Thai at Heart]

So actually, after a little wrangling, he got treated.

They are doctors not.monsters

[theguyfromanotherforum]

Beware? I thought this was a common knowledge.

I am Canadian resident for income tax purposes (I even pay for health premiums on taxes) and I have no right to see a doctor because I was outside of Canada for more than 6 months.

[brewsterbudgen]

Beware? I thought this was a common knowledge.

I am Canadian resident for income tax purposes (I even pay for health premiums on taxes) and I have no right to see a doctor because I was outside of Canada for more than 6 months.

But this thread is about the UK.

[theguyfromanotherforum]

In most "first world" countries if you are a non resident for more than 6 months you automatically lose rights to any benefits until you re-establish your residency.

[samsensam]

the solution is simple; re-establish your residency. next.

[Bkungbank]

On humantarian issue no hospital refuse to treat a cancer or near die patient in any excuses even he is not holding resident status.

[brewsterbudgen]

In most "first world" countries if you are a non resident for more than 6 months you automatically lose rights to any benefits until you re-establish your residency.

Not your state pension I hope!

[dragonfly94]

I go home at least every two years and the first stop is always the Doctors, he does not know I live abroad. The dentists seems to make no difference, he knows and always has a chat about Thailand as he worked here as one, never a question about entitlement to NHS treatment there.

[brewsterbudgen]

I go home at least every two years and the first stop is always the Doctors, he does not know I live abroad. The dentists seems to make no difference, he knows and always has a chat about Thailand as he worked here as one, never a question about entitlement to NHS treatment there.

God bless the UK! Although I think I'll stay here in Thailand for now...

[Neeranam]

Easy, get a letter from immigration or work. Easy in this corrupt country.

Or, as soon as you go back to the UK, go down to the Unemployment place. They'll say you are not a resident and must wait 26 weeks but they will give you a UB40 card. Use this for free dental treatment or at a hospital.

[MaeJoMTB]

Easy, get a letter from immigration or work. Easy in this corrupt country.

Or, as soon as you go back to the UK, go down to the Unemployment place. They'll say you are not a resident and must wait 26 weeks but they will give you a UB40 card. Use this for free dental treatment or at a hospital.

Jobseekers allowance is only available to those who have paid last years NI contributions.

You can still sign on as unemployed, they just don't give you any money.

While signed on as unemployed, they give you free NI contributions ....... so next year .......

You can also sign on as unemployed, and not seek work, in which case they still give you NI contributions (but no cash).

[steve187]

How can Thailand be my home when I'm a non-immigrant and can only stay here (10 years continuously so far) as long as I have a valid work permit/extension? If my work ends, I have to leave for "home", i.e. the UK. I haven't severed my UK connections, I'm just working overseas.

As far as the UK is concerned, the decision as to whether you are resident in the UK is based entirely on how many days you spend in the UK per year, and is nothing to do with any permission you may or may not have got from another country to live there.

For tax purposes you are simply considered non-resident in the UK if you are present for less than 182 days in any one year, and this is also the case in considering whether you are eligible for free NHS treatment. This is also stated on the NHS website:

http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

• Anyone who has lived lawfully in the UK for the 12 months prior to treatment. An absence of up to 182 days is allowed but you must have had immigration permission to be in the UK for the full 12 months"

So if you have been in the UK for less than 182 days in any one year you are considered non-resident and so not eligible for free NHS treatment. This is independent of any declaration you have made -they decide whether you are resident, not you!

However if you have 10 years of contributions and you have worked in another country for up to five years , but not longer, you are also still eligible for free NHS treatment. Unfortunately your 10 years away excludes you from this!

"If one of the following applies to you then you will be exempt from charges for all of your NHS hospital treatment, except any statutory charges such as prescriptions.[..]

[...]

• Former UK residents of 10 continuous years or more who are now working abroad (including self employed people) for not more than five years

good link but its for visitors to UK, it mentions permission to stay etc. different rules apply to British citizens and for returning citizens. I know of someone who returned after 8 years and was never asked one question about his absence.

edit link here - http://www.telegraph.co.uk/finance/personalfinance/expat-money/10834116/NHS-rejects-expats-returning-from-Spain.html

Edited March 9, 2015 by steve187

[Chivas]

Clear message from the thread is to maintain an address in the uk and remain on your GP's list whatever the cost.........

[steve187]

how many people live full time in the UK and have not been to the doctor for years, how do the doctors know you are not in the UK unless you tell them. you may just be a well person, just like the others that don't go.

[MaeJoMTB]

how many people live full time in the UK and have not been to the doctor for years, how do the doctors know you are not in the UK unless you tell them. you may just be a well person, just like the others that don't go.

I think you'll find quite a lot of the posters on this forum felt the urge to inform any official agency they could find that they were moving to Thailand.

Don't ask me why.

[Issangeorge]

Beware? I thought this was a common knowledge.

I am Canadian resident for income tax purposes (I even pay for health premiums on taxes) and I have no right to see a doctor because I was outside of Canada for more than 6 months.

If you are an Ontario resident you have to spend 5 months in the province. I know some people who winter in Florida and have a Cottage in Quebec, and their permanent home in Ontario. They never stay in Florida for more than 6 months, but if you figure in the 2 months they spend at their cottage, they are outside of Ontario for more than 7 months and thus technically not eligible for health insurance. I don't know if many people even know this. They know they can't be outside of Canada for a certain period of time, but I don't know if they realize other provinces in Canada count the same as being outside of Canada.

[ExPratt]

I think if you don't use your GP for 5 years they return your records to their central office and then you have to reregister