If I live between 2 countries can I still use the NHS?

[Reluctantnomad]

I am engaged to marry someone from a different country. I have a serious chronic illness that means I can't survive in my DP's country depending on doctors there.

If I spend time in both countries when we get married, can I keep using the NHS even if I wouldn't be here 12 months of the year?

My DP can't live here - father to teens, and they are obviously the most important consideration in all this. Once they are finished school we can live wherever.

I am worrying.

My Greek friend lost his prescription medicine while in the UK. We phoned up the local GP, who said she was happy to see him and issue a prescription. After the appointment he went to the receptionist and offered to pay. The receptionist stared at him blankly and said that she couldn't take money from him, since she had no mechanism for registering money from foreign nationals. He then went to the chemist and was handed the prescription free, as he is over 65. Again, he tried to pay. Same story - the chemist simply didn't know how to register the payment, so he couldn't pay and got it free. He'd probably be damned as one of the foreigners coming in and fleecing the NHS, except he made every effort to pay.

Sorry, for my previous post I think that’s for emergency treatment,

Once you move, your gp will take you off their patients list immediately. So it would be hard to do this unless you had a permanent address you could use as yours.

Why wouldn't you be covered under your DH's insurance?

I'm in the states. Lots of British couples get relocated here by large companies. Large companies in the US provide their employees with private insurance that covers their families (which includes spouse but not non-married partners). Therefore, all the British women I know in the US have been covered under quite nice private insurance.

I don't mean to start debate about health care in American --- it is a mess and an embarrassment, but rather to point out that even though it is a mess, university educated professionals and their families have quite good care.

Canada's system is different, but there are still ways to be on the system as an immigrant (varies from province to province).

I think it would be useful to know which country the OP is hoping to move to. Or at least an approximate area of the world.

DJ some expat policies will cover pre-existing conditions but may have a qualifying period before accepting claims.

elisaveta my Australian parents visiting here tried to do the same. My mum got chicken pox and was really poorly. In Australia even though there is medicare you pay a 'gap' for GP appointments etc. We tried to see if we could pay something here as we felt that was only fair and could not, everyone just said it was not possible to contibute or pay etc.

Elisa, that’s a very unusual story. Having lived abroad the process is you have to emergancy register with a gp for them to be able to see you and issue a prescription. Payment is then taken as normal.

A gp issuing a prescription to a non patient and a pharmist giving out free drugs is way outwith the simple normal process. All they had to do was fill in the form to register him as a temp patient and it’s job done. Every surgery knows this, because if you fall ill in one part of the uk and need to see a doctor but don’t live there, the surgery will take you on as a temp patient.

I suspect your Greek friend is having you on.

Bluntness he was exempt from payment of NHS prescription charge as over 65?

In my experience too, gps have no way to charge or process payments for this sort of thing. They're just not set up for it.

Currently all though you are not entitled you might get away with using the NHS but in this current political environment I'm expecting the pressure on hospitals to chase for payment for overseas visitors and to check for entitlement is going to increase.

It's the United States. We would of course get the absolute best in insurance, we have looked at this already and would buy that without question.

However, in light of recent developments, it's left me scared that if policy changes again, insurance companies might be allowed to exclude my condition when I go to renew my insurance next time round. Making it unaffordable to stay alive, quite frankly.

It's not that my DP would just be happy to leave the kids once they have left school and are at college we have discussed this extensively and they would be well able to visit, and us to go to them, once they leave their home city during university holidays. They won't be around for day to day contact when they go away to study. So please don't patronise me on that side of things. I think it's pretty reasonable for a parent to move to a different city once their children leave school and go away to study. They are always going to be welcome to come and stay or live with us, should they so choose, wherever we are.

My kids used the nhs while they were here over the summer (they came for 6 weeks) whenever we lived abroad. My gp knew they lived overseas and basically said it was too much hassle (small gp surgery, probably not too many overseas/foreign visitors).

I don't want to 'get away' with anything though. I just am interested in knowing the legalities of who is and isn't entitled, especially those who move between two places, but it seems I wouldn't be. Okay, back to the drawing board then.

Cambridge Uni have a good overview here: www.hr.admin.cam.ac.uk/hr-services/relocating-uk/living-uk/healthcare/eligibility-nhs-treatment

Be very careful with American insurers - most will mark you ineligible for any domestic policy if you are deemed to be a UK resident and international policies are very expensive.

It would really help to know which country. There may well be people on here who live there and can give you more info about whether you'd be covered.

I wouldn't be moving to a country if I wasn't sure their health system could offer me the treatment I needed.

