Are you entitled to FREE NHS treatment on a work permit? (HSMP/Tier 1/Other)

I have many of the same questions as NYStacey did - are you still out there, and how did it go for you with the NHS?

I have a Tier 1 visa, and the very nice-looking surgery I went to today in Harrow is also giving me the runaround about employment. They say that I have to show that I am actively working to register, and that it's "dodgy" when, like me, you're self-employed (I'm currently writing and looking for freelance work, but haven't actually earned anything since I got here, except for payment for work I did before I moved a month and a half ago). I also suspect, if what previous posters have said is true, that asking for pay slips &c is probably not legal, but do I really want to play hardball with them?

The irony is that I work in health care, and I really want to blog, for a US audience, about my experience with the NHS! So I'm kind of hoping they don't screw up on me here .

well, I havent been to register with a GP but I will be doing that next week or so...
I anticipate no problems, though I do have a job now...but I've heard that should really be no problem.   Slightly related, Getting a NIN number was pretty quick and easy by mail...

I know I should have been to register to the GP earlier and even when I didnt have a job, at least to try my luck and be able to share my +/- experience, but I didnt...
I suppose I can still ask the same questions, and also wait and see what they ask of me, ex/including any proof or work, address, etc...

good luck as well!!!

Hi nystacey.  Please keep us posted, I am moving in one week and am still confused about the whole NHS situation.  I keep hearing its no problem but will not know until am there and try it for myself.  Anyways good luck and I will also post my experience once I go thru it. 

Cheers!

An update... I ended up playing hardball a little bit, by calling the local primary care trust (they have a Patient Liaison office) to doublecheck with them what the legal requirements were. They talked to their legal people, and also the surgery I had visited, and confirmed that all I needed was to demonstrate that I intended to stay for the long-term.

So, along with my passport, I went back to the surgery with copies of the bill of sale of my condo, the invoice from UPakWeShip, and a bank statement with my UK address on it. They were very nice (I was worried they'd think I was trying to get them into trouble) and passed along my paperwork to the NHS, saying I should hear from them shortly!

It was a little scary to think - as someone mentioned above - that the surgery receptionists might hold so much power re. who gets health care...

Well my experience was this - went to the local GP, submitted copies of passport and visa.  They were not sure what the process was but said they will call me back.  They called back and said that since I was unemployed I had to wait until Id been 6 months in the country - and then they would be able to register me.  They said that if I had a job they would have been able to register me inmediately but since i dont have one yet - i have to wait the 6 months

Well my experience was this - went to the local GP, submitted copies of passport and visa.  They were not sure what the process was but said they will call me back.  They called back and said that since I was unemployed I had to wait until Id been 6 months in the country - and then they would be able to register me.  They said that if I had a job they would have been able to register me inmediately but since i dont have one yet - i have to wait the 6 months

Which is incorrect.  If you have a settlement visa, employed or not, you are entitled to use the NHS.  Tier 1 is a settlement visa.  Can you find another surgery?

Which is incorrect.  If you have a settlement visa, employed or not, you are entitled to use the NHS.  Tier 1 is a settlement visa.

Not necessarily. This has been discussed previously:

This has been discussed on the board previously. I don't know if it is a change but the rules state that you either have to be employed or a resident for 12 months to qualify. Spousal visas are a bit different where the visa holder is the spouse of a person already eligible so their eligibility is from the first day they arrive. Tier 2's are sponsored and already have employment so they're covered as well, Tier 4 students are covered if their program is longer than 6 months or if less than 6 months it must be government funded. It seems that Tier 1's are the only ones left out if they do not have employment.

An extensive discussion of this can be found here: http://talk.uk-yankee.com/index.php?topic=55928.0

http://talk.uk-yankee.com/index.php?topic=55928.0

Tier 1 is a settlement visa.  

A Tier 1 isn't a settlement visa, it is techically a time limited work visa that can lead to 'settlement' aka ILR. Tier 1 also assumes that the holder will go where the jobs are. If another offer comes up in another country that is better it is likely that they will follow the job.

Specifially from the DHS Website:

Are you engaging in employment in United Kingdom (UK)?

What if I should need hospital treatment?

Under the current Regulations, anyone who is engaging in employment with an employer who has his principal place of business in the UK, or who is a self-employed person whose principal place of business is in the UK is fully exempt from National Health Service (NHS) hospital charges in England. This exemption applies to your spouse, civil partner and children (under the age of 16 or 19 if in further education) if they are living with you in the UK on a permanent basis.

Please note that to be exempt from NHS hospital charges on this basis you must be in employment at the time you receive treatment. If you are here on a work visa but currently unemployed you will be charged for your treatment, unless you are otherwise exempt from charges.

