NHS Rights for Expats

Hannah Beecham  Tuesday, Feb 2 2010   11.42

A Bitter Pill for Expats to Swallow

Expats rights to healthcare treatment, free at the point of delivery, are being slashed, with many automatic rights curtailed.

Not only are more countries insisting that British expats finance their own healthcare needs, whilst abroad, through private insurance plans, but, in a highly significant move, the UK government is curtailing their automatic rights to free care and treatment under the UK's National Health Service.

Every expat is potentially affected, so, no matter where you (and perhaps your family) are based, if you're not familiar with the new rules, now's the time to gen up on your healthcare rights and responsibilities.

 "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."

Who's exempt from charges?

It's not all bad news; at the time of writing, expatriates based in countries outside the European Economic Area, which have a bilateral healthcare agreement in place with the UK, such as New Zealand, Russia and Australia, will find themselves also exempt from emergency NHS charges (but expect a charge for treatments classified a 'routine'). Ms Osman confirms that expats resident in other countries are not eligible for free NHS treatment, irrespective of how long they lived in the UK prior to moving abroad.

Expatriates living within the European Economic Area have been subject to the six month clause since 2004 when the new rules were introduced.

A quizzing time

So, no matter where you're based or how long you've lived abroad, you must expect to be quizzed if you return to the UK for treatment. The guidelines seek to ensure that you have 'properly' returned and taken up residence back in the UK and are not taking advantage of free healthcare whilst continuing to live abroad.

 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?

Rights and wrongs of the matter

Many expats feel aggrieved at being charged for something they feel they have, as British citizens, an entitlement to, and throughout their working lives whilst in the country have paid up for through their National Insurance contributions.

 Whatever the rights or wrongs of these changes, it is now a fact that if you have become permanently non-resident in the UK, you have lost your entitlement to free treatment under the NHS.

 British expatriates who are over the state retirement age and who have moved to a country within the European Economic Area, will continue to benefit from established reciprocal agreements enabling them to receive free care and treatment under the healthcare system of their host country.

Factor in insurance costs

For everyone else, accessing treatment will depend on whatever arrangements you are prepared to make and pay for with a private healthcare insurance provider. It's essential that all expats factor in the costs of such insurance before leaving the UK. And remember, the older you are the more expensive the insurance cover will prove to be.