Ah cross-post.

I'm in the US and I have worked in insurance. Would you be on your DH's work-provided insurance? If so, it has to cover pre-existing conditions, and I don't see this rule changing even with the Republicans in charge.

If OTOH you would be buying your insurance on the private market then I'd be more worried.

I suspect surgeries in areas where foreign visitors are rare, will not know how to take payment. That is certainly not the case in areas where foreign visits are common. I know the GP surgeries around me ask to see all documents if there is any question that you might not be a resident e.g. newly registering but no previous surgery to transfer existing records from.

Yeah, DP is self employed, so we'd be buying it ourselves.

OP, I speak as someone who's lived abroad for 40 years but who still has a house in the UK thats used for short holidays. You are not entitled to NHS care when you make your move overseas. You would be able to access it in an emergency but there would more than likely be a member of hospital staff sent to your beside to ask how you intend to pay for your care. If you needed to see the GP you could register as a temporary resident but given it can take weeks to see a Dr in the UK you might be there a while.

I have all of the family insured so that is something goes amiss when in the UK we dont have to worry. But a few weeks ago for e.g. when I was in the UK and I became really unwell and needed to see a GP ( I wasnt ill enough for A&E) I called our local surgery to be asked if I could be registered on a temporary basis. I was but they wouldn't take any money for it even via the insurance. No one seemed to want to spend time on the paperwork so I just put 100 pounds in a charity tin on the receptionists desk and left it at that. I'd read something previously that an appt cost the NHS about 47 pounds so i added extra for inflation as well as keeping it in line with what a private GP appt might cost. I was told there was no need to be doing what I did but i felt strongly about it but even now its not sitting right as it didnt go into NHS coffers.

I am now aware however that there are private GP's available in the Uk that you can access through BUPA - but you dont have to be a BUPA member to use them. You just need to be able to pay for the appts and any medication prescribed on a private prescription.

bluntness - no, he wasn't. Was with him at the time, and his experience is replicated by others on this thread.
And actually now I remember - when we were living in Ireland, we were visiting my parents and my son fell ill and we took him to the local GP who just smiled, and said that it must feel odd not to pay for treatment here in the UK. As it happens I did have our EHIC cards, but nobody asked to see them. That was fifteen years ago, but it doesn't seem as if very much has changed.

Yeah, DP is self employed, so we'd be buying it ourselves.

Hmm, yes that's tough.

I would probably still move, but be aware that I might at some point move back to the UK if the insurance rules did change.

Also, try to work out how much your treatment's going to cost, even with insurance. Our crappy-but-not-such-expensive-premiums insurance requires that we pay for the first $3000 per year per person of treatment. We do often get the treatments at a reduced rate negotiated by the insurance company but it still adds up.

left me scared that if policy changes again, insurance companies might be allowed to exclude my condition when I go to renew my insurance next time round.

Insurance in the US is in flux, and nothing would surprise me. However, before the Affordable Care Act (Obama Care) when insurance companies were allowed to exclude conditions, it was only for new policies for people who were previously uninsured, and it was excluded for a set period of time. If someone already had a policy, they continued to be covered. So if they went back to that rule, your insurance company would have to continue to cover you (though they could raise the rates to something absurd).

However, rates could go up for everyone, and buying insurance as a self employed person is risky in the US (which is part of what the Affordable Care Act was trying to fix.)

Would you work in the US? Do you have the skills and education to work for a large firm? I absolutely believe the safest and most cost effective way to have insurance in the US is through a large company.

Yes, I know. We have done plenty of research, it is because of what is going on politically that I'm slightly afraid. It seems that right now, people with pre existing conditions are safe - but it was all up in the air over the last few months so that could easily happen again. Nothing is very secure in America at the moment with healthcare, though when it works I think it is excellent.

Costings even with the best insurance plan are going to be about $5-600 per month for co pays and deductibles. That's okay. Without insurance medicines will be about $2.5k per month, and that's not okay.

Sorry Coyote I've xposted with you.

Yes I know they might technically have to cover me if I'm already insured with them, but they can just raise my premium to about $30k or something ridiculous.

I could work for a large company I suppose, I prefer to be freelance though.

I my opinion, unless either you or your boyfriend have the skill set and desire to work for a large company, it wouldn't be wise for you to move to the US. It's not just because of the current climate with health care, but because this is how health care has been for many decades in the US.

I'm sorry.

DP is a high earner and works on a consultant basis so works with big companies, just not as an employee

I don't want to be a huge financial burden.