NHS coverage - howzit work?

Hi,

Pardon me if this has been answered before, but,  how does NHS healthcare coverage work? I mean for primary care coverage. Does one pay a monthly fee and then a subsidized amount for each service?  The only NHS fee info I've been able to find online are charges for eyecare and dental care, nothing about dr's visits, primary care and hospitalization.

I have never worked in the UK so obviously have never contributed any healthcare taxes, so I was wondering how that affects qualification for NHS, and how I should plan for coverage for my wife and I when we (ultimately) move there.  Is NHS open to us or would we have to consider private insurance?

ta
litirte

What kind of visa will you be on when you come here?

As you and your spouse are both EU nationals, you do not have to pay to use the NHS when you move here.  As you are planning to move to Scotland, however, and are of an older age, I would consider very seriously where you move, as healthcare services in rural areas can be a bit more sparse depending on location.  Dental care is particularly difficult to come by in rural regions.  In North Berwick, a healthy-sized down in the Borders for example, new patients have to make a 60 mile journey to England for even routine dental care, as there is an acute shortage of services in that area. 

Thank you for clearing that question up.  Availability of services, medical and otherwise, is high on our list of priorities in choosing a location.  I'd be interested in hearing of any positive experiences in Scotland. Somewhere I ran across a very positive report on the services provided by NHS in Broadford (Skye), so it sounds like these do exist.

You mentioned "new" patients in your Berwick example as having to look elsewhere. Is this because there is no capacity left in Berwick? If so is this a common occurrence, i.e. local services being closed to new patients?

In contrast, my medical coverage here at home in the US just changed again, in a cost-cutting move on the part of the company I retired from. This will make the third time in the last four years that it's changed and each time we've had to change doctors, adjust to new charges etc.  This time the monthly premiums went up 25% and, since we went from an HMO to a company self-insurance  plan, we now also have to meet annual deductibles, which are quite a burden. On top of that, we pay for our own dental coverage and vision care and we travel the 60+ miles into Boston to get those. As I look towards Medicare in a couple of years  the picture gets even bleaker. NHS sounds so much more humane!

Thanks again
Litirte

We have a member who lives up in the Highlands who may be able to shed a bit more light on the situation up there.  I'm in Edinburgh, and as a large city it's never been a problem to access healthcare, but it can be in some areas.  I just registered at the same surgery my husband's gone to all his life and his parents before him.

There's a major shortage of dental care/dentists in a lot of areas.  So they can't take on new patients - only treat existing ones.  People don't tend to move around as much as they do in the States - you'll find many who have been going to the same surgery (as the doctors' practice is called here)/dentists their entire lives and for several generations. 

Berwick is in England.  It's just over the border - lovely place!  North Berwick is a small town outside Edinburgh - en route to Berwick-upon-Tweed.

Yes, if dental care is a huge priority, prepare to pay for private care or find a place you know you can get NHS coverage. There is a huge shortage of NHS dental care UK-wide. It is a very serious problem.

Generally, the NHS works on a 'free at the point of access' basis, i.e. you walk into a NHS hospital or medical centre, and consultation/treatement is free, regardless of whether you work or pay taxes.  There is, however, a fixed cost for prescriptions (currently £6 or so) and you have to pay for dental care (either a fixed NHS cost or a cost levied by the dentist).  My American wife has NEVER been asked for ID or proof of residency to qualify for treatment and we've even been able to take visiting relatives to see our doctor at no cost.  I think we have been lucky and it has certainly helped that I am a UK citizen and we have registered with a GP together.

I think there are rules on eligibility.  My simplistic understanding is that if you are here as a temporary resident or from the EU, you are entitled to the same care as UK citizens.  You may want to check on the NHS website or with the UK Embassy - there's stuff on this web site too.  Like I say, we have never been asked to prove eligibility, but I think the NHS may be 'tightening up' and may check, but I can't see staff asking to check documentation before treatment - the system just isn't like that here.

The key to healthcare here is registering with a GP, who then refers you for treatment. Unlike the US, patients very rarely self refer and if they do, it would have to be on a private basis.  So, the most important thing is to get a good GP!  When you move, don't rush to register with the nearest GP, but ask your neighbours/colleagues, who they would recommend.  If you're not happy with your GP, you can change.  This is the theory, but you may find that in practice, it can be tricky as there may be no other choice!  We have had some mediocre GPs, now have an excellent one and are generally very happy with our family's medical care.

I also have private healthcare through from my employer, which just means that a referral can be made to a private hospital and you may get seen more quickly.  However, my experience of private healthcare so far has been bad - too many forms to fill out to be approved for consultation and then referred to some hospital miles away, when I could have gone to the NHS hospital in my town and probably be seen by the very same doctor!

Anyway, everyone has experiences to share of the NHS, so scan some of the other threads to get a wider picture and good luck with the move!

I think there are rules on eligibility.  My simplistic understanding is that if you are here as a temporary resident or from the EU, you are entitled to the same care as UK citizens.  You may want to check on the NHS website or with the UK Embassy - there's stuff on this web site too.  Like I say, we have never been asked to prove eligibility, but I think the NHS may be 'tightening up' and may check, but I can't see staff asking to check documentation before treatment - the system just isn't like that here.

Litirte is an EU national, as is his spouse.  They are entitled to NHS treatment just as a UK national is.

Hi,

I live in Inverness, and have found that there are no NHS dentist taking new patients at this time, just the same as a large portion of the UK.  I have found, however, that registering with a doctor's surgery is much easier than when I was in London.  The care my family and I have received has been great, never having to wait more than a day to get in to see a doctor in a pinch.  There are down sides to the NHS like waiting lists for testing, therapy and seeing specialists which can be difficult to deal with.  I am a nurse and hear horror stories from my patients about how long they have been on lists, but with a little tact and persistance, some times waits can be shortened.  Both systems have the good and bad points, you just have to figure out the best way to deal with them.  Best of luck!

Sorry for the tardy acknowledgement! I appreciate all your responses - they are very helpful, as usual.

Some of the NHS down-sides don't sound much worse than what we experience in the US. But,  if the NHS service does fall short sometimes they at least don't demand one's first-born in payment, as they do here in the US. Our first-born is really, really getting tired of being handed around!


Litirte