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-   -   NHS prescriptions/Student Loan Company/HMRC (https://britishexpats.com/forum/usa-57/nhs-prescriptions-student-loan-company-hmrc-772965/)

Zep1988 Sep 27th 2012 5:17 pm

NHS prescriptions/Student Loan Company/HMRC
 
In the midst of preparing for the big move (this Feb) on an H1B visa, I recently read something on here which suggested (it didn't say it explicitly) that as soon as I move I won't be entitled to healthcare on the NHS, regardless of any national insurance I have contributed in my life. Firstly, is this true, or is this only for moves that are on 'resident' (the h1b is non-resident) visas? In other words, do I then need travel insurance that covers health care every time I visit home?

This brings me to my next question; I have asthma, it isn't a serious condition for me but I do need an inhaler. I heard something about prescriptions being really expensive in the US, even with health insurance (which is covered by my employer). Just how expensive is it likely to be for me?; I currently need one preventative inhaler per month which costs £7.60 or something, plus the occasional blue one when my asthma is bad, also £7.60 but lasts for months. Until I read about not being entitled to NHS, I was hatching a plan to get a pre payment certificate over here and just have my parents order and post them to me. In the event that I am entitled to NHS is this such a bad idea? In the event that I am not entitled to it, what is to stop me just never telling anybody in the NHS I'm leaving? I am registered at my parents address so it's not like I'm selling my house or anything.

Along a slightly different line, there is a lot of chat about how I need to inform HMRC I'm leaving for tax reasons. This is fine. Does this automatically mean the Students Loan Company will know as well? I'm NOT trying to avoid paying back my student loan (I do hear its possible if you are out of the country), I acknowledge that I owe the government money, but it would be nice to have a few months respite while I get myself on my feet in the US.

Sorry for the essay, in the grand scheme of things these are tiny problems but I would greatly appreciate some clarification!

GeoffM Sep 27th 2012 5:27 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by Zep1988 (Post 10303279)
In the midst of preparing for the big move (this Feb) on an H1B visa, I recently read something on here which suggested (it didn't say it explicitly) that as soon as I move I won't be entitled to healthcare on the NHS, regardless of any national insurance I have contributed in my life. Firstly, is this true, or is this only for moves that are on 'resident' (the h1b is non-resident) visas? In other words, do I then need travel insurance that covers health care every time I visit home?

NHS cover is based on residency, not taxes paid. As you'll be out of the country for more than 3 (?) months, you'll lose NHS cover. You'll get it back the day you permanently move back to the UK. Think of it like car insurance: it's only valid while you're paying it. Yes, you should have travel insurance for visiting the UK - but be aware that health insurance in the US may include travel cover automatically (check your policy).


Originally Posted by Zep1988 (Post 10303279)
This brings me to my next question; I have asthma, it isn't a serious condition for me but I do need an inhaler. I heard something about prescriptions being really expensive in the US, even with health insurance (which is covered by my employer). Just how expensive is it likely to be for me?; I currently need one preventative inhaler per month which costs £7.60 or something, plus the occasional blue one when my asthma is bad, also £7.60 but lasts for months.

My son recently got an aerochamber as part of his prescription. Cost for a plastic tube: $38 - and that's with a health plan. Anyway, check your health plan again to see what prescriptions cover - ours are $10 copay which is on a par with what you pay for NHS prescriptions. Yours could be more or less.


Originally Posted by Zep1988 (Post 10303279)
Until I read about not being entitled to NHS, I was hatching a plan to get a pre payment certificate over here and just have my parents order and post them to me. In the event that I am entitled to NHS is this such a bad idea? In the event that I am not entitled to it, what is to stop me just never telling anybody in the NHS I'm leaving? I am registered at my parents address so it's not like I'm selling my house or anything.

Nothing to stop you doing that except your own honesty and integrity.

Before you leave, ask your GP for a 3 month supply as you'll be moving. They sometimes prescribe more but at their discretion.