Spousal, fiance(e), Unmarried Parnter and Civil Partnership visas are settlement visas, because the visa, although temporary time limited, assumes that the visa holder is seeking to live permanently since that is where the personal family ties are.

The term 'Settlement' means two different things to visas issued inside and outside the UK.

ETA: The previous thread geeta refers to contains a bad link that cannot be updated so here is the updated list of who is entitled to Free NHS:

People Entitled to Full NHS Hospital Treatment free of charge
 
Anyone who is working in the UK for an employer who is based in the UK or is registered in the
UK as a branch of an overseas employer (this includes self employed people). You must be actually working, not just looking for work;

Any unpaid worker with a voluntary organisation offering services similar to those of a Health Authority or Local Authority social services department;

Any full time student on a course of at least 6 months duration, or, if less than 6 months, a course substantially funded by the UK government;

Anyone who has come to live permanently in the UK. If you make an application for permanent residence after you get here you are chargeable until your application is approved;

Anyone who has been lawfully living in the UK for twelve months immediately prior to treatment;

Refugees and asylum seekers whose applications are still being considered;

Anyone employed on a ship or vessel registered in the UK or working offshore on the UK sector of the Continental Shelf;

Anyone who receives a UK war disablement pension or war widows pension;

Diplomatic staff working in embassies or Commonwealth High Commissions in the UK;

Members of Her Majesty’s UK armed forces*;

UK Civil Servants working abroad who were recruited in the UK and employed by Her Majesty’s Government*;

Anyone recruited in the UK who works abroad for the British Council or the Commonwealth War Graves Commission*;

Anyone who is working abroad in a job financed in part by the UK Government in agreement with the Government or a public body of some other country or territory*;

Anyone working abroad for not more than 5 years as long as they have lived legally in the UK for ten continuous years at some point (including self employed people);

Anyone working in an EEA country member state and contributing compulsory (not voluntary) UK national insurance contributions (class I or II);

Anyone who is a national of an EEA member state, a refugee or stateless person or their dependant or survivor living in an EEA member state who is referred to the UK for specified treatment with an EC form E112 or E123;

Anyone who is referred by their home country authorities for specified treatment in the UK under the terms of a bilateral agreement;

Anyone who is detained in prison or by the Immigration Authorities in the UK;
Serving NATO personnel, posted in the UK, who are not using their own or UK armed forces hospitals;

UK state pensioners who have lived lawfully in the UK for 10 continuous years at some point, who now live for not more than 6 months each year in another EEA member state and not less than 6 months each year in the UK;

Missionaries working overseas for an organisation principally based in the UK, regardless of whether they are receiving a wage or salary*;

Those who have been formally identified or suspected as being a victim of human trafficking;

The spouse or civil partner and any dependent children of anyone who is exempt under the above criteria, if they are living permanently with the exempt person. Coming to visit the exempt person for a few weeks or months does not give exemption.

* These categories of exemption provide that the spouse/civil partner/dependent children are exempt from charge in their own right so that the principal exempt family member does not have to be in the UK with them at the time of their treatment.

So Basically Mara will be eligible to NHS once she has been in the UK for 12 consecutive months or is employed or the spouse/CP of someone who is already eligible to NHS...whichever occurs first.

Just to make sure, if/when I switch to Tier 1 PSW in November/December (assuming these rules don't change by then) I would still be covered since I've been in the UK for over a year on a student visa even if I don't have a job at that point?

If so, that takes a little bit of worry off!

Just to make sure, if/when I switch to Tier 1 PSW in November/December (assuming these rules don't change by then) I would still be covered since I've been in the UK for over a year on a student visa even if I don't have a job at that point?

If so, that takes a little bit of worry off!

Since you would have been lawfully resident in the UK for 12 months at that point you would be exempt from charges, so the requirement of actually being employed does not apply.

Since you would have been lawfully resident in the UK for 12 months at that point you would be exempt from charges, so the requirement of actually being employed does not apply.

Well that's good news, thanks!

I am a US citizen and a consultant physician in Edinburgh, on a Tier 1 (General) Migrant visa.

Practically speaking, GPs and NHS hospitals are pretty poor about determing if an immigrant's visa entitles them to healthcare in the NHS (when our HR department sends me job applicants to interview, they can't even tell me correctly what visa the job applicant has).  The most common way they settle the issue is not to ask for your visa or proof of residency/employment.  They usually settle the issue by asking for your National Insurance (NI) number.

I think GPs/hospitals rely on the NI number as proof of entitlement for a few reasons.  Most immigrants that I know of obtain their NI number from their first job (my HR department knew exