mmhendrie

Folks,

Brit LPR living in CA., moved to the States from UK 13yrs ago. When I left, NHS was very much a "just turn up and get treated" situation.

Haven't given it much thought in the past, but the end of 2010 my wife (US Cit) and I had a baby. We're hoping to visit the UK this April. My son is dual cit, but as yet doesn't have proof of British citizenship, and won't have it before our trip.

Can anyone fill me in on the situation with the NHS now? I've heard things about NHS cards etc. mentioned. If my son gets ill, can we just take him to the NHS for free, or has all that changed? What about if my wife or I gets sick?

Should we now be purchasing health insurance on trips as folks from the UK visiting the States would do? Do US health insurers typically cover trips abroad?

thanks,
Matt

avanutria

I believe that since you are no longer a resident, if you seek NHS treatment for anything you're supposed to inform them of that fact so they can bill you. How often this is actually done or enforced, I don't know.

I would be extremely surprised if your US coverage covered you overseas. If you're worried you might need health care while travelling I would recommend you look into appropriate travel insurance.

Mummy in the foothills

Ds got sick on Christmas day while we were visiting when he was two. The on call doctor came to the house and charged us, it was £75 or something like that ( it was years back) then gave us a private prescription and told us where would be open till noon and we paid a small amount for some antibiotics.
Dd I took to the emergency room (2009) but never got as far as the doctor, we told them we were from the US, so no local permanent address. her dislocated elbow went back in place while we waited, the receptionist had said depends on the doctor whether we would have been charged or not she wasn't sure how much.
Our Blue cross medical ins (in 2009) said we were already covered for international trips and so didn't need to buy anything else, how they would have been to claim from I have no idea

Michael

Most US health insurance plans cover you overseas at the out of network price. However, you will have to pay for it, get medical bills, and then bill the insurance company yourself.

limeynus

when I last went back at christmas I got myself travel insurance - it was about $35 for 2 weeks. My US medical insurance said they would only only cover for initial emergency care at 100% of bill charges, however they didn't explain what "initial emergency care" actually covered and that left me a little worried.

Edited to add: I got my insurance through HTHtravelinsurance.com and their website was such that you could tailor your coverage to your needs somewhat.

SanDiegogirl

You are no longer eligible to use the NHS.

The NHS will treat visitors who need emergency treatment. They will stabilise at no cost, but if inpatient treatment is needed that is charged for.

For everyday sickness - coughs, colds, sore throats, upset stomachs etc etc - if you call a doctor or use an emergency room you can expect to be charged.

Your US health plan may cover overseas treatments. My previous Group health plan did, my current individual health plan does not. Expect to pay for everything when you are overseas and then claim back from your insurer. If you are not already insured, take out travel insurance. Again you will pay up front and then get re-imbursed.

MarylandNed

Just echoing what you've already been told. You're not covered by the NHS anymore. Travel insurance is pretty cheap and it's really not worth the risk going over there without it - especially with an infant.

Bob

The ER would be free.

Would need travel insurance to cover repatriation costs for anything a bit more significant though.

Yorkieabroad

I'll throw in a counter-view to all that...and its one of the few criticisms I have of the NHS. In my experience (see below) they don't know how to charge which I think is appalling given the funding crises some areas are in!

We've used the NHS a few times when we've been back visiting family - always for the kids - ear infections, strep throat, things like that, never anything major (odd that they never get sick here...only when we go away change in the germ pool?).

We have always been totally up front about being non-resident and therefore needing and being willing to pay. Our US insurance covers us at our of network rate on a reimbursement on presentation of supporting documents basis.

The only costs we have had have been a couple of times for prescriptions - normally we don't even pay these as they give us free samples instead! To be fair, we go back to a countrified area where there are very few oversseas visitors or holidaying expats, and I think it doesn't cross their minds to think that people may have to pay - when we mention it the staff invariably get a blank/confused look on their faces then move rapidly on as if someone had just farted in church....We always drop an appropriate lumpsum in whatever charity box they have on the counter, in lieu of payment to the NHS.

Once, when we were back for an extended 5 month visit I had a well check (including bloodwork, and an ECG) with the old doctor that I'd seen for donkeys years before moving overseas. I specifically wanted to do it this GP because he was the one that diagnosed a problem with my fathers heart when the cardiologists couldn't work out what was wrong He told me he would invoice me, but not to worry if I didn't receive it because the office staff were still working out how to make up an invoice....! When we were due to leave, I went down to see him again, and he told me they couldn't charge as they didn't have a system set up, so I dropped a large cheque in the collection box they had for a local kids charity. OK, the cash didn't go where it was supposed to, but it did partly assuage my guilty feeling at using a service I wasn't entitled to.

But the experience may be very diffferent in a hospital in a large city with regular overseas visitors coming through the door.

Jerseygirl

All visitors to the UK are entitled to free emergency treatment. Non emergency treatment is at the discretion of the doctor/clinic/hospital. In other words for non emergency treatment you may or may not have to pay for it.

IMO I would buy travel insurance...it's not worth the risk or worry...especially with children.

lisa67

Check with your insurance here. Ours covers us when we go back to the UK

Jerseygirl

Good point...so does ours.

CamVet

Charging people means needing an administration able to deal with things like generating invoices, receiving payment, dealing with customers on the phone, following up aged debtors, etc. In this case it gets even more complicated by the fact that all debtors live abroad, and are subject to and/or protected by a whole array of foreign laws which are very hard to track for every single country. Anyone who's ever ran a business knows this costs money. For many NHS trusts where overseas visitors are rarer than hen's teeth it may be cheaper not to charge !

Marocco

Legally, you are eligible for NHS treatment if you are "ordinarily resident" in the UK. There is no simple, precise definition of what that means, and the status also depends on the person's intentions. Of course, it comes with potential UK tax liabilities.

In order to register with a UK surgery, you normally need proof of identity, proof of legal status in the UK (for non EEA/Swiss citizens) and proof of address (e.g. bank statement or utility bill). Without proof of address, you won't be able to register. Even if you were registered with a surgery a long time ago, it's very likely that since then they have removed you from their list of patients.

Jerseygirl

This is the official answer I received from the NHS a few months ago.


It may be helpful if I explain that the NHS is regarded as first and foremost for the benefit of people living in this country. Entitlement to free GP treatment, NHS hospital treatment and subsidised dental treatment is based on residence in the UK, not on nationality, citizenship status, the payment of taxes or National Insurance contributions.

Overseas residents visiting the UK who require treatment that a GP or healthcare professional regards as emergency or immediately necessary treatment will receive that treatment free of charge. However, for other primary medical services, GP practices may accept (or decline) such people as registered patients in the same way as they make decisions about people who are permanently resident. If the practice does use its discretion to accept such an overseas visitor on to its list, the GP practice is required, under its contractual arrangements, to provide that treatment free of charge to the patient. If the GP practice does not wish to accept the overseas visitor on to its list, it can offer to treat them as a patient on a private, paying basis. General practice is expected to exercise this discretion with sensitivity and with due regard to the circumstances of each case.