NHS Treatment Restrictions

[macd]

it used to go something like this . . . . the time limit for the loss of NHS treatment is technically 90 days but on return if questioned you can state you are renewing full time residency back in the UK and you can then receive free NHS treatment.
If I'm wrong, I'm sure I will be corrected.

It did indeed "used to", but doesn't any more. As said, there is now no specified time limit to absence, but for many treatments (by no means all), ordinarily resident is required. HMG literature is unambiguous on this.

GPs and other medics have a lot with which to keep up-to-date. I imagine (and hope) that matters clinical attract more of their attention than matters bureaucratic. Is it really surprising that some of their judgments on the latter are out of date?

 

[Seven Spades]

So if you are resident in Spain then you need a Spanish Ehic and then you won’t pay here.

 

[nortada]

https://assets.publishing.service.g..._data/file/736849/Ordinary_residence_tool.pdf

The above might be useful.

 

[macd]

So if you are resident in Spain then you need a Spanish Ehic and then you won’t pay here.

You might need one, but being eligible is a different matter. Throughout the EEA, EHICs must be issued by the national health insurance institution where you are insured, not where you live. If you're living and working in Spain, then you may qualify for an EHIC from their social security body, TSE. Some countries accept resident UK citizens into their healthcare scheme more readily than others. I believe Portugal, and perhaps also Spain, are relatively generous on this. (Nortada will know.) Many Brits, however, would be eligible only for a UK-issued EHIC. As mentioned above by Tony Cross, UK pensioners and some other groups resident in the EU27/EEA may be eligible for "S1" cover, underwritten by the UK.

Of course much of this could change, for the worse, quite soon.

 

[Graham376]

You might need one, but being eligible is a different matter. Throughout the EEA, EHICs must be issued by the national health insurance institution where you are insured, not where you live. If you're living and working in Spain, then you may qualify for an EHIC from their social security body, TSE. Some countries accept resident UK citizens into their healthcare scheme more readily than others. I believe Portugal, and perhaps also Spain, are relatively generous on this. (Nortada will know.) Many Brits, however, would be eligible only for a UK-issued EHIC. As mentioned above by Tony Cross, UK pensioners and some other groups resident in the EU27/EEA may be eligible for "S1" cover, underwritten by the UK.
Of course much of this could change, for the worse, quite soon.

NHIC cards are issued by one's country of residence and it's within the rules to be resident in more than one country. Having permanent residence status in Portugal, I'm in their health system free of charge and have an EHIC issued by them, no need to be working or making contributions. I think those on temporary 5 year residence can also have one. Have no info about health system in other countries.

 

[macd]

NHIC cards are issued by one's country of residence

They are not. They are issued by your country of health insurance (in your case, Portugal which, as I suggested, has a rather more flexible practice than most EEA countries).
This is the official EU position, from their europa website: "You obtain a card by contacting the health insurance institution where you are insured and which is therefore responsible for assuming your healthcare costs." (My bolds.)

 

[Graham376]

They are not. They are issued by your country of health insurance (in your case, Portugal which, as I suggested, has a rather more flexible practice than most EEA countries).
This is the official EU position, from their europa website: "You obtain a card by contacting the health insurance institution where you are insured and which is therefore responsible for assuming your healthcare costs." (My bolds.)

You are missing the point. To get into (say) Portugal's health care system, it's necessary to be resident there. A visitor can't just turn up and ask to be included in their system. From the Expatica site - the local health provider or insurer in your country of residence will be the first point of contact.

 

[longjohnsilver]

Which year, because Hutton was a Health minister under Blair, Hutton left the role in 2005

And Liam Fox in 2003, so I guess it’s at least 16 years old.

 

[macd]

You are missing the point. To get into (say) Portugal's health care system, it's necessary to be resident there. A visitor can't just turn up and ask to be included in their system. From the Expatica site - the local health provider or insurer in your country of residence will be the first point of contact.

No, Graham, it's you that is missing the point by generalising from the particular practice in Portugal. As said, EHICs can only be issued by countries in which the applicant is (health) insured. If Portugal is more generous than most in extending that insurance to resident visitors, then that's your good fortune. To suggest for one instant that such practice is EEA-wide is irresponsible. If you disagree with my quote from the europa site, "an official website of the European Union", "I suggest you take the matter up with them.

As for your Expatica quote, you omitted the caveat with which the sentence began: "In most cases...." That is key because in most cases applicants will have spent their entire lives in the country in which they have contributed to the state healthcare system, so insuring country and country of residence will be one and the same. You (I presume) and I (for sure) are exceptions to that.

Incidentally, I made not the slightest suggestion that "a visitor can just turn up and join their system." Those words are entirely yours.

 

[nortada]

Careful Graham, they will want to join us in our utopia.

You are aware of my status and I can confirm from personal experience that, in Portugal, your take is correct.

