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Although it is beyond the scope of this website to cater for every contingency regarding the relationship between those coming to the United Kingdom, access to the National Health Service, and when private medical insurance is deemed mandatory, we have tried to illustrate the most salient points:

Whilst there are always exceptions to the following, there are important two factors that should be borne in mind when considering applying to enter the United Kingdom, namely, that you should have ‘sufficient financial resources’ and, in many circumstances, that you have ‘comprehensive sickness insurance’.

This applies even if you are an EEA/EU citizen, as these principles are enshrined in the DIRECTIVE 2004/58/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 29 April 2004.

http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:229:0035:0048:EN:pdf

Indeed, the UK Borders Agency specifically mentions these two factors in relation to the following categories:

If you are a student

“If you are a student, you need to provide a school, college or university letter confirming enrolment and the completion date of the course. You will also need to provide a statement confirming that you have sufficient financial resources during your period of study along with supporting evidence such as a bank statement or evidence of a grant or scholarship; and evidence that you have comprehensive sickness insurance.”

If you are economically self sufficient

“If you are economically self-sufficient, you need to supply evidence of comprehensive sickness insurance and funds sufficient to maintain yourself and any family members included in your application during the time you intend to reside on this basis. These funds can come from the employment or self-employment of any of your family members legally working and residing in the UK with you.”

The full article can be found at:

http://www.ukba.homeoffice.gov.uk/sitecontent/applicationforms/eea/guide-eea


Additionally, UK Border Agency relates the regulations regarding visitors:

If you are a visitor to the United Kingdom or have temporary permission to live here (we call this limited leave to remain), you may be able to register with a GP in your area and receive free treatment. The GP can decide whether or not to register you. You may not be able to receive the full range of hospital treatment, because you must be a permanent resident or have lived here for a year to qualify for it. This applies even if you are a British citizen or have lived or worked here in the past.
“Certain categories of people are able to receive the full range of hospital treatment, including asylum applicants whose application is still being considered, anyone who has lived here legally for the previous 12 months, and diplomatic staff.

If you are not in one of the categories that are able to receive free treatment, you may be asked to pay for any hospital treatment you receive. You may therefore wish to ensure you have health insurance to cover your stay in the United Kingdom.”


It is important to reiterate the above, regarding access to the full range of hospital treatment under the NHS in that “you must be a permanent resident or have lived here a year to qualify for it”.

Further information can be found at:

http://www.ukba.homeoffice.gov.uk/ukresidency/rightsandresponsibilities/healthcare/

To go into slightly more detail and expand on the above, it is logical to ask:

So who is entitled to access the National Health Service?

The answer is, basically, anyone who is deemed to be ordinarily resident in the UK is entitled to free NHS hospital treatment in England. “Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled.

Anyone who is not ordinarily resident is subject to the National Health Service (Charges to Overseas Visitors) Regulations 1989, as amended.  These regulations place a responsibility on NHS hospitals to establish whether a person is ordinarily resident; or exempt from charges under one of a number of exemption categories; or liable for charges.

The UK Border Agency specifically states that “Visitors are not allowed to enter or stay in the United Kingdom to receive free medical treatment from the NHS. Except for treatment given in a hospital's accident and emergency department, you will be charged for any treatment you receive. You should ensure that you have enough medical insurance to cover your stay.”

What about British Nationals? I have paid taxes in the past.

Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence.  The only thing relevant is whether you ordinarily live in the UK.

How do I know if I have to pay?

The Regulations state that the hospital providing treatment is responsible for establishing who is entitled to free NHS hospital treatment. They will make their decision in accordance with the Regulations. The hospital can ask you to provide evidence to support any claim to free treatment and it is your responsibility to do so if asked. If the hospital decides you are eligible for free NHS treatment you will still have to pay statutory NHS charges such as prescription charges unless you are otherwise exempt. If the hospital decides you are not entitled to free NHS treatment charges will apply and cannot be waived.

