Dealing with Glaucoma in UK

The EU Directive said only EEA/CH citizens who are worker qualified persons can have what a citizen of that member state can have, for themselves and all the thier family members..

The 2004 Directive states that those who are only students or self sufficient qualified persons must not be "an undue burden" to that member state and these must have Comprehenisve Sickness Insurance for themselves and every family member they brought with them (even if that non-EEA/CH family member is working). Do you remember how you looked into if your health cover was viewed as a CSI and bought (?) a CSI for your US citizen daughter?

Completely changed. There are no more "EU rights" in the UK. NHS England have also instructed their OVMs to take an EHIC for A&E for those who are visitiing, to claim those costs back from an EU country.  Not sure what NHS Scotland is doing. Some EEA countries have negotiated a deal for limited NHS treatment for their visiting citizens. Those arriving at the NHS with status under the Withdrawal Act, will need to prove to the NHS that they are living in the UK to avoid being charged (with 50% added), just as British citizens and those with ILR have to do.

Hi. Yes, we had CSI for both of us - it was a requirement for the self-sufficient settlement route for the Daughter to accompany me. London handled that as it was an immigration issue, and not a devolved power to Scotland. (If I'd gone alone, I could have availed of the agreement between Ireland and the UK - free movement - as I am an Irish citizen. That always felt a little shaky to me, given London's propensity to change the rules without much notice and the increasingly testy relations between UK and IE during Brexit. And I couldn't use it with my Daughter as she was too old at that point.)  To find an appropriate policy, the statutory language at that time said that it had to be truly comprehensive - it needed to cover pretty much everything one would normally expect to deal with, as far as medical care. There was some wiggle room for pre-existing conditions, however, and also catastrophic illness/accidents. I did a lot of research and a lot of reading, and also discussed with the EU agency tasked with helping EU citizens living abroad. They were of huge help.  We went with Vitality, as it was the cheapest. They advertised telemedicine, but it turned out that was not available in Scotland. They also said they had several GPs you could see in person at no charge, but that turned out to be only in London. Most of the other perks (gym memberships, discounts, Ocado, etc.) also turned out to not be available in Scotland. BUT the policy ticked all the boxes and made the Daughter legal. I had Blue Cross free from my former employer.

Scottish law has it (at least it did then) that if you were living in Scotland with the intent to remain there, you were eligible for healthcare on the same basis as a citizen. Edinburgh handled that bit as that WAS a devolved power. 

Not sure what England did/does, but I have a vague recollection that it was much more draconian, all around.

In doing a bit of searching, I found that there's been court cases brought to the EU high courts related to CSI. There seems to have been a ruling that states that, in some circumstances, having access to the NHS is equivalent to having  CSI.  Lifting liberally and editing for space, from a lawyer's page:

"The preliminary ruling of the Court of Justice of the European Union in C-247/20 VI v Commissioners for Her Majesty’s Revenue & Customs concerns the interpretation of EU law in relation to the requirement of comprehensive sickness insurance cover (“CSI”) in the host Member State."

"The UK’s position has so far been that access to the NHS is not sufficient to meet the requirement to have CSI and that economically inactive Union citizens (students or self-sufficient persons) and their family members needed private comprehensive health insurance (alternatively, a European Health Insurance Card for persons who did not intend to stay in the UK permanently, or to be covered by reciprocal arrangements)."

and

"Having established the interpretation of the Directive and Article 21 TFEU regarding in what circumstances and to whom the requirement to have CSI applies, the Court turned its attention to how the requirement can be satisfied. It confirmed that the requirement to have CSI is satisfied when the child has CSI that covers the parent and vice versa. The documents before the Court showed that VI and her son were affiliated with the NHS; the UK’s public sickness insurance system offered free of charge, in the Court’s words."