As to other EU countries, it appears to be substantially different so it is for others to paddle their own canoe in the environment they find themselves in.

Could be wrong but from all of my research, post Brexit, little or nothing will change in Portugal.

 

[neil1967]

What irritates me is that by the time I retire I will have paid an awful lot of tax and NI, and once I retire my pension will continue to be taxed at source (as are all UK Govt pensions, irrespective of any future country of residence or even change of nationality), so if I choose to live abroad when I retire, why should my access to the NHS be curtailled? I accept that if you chose to emigrate when young that is a different matter, but surely it can't be right that one rule applies to all?

 

[Graham376]

It irritates many of us. The name of the game is to obey the 11th commandment - "don't get caught" out of the country, maintain an address somewhere, maybe on relative's electoral role.

 

[Old Harry]

We lived in the Netherlands for seven years. When I signed up with a GP over there I gave him all the info concerning my UK GP and assumed that he obtained all my medical history. I then advised him when we returned to UK.

First time I visited my GP at home he said: 'we haven't seen you for a while, must be keeping healthy'. In our case I did everything I should but it seems the message did not come through. But if you do not tell your GP that you have been away for more than six months, how will he know?

The NHS go through the motions, visit hospital "have you been resident for the past 12 months" Yes, jobs a good-un

 

[macd]

once I retire my pension will continue to be taxed at source (as are all UK Govt pensions, irrespective of any future country of residence or even change of nationality),

Like many generalisations about income tax overseas, this is somewhat true, but certainly not to the extent you describe. Yes, in Portugal you would definitely be taxed by the UK on UK Govt pensions (although what constitutes a govt pension is not quite so simple as you might suppose**), because that's what the relevant tax treaty prescribes. But in many other countries, including the one just across the Guadiana, some individuals would be taxed where they are fiscally resident. In many countries (but not Portugal), changing nationality does have the effect of providing full relief for UK govt pensions. Full details can be found in HMRC's "Digest of Double Taxation Treaties", available on line.

Also worth noting that such treaties can change. For instance, the rules for Spain changed significantly only four years ago, so some advice given before then would be wrong now.

** For instance, pensions from the Post Office, Bank of England, Port of London Authority, Environment Agency, to name just a few, are defined as non-government. NHS pensions can be govt or non-govt, depending on type. It really isn't simple, which is why liability should be determined on a case-by-case basis.

 

[Tinto]

Anyone here have any knowledge of people with a chronic condition which requires constant medication? That's my situation. I have three monthly blood tests to check that my meds are not doing me harm and a yearly conversation with the consultant. My meds get delivered to my local pharmacy so anyone can pick them up.

My plan is to spend time in the Med and fly back every three months for my meds and blood tests. My question is, would this see me fall foul of the rules? My meds cost the NHS £25,000 a year so not something I can afford to pay for myself. I am 50 years old and intend to keep paying my National Insurance full stamp.

 

[Graham376]

Best check out the rules on NHS site but, my understanding is that if you are out of the country for >3 months then you become the problem of the State you are in so, returning to UK every 89 days should keep you in the clear. Multiple 3 month absences could cause problems - but only if you tell them

 

[macd]

As mentioned earlier, the qualification for full, free NHS healthcare is being "ordinarily resident". Despite what Graham writes, there is no specific period of absence which denies a patient rights to free treatment (although that used to be the case until declared illegal).
Supporting Information: Ordinarily Resident

This is the "tool" the NHS uses to determine ordinarily resident status:
https://assets.publishing.service.g..._data/file/736849/Ordinary_residence_tool.pdf

Note in particular: "Temporary or occasional absences from the UK will not prevent a person from being ordinarily resident, including extended or regular periods of travel for pleasure. " [My bolds]

 

[Gentleman of Leisure]

Seems the UK Gov will be charging for treatment for those who spend >6 months out of country.

Ex-pat pensioners denied NHS treatment

It's dated 2003!

 

[macd]

[deleted]

 

[Graham376]

As mentioned earlier, the qualification for full, free NHS healthcare is being "ordinarily resident". Despite what Graham writes, there is no specific period of absence which denies a patient rights to free treatment (although that used to be the case until declared illegal).

If a patient is going to be abroad for more than three months then all that he or she is entitled to at NHS expense is a sufficient supply of his/her regular medication to get to the destination and find an alternative supply of that medication abroad
ADVICE SHEET: NHS treatment for travel abroad https://www.coventrywarksapc.nhs.uk/mf.ashx?ID=ab0313dd-450e-40b1-960f-264a746ca03e

P.S. When I was receiving treatment earlier in the year, the consultant suggested a follow up visit which I said I couldn't do because of being away for extended period. He basically said he hadn't heard that as extended absence could result in withdrawal of treatment. We have two friends who have been refused NHS treatment on return to UK, despite having UK addresses.