UK healthcare: No Automatic free access to NHS – April International UK highlights changes to the UK system for expatriates in Europe

Long term health insurance in another country is an area UK expatriates will often not have considered in any detail, particularly if they were used to the free care available in the UK. The NHS is a residence-based healthcare system. Therefore, once a person has moved permanently away from the UK they are no longer entitled to medical treatment under normal NHS rules. However, some overseas residents in receipt of UK State Pensions and some other benefits may be able to access limited paid for cover under the E121 scheme locally.  April International UK’s own research suggests many UK nationals who retire abroad to European countries such as Spain think that they will be fully covered locally via what used be known as the E111 facility.  

Many are still unaware that a replacement system, the European Health Insurance Card (EHIC) is now in place and E111s have not been valid for at least three years. Whilst the European Health Insurance Card entitles short-term residents to reduced-cost and sometimes free medical treatment in the EU, Iceland, Liechtenstein, Norway and Switzerland, it should not be seen as a replacement for proper, comprehensive health insurance. The retired expatriate market is therefore one which presents many challenges for insurances companies. April International UK are one of a small band of insurers who can insure new applicants from age 65 right up to and beyond age 80 years. Inevitably there are some limitations to the cover and in particular, April International UK will medically underwrite all new applicants age 65 years and above.

In effect this means that pre-existing conditions declared on the medical questionnaire would be excluded from future cover. Debbie Purser comments, “The retirement market is one which our experience tells us is likely to be more sensitive to claims than the norm, This is partly a function of age, but from a psychological perspective, if a client is feeling unwell, they are less likely to take a risk with their health abroad than if they were in the UK, where friends and family might be on hand to help take care of them. In practice, this means they will probably go to the Doctor more often.” Debbie Purser continues, “Our advice to anyone planning overseas retirement is to budget for some element of international health insurance, preferably with a 24 hour assistance facility to assist with both foreign language and of course to access to hospitals and Doctors in country, because in the event of serious ill health, they cannot normally simply return to their country of birth and once again access the state system free of charge.”