"The Court confirmed that it is open to the host Member State to make affiliation to its public insurance system of an economically inactive Union citizen subject to conditions, to ensure that the citizen does not become an unreasonable burden on the public finances of the host State, provided these conditions comply with the principle of proportionality. The maintenance of comprehensive private sickness insurance enabling the reimbursement to the State of health expenses incurred, or contributory payments to the public sickness insurance system were given by way of examples.

Notwithstanding this, the Court unambiguously confirmed that once a Union citizen is affiliated to such a public sickness insurance system in the host Member State, he or she has comprehensive sickness insurance within the meaning of Article 7(1)(b)."

and

"In practice this ruling could mean that, even if  a person did not previously have a right to reside in the UK under EU law solely on the basis of not meeting the requirement to have CSI, once they are registered with or otherwise access the NHS, the requirement to have CSI is satisfied and the person acquires a right of residence. Whilst there are charges imposed for some types of NHS treatment to people that are not lawfully or ordinarily resident in the UK, there were no charges for individuals that had a right of residence in the UK under EU law (when that was applicable). Such an obligation to pay for NHS treatment would, thus, have been extinguished immediately by the very fact of having accessed the NHS, provided that that conferred a right of residence by satisfying the CSI requirement."

and

"The question of whether the requirement of the first limb of Article 7(1)(b) is also met, namely that the person has sufficient resources for themselves and their family members not to become a burden on the social assistance system of the host Member State, is distinct and has to be considered, in accordance with the principle of proportionality. The Court confirmed that, in circumstances such as those of VI and her family, access to the NHS free of charge, in and of itself, does not amount to an unreasonable burden on the UK’s public finances. Nonetheless, this will be fact specific and in different circumstances, a different conclusion could be reached."

So I think that some serious legal consultation would be in order before I bought CSI or went without it. If I was an EU citizen, which the OP is not. (I don't think.)

REF:  01 Apr 2022  https://immigrationbarrister.co.uk/comprehensive-sickness-insurance-csi-cover-and-the-nhs/

 (If I'd gone alone, I could have availed of the agreement between Ireland and the UK - free movement - as I am an Irish citizen. That always felt a little shaky to me, given London's propensity to change the rules without much notice and the increasingly testy relations between UK and IE during Brexit.

That seems to have been the thoughts of the Republic of Ireland too. As this was only an agreement, when they realised that there was no stopping Brexit, they asked the UK to put this into law for irish citizens.

Some on forums have recently been discussing about how the UK has been opposed to immigration for over a hundred years, regardless of which political party was in government. It seems citizens of a few countries used to be able to just move to the UK, but now Ireland is on the only country, so you could be right.

I thought that perhaps the other EEA countries might object under the EU's equalities law, to Irish citizens still being allowed to move to the UK,

In doing a bit of searching, I found that there's been court cases brought to the EU high courts related to CSI.

All the other EEA countries have insurance based national healthcare and that made the NHS a target.

Not everyone is as honest as you and your daughter. It was quite common to see posts from EEA citizens and their Family Members who should have CSI but didn’t bother and it was quite easy to get NHS treatment without paying. If they got caught without CSI, they bought CSI and that meant they could remain in the UK under EU rules. Then they could cancel the CSI. But Brexit happened.

The UK is asking for proof of CSI. Not having a CSI when required, can mean they are not of good character.
Page 50
https://www.gov.uk/government/publications/good-character-nationality-policy-guidance

Discretion can be given in their favour over their failure to have CSI and I did read somewhere that the UK will not refuse citizenship based solely on not having CSI, which seems to suggest it will be used if the UK wants to use this in combination with something else. Similar perhaps to the UK requesting all their criminal record in other countries for the EUSS?

So I think that some serious legal consultation would be in order before I bought CSI or went without it. If I was an EU citizen, which the OP is not. (I don't think.)
 

The UK doesn’t need to use these EU "CSI" rules anymore.

If you are living in the UK on a valid EUSS pre-settled  or  valid settled status, you can use the NHS bill free.