What if I do not meet one of these exemptions from charges?

If you are not ordinarily resident or exempt under the Regulations, charges will apply for any hospital treatment you receive and cannot be waived. If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK.  There is no facility to purchase healthcare insurance from the NHS therefore any necessary insurance must be organised privately.

Some health services are free of charge to everyone. These are:

• treatment given in an accident and emergency (A&E) department or in an NHS walk-in centre that provides services similar to those of an A&E department;
• treatment for certain infectious diseases (but for HIV/AIDS only the first diagnosis and counselling that follows it are free);
• compulsory psychiatric treatment; and
• family planning services.

Department of Health Guidelines:
http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074374

The National Health Service (Charges to Overseas Visitors) Regulations 1989:
http://www.opsi.gov.uk/SI/si1989/Uksi_19890306_en_1.htm

The National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2006:
http://www.opsi.gov.uk/si/si2006/20063306.htm


The National Health Service leaflet:

'Did you know that you may have to pay for hospital treatment whilst here?'

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4088998.pdf

Basically, what the above amounts to is, that in many cases any visitor, either wishing to reside temporarily or permanently in the United Kingdom, will often be required to provide evidence of comprehensive sickness insurance and that must include emergency cover.

If you are required to have ‘comprehensive sickness insurance’ surely, you can take a private medical policy when you arrive?

 
If you are required to take out private medical insurance as a condition of residing in the United Kingdom, unless you have been “Ordinarily resident” in the United Kingdom and registered with a U.K. General Practitioner you will be unable to take out domestic United Kingdom private medical insurance.
 

In many cases, particularly if you are coming to the United Kingdom from outside the EEA/EU, you will be required, as a condition of obtaining a Visa, to provide documentary proof that you hold current and sufficient comprehensive sickness insurance before you receive the visa.


 

The Solution

Our recommended plan is the SevenCorners “Liaison Majestic” plan, a policy designed to cover individuals and families whilst travelling outside their home country.
 
Seven Corners, Inc. began offering international medical insurance to the worldwide community in 1993. Previously known as Specialty Risk International Inc. (or SRI) up until January 1st, 2007. SevenCorners is an American company which was founded by international insurance professionals with a strong commitment to customer service and a belief that the public deserved reliability when purchasing international insurance.
 

 
The plan itself can cover any period from five days up to three years - for those over 65 years of age; Liaison Majestic is only renewable up to one year.
 
 

 
The geographical extent of the cover is worldwide, normally excluding the United States, unless that option is selected.

The plan itself has several overall medical benefit maximums, of $60,000, $125,000, $600,000 and $1,000,000 along with voluntary deductibles ranging from $0, $100, $250, $500, $1,000 and $2,500, which provides a wide enough scope of options to suit any budget.
 
As you would expect, the plan not only covers inpatient and outpatient costs, but also, hospital board, intensive care, emergency medical evacuation and repatriation, dental (accidental coverage), restricted home country cover, return of mortal remains, emergency reunion, accidental death and dismemberment, local ambulance expenses, coma benefit, felonious assault benefit, terrorism, and even interruption of trip and limited coverage for checked in baggage.  The above are explained, along with their respective benefit limitations, in the attached Liaison Majestic brochure.
 
Exclusions
 
As with all fully underwritten medical insurance policies, pre-existing medical conditions are not covered by the plan.  They are specifically defined as meaning “any condition that would have caused a person to seek medical advice, diagnosis, care or treatment during the 36 months prior to the Effective Date of coverage under this Plan; 2) a condition for which medical advice, diagnosis, care or Treatment was recommended or received during the 36 months prior to the Effective Date of coverage under this Plan.”
 
However, if you are a U.S. citizen and travelling outside the United States the period is lowered from 36 months to 12 months prior to the Effective Date of Coverage.
 

Quote & Buy for Immediate Coverage




The above is offered as guidance only and no liability is accepted under any circumstances for any errors or omissions contained therein.
 








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