Originally Posted by Zep1988 (Post 10303279)
Along a slightly different line, there is a lot of chat about how I need to inform HMRC I'm leaving for tax reasons. This is fine. Does this automatically mean the Students Loan Company will know as well? I'm NOT trying to avoid paying back my student loan (I do hear its possible if you are out of the country), I acknowledge that I owe the government money, but it would be nice to have a few months respite while I get myself on my feet in the US.

People here have posted about how they have paid their student loans from abroad. You tell the SLC and agree a payment plan with them, but the specifics I do not know.

Weeze Sep 27th 2012 5:32 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
Student loans- tell the company direct. I still ask them to use a UK address as otherwise correspondence can take forever to get here.

Asthma- pretty difficult to tell you how much your inhaler will be as it will depend on your medical coverage. I got one when I first moved over which I remember being pretty expensive even just at a 20% copay.

NHS-You are entitled to use the NHS for a few years after leaving the UK from what I remember (when you are in the UK). Claiming drugs on it when you are not in the country and getting them shipped sounds pretty illegal to me. Aside from the moral issue, i would have thought the customs declaration would be fun. Why not ask your doctor for a reasonable supply to bring over to give you chance to get yourself sorted?
http://www.nhs.uk/NHSEngland/Healthc...roduction.aspx

Edit: just seen Geoff's post, Opps, I thought NHS care went on for longer if it wasn't a permanent move.

GeoffM Sep 27th 2012 5:47 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by Weeze (Post 10303301)
Edit: just seen Geoff's post, Opps, I thought NHS care went on for longer if it wasn't a permanent move.

Hmm, you might be right:
http://www.adviceguide.org.uk/wales/...rom_abroad.htm

normally work in the UK, but are temporarily working abroad for less than five years. You also need to have lived in the UK continuously for at least ten years before going overseas.
:confused:

Zep1988 Sep 27th 2012 5:53 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
Thanks for responses so far. I personally don't see a 'moral issue' with the prescription plan at all, I've paid National Insurance for years and will still be a British Citizen, I'd even be willing to continue paying NI if that was possible (?), but you do raise a good point about customs. Perhaps I'll ask my doc for as many as he can give me and then be prepared to take the financial hit when I get over there. I haven't actually had the chance to look over my US health insurance policy yet, but given various testimonials of the company I am going to work for as an employer I am not worried.

Zep1988 Sep 27th 2012 5:55 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by GeoffM (Post 10303324)
Hmm, you might be right:
http://www.adviceguide.org.uk/wales/...rom_abroad.htm

:confused:

That says for 'hospital treatment' though, which presumably doesn't cover prescriptions!

Sheepdip Sep 27th 2012 5:56 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
good link - also like the bit about free treatment if you get a UK state pension (not that I'm there yet or if it will still be the case when I do :) )

Jerseygirl Sep 27th 2012 5:57 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
Just to be clear NI contributions have little to do with the NHS. NI pays for child benefits, unemployment benefits and other social services. UK income tax finances the NHS. Once you leave the UK to live in the US you are no longer a UK resident and therefore cannot use the NHS.

The cost of meds depends on what they are, who you buy them from, whether you have meds insurance. I have asthma and pay nothing for my inhalers.

Be very careful about getting meds sent to the US. They may or may not be allowed.

dunroving Sep 27th 2012 6:08 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by Zep1988 (Post 10303333)
Thanks for responses so far. I personally don't see a 'moral issue' with the prescription plan at all, I've paid National Insurance for years and will still be a British Citizen, I'd even be willing to continue paying NI if that was possible (?), but you do raise a good point about customs. Perhaps I'll ask my doc for as many as he can give me and then be prepared to take the financial hit when I get over there. I haven't actually had the chance to look over my US health insurance policy yet, but given various testimonials of the company I am going to work for as an employer I am not worried.

Maybe you missed it in the earlier post, but emtitlement to NHS treatment is based on residence in the UK, not citizenship, and is unrelated to how much taxes or NI you have paid in the past.