Those wanting to live in the UK are the same now as other immigrants, need a sponsor *, visa and pay the health surcharge for at least 5 years.

Those visiting need to pay and that includes visiting British citizens (unless they have an exemption). EEA citizens can use their EHIC from an EEA country to pay. Some EEA countries made a better deal with the UK for their citizens than the EU did for the 27 EU countries.

England brought in charging regulations and NHS England must now refuse treatment if they are not allowed to use the NHS bill free, unless the full estimated cost plus 50%, is paid in advance. If it is urgent treatment and they cannot fly home because of that medical problem, treatment is given to enable them to return home, but they are billed and 50% is added.
This is the guidance on implementing the overseas visitor charging regualtions in England for health and for social care,  if you want a read.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1077186/overseas-nhs-visitors-charging-regulations-guidance.pdf


The UK government recommends that visitors take out health insurance, to be able to claim the money they paid to the NHS from their insurers.


* I should have added that there is another visa than can be applied for that can lead to settlement in the UK, the Innovator visa.

You can apply for an Innovator visa if:

    you want to set up and run an innovative business in the UK - it must be something that’s different from anything else on the market
    your business or business idea has been endorsed by an approved body, also known as an endorsing body
    you meet the other eligibility requirements
https://www.gov.uk/innovator-visa
 https://www.gov.uk/innovator-visa/eligibility

Ah, well. It's unlikely we'll be back. I had thought that if the daughter got a job where she traveled a lot I might just sneak back to Scotland. But with things are they are in the world, I don't think that's a good idea anymore, and she's no looking like she's going to get that kind of job anyway (for the same "world" reasons).

Speaking of, and this is WAY off topic, it sure seems like things are imploding over there today.  The daughter has been sitting in front of the TV knitting, and I think that, besides a big bowl of popcorn, the only thing that would make her happier right now is if there was a run on tar and feathers in London. She says, and I'm paraphrasing, "Well, good! That man ruined my life. I hope they rake him over the coals."  I think she may mean that literally. 

Pound is at $1.19 and still dropping slowly, too.

Speaking of, and this is WAY off topic, it sure seems like things are imploding over there today.  The daughter has been sitting in front of the TV knitting, and I think that, besides a big bowl of popcorn, the only thing that would make her happier right now is if there was a run on tar and feathers in London. She says, and I'm paraphrasing, "Well, good! That man ruined my life. I hope they rake him over the coals."  I think she may mean that literally. 

I figured the press in the US must have been quite dramatic, my mom messaged to make sure I was okay. Had to explain that the government upheaval had very little impact on my day to day on the outskirts of a town an hour from London.

I figured the press in the US must have been quite dramatic, my mom messaged to make sure I was okay. Had to explain that the government upheaval had very little impact on my day to day on the outskirts of a town an hour from London.

Yeah, actually it's been rather restrained. There was a bit on the Nightly News, but it wasn't the lead story on the channel I watched - it could have been on another. Lots going on in the world, especially relating to guns, so....  Perhaps your mom saw something we didn't. A lot of people here don't understand the concept of a "government falling" ala UK style. They think in terms of like a coup, where the military takes over. That kind of thing, I think. They don't quite get that the civil service just keeps ticking over and things just keep getting done and that it's just the politicians who get sacked.

There has also been some coverage of blockades on the motorways, NHS overstretched, heating fuel prices going through the roof, etc., but only in passing. And some about NI. But all that doesn't make nearly the flashy headlines that draw viewers in (and thus make the news attractive to the merchants who buy airtime during the newscasts who want the most viewer headcounts for their money).

We watch the UK news a lot, though. (Sky, BBC, and via France TV and Euronews). So the Daughter was watching Sky, which had a "minister quit" counter up in the top corner of the TV screen that was ticking up, periodically. Seriously, I haven't seen her that gleeful in months. Warmed the heart, that did.