You can continue paying NI while being resident overseas, but this has no relevance to NHS entitlement.

You should read your new employer's health insurance policy. Some include pre-existing conditions. Most will cover them, but some have a clause that says you aren't covered for pre-existing conditions for the first 6 months (for example). In that case, you'd be paying full whack for any prescriptions related to your asthma. However, some also waive this if have previously been covered by health insurance elsewhere. From many posts here on the topic, US health insurance companies will take into account NHS "coverage", but usually require confirmation evidence (e.g. a letter from your doctor).

Use the Search facility and you'll learn a lot of things you really should be thinking about and/or doing regarding coverage for health treatment in the US. It's easy to get complacent about health care when you are used to the NHS, but the US is a whole different ballgame, as they say.

GeoffM Sep 27th 2012 6:09 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by Zep1988 (Post 10303333)
I personally don't see a 'moral issue' with the prescription plan at all, I've paid National Insurance for years and will still be a British Citizen

That's irrelevant for the reasons already posted. If you're not entitled then it's as simple as that. You don't get to decide whether you should be entitled.

As JG's and my examples showed, it might cost you more to get stuff imported anyway, regardless of the issues involved with that. You say you're not worried about your plan but you really should read up on it as health care in the US is a huge factor in your life and wallet.

Jerseygirl Sep 27th 2012 6:14 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by Zep1988 (Post 10303333)
Thanks for responses so far. I personally don't see a 'moral issue' with the prescription plan at all, I've paid National Insurance for years and will still be a British Citizen, I'd even be willing to continue paying NI if that was possible (?), but you do raise a good point about customs. Perhaps I'll ask my doc for as many as he can give me and then be prepared to take the financial hit when I get over there. I haven't actually had the chance to look over my US health insurance policy yet, but given various testimonials of the company I am going to work for as an employer I am not worried.

Again be careful about what meds and how much of them you bring into the US. Some meds dispensed or even bought without prescription in the UK are not allowed in the US. ie meds containing codeine. If the meds are allowed the quantity will be limited. You cannot bring as much as you can lay your hands on. Google search for the US Gov website for guidelines.

Bink Sep 27th 2012 6:47 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
I can only help in regards to my personal experience of Student loans. They don't like you not paying it - they may try and hit you up for the months you miss payment on if you try and delay it, but I reckon so long as they're getting some money in on it and it's being paid back they probably won't bite down on you too hard.

There's an oversees repayment form you have to fill out and send to them: http://www.direct.gov.uk/prod_consum.../dg_078083.pdf

They wanted the money monthly from a GBP account for me but I believe they now accept foriegn transactions too. My monthly repayment was quite high, I will warn you. The earning threshold is much lower in the US than it was in the UK. I ended up clearing it with savings as I only had 5 grand or so left to pay.

Zep1988 Sep 27th 2012 7:04 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
OK. Well it certainly seems like my idea had a good few holes in it, thanks for clearing that up! And thanks for the student loans info, I'll probably just fill in the form, no doubt it will take them eons to actually get back to me anyway so that will give me at least a bit of a break.

civilservant Sep 27th 2012 10:10 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 
Isn't it illegal to ship medicines paid for by the NHS out of the country?

If not it really should be. I seem to remember it being illegal in Australia as so many go to Indonesia/China etc.

mikelincs Sep 27th 2012 10:24 pm

Re: NHS prescriptions/Student Loan Company/HMRC
 

Originally Posted by civilservant (Post 10303653)
Isn't it illegal to ship medicines paid for by the NHS out of the country?

If not it really should be. I seem to remember it being illegal in Australia as so many go to Indonesia/China etc.

People moving abroad are usually advised to get three months meds before they move, this is to cover any time lag between arriving and your health care getting sorted out, I know that when we moved within the EU, we took three months. You certainly can't post or send meds abroad, but you can take them with you, depending on the laws of the country you are moving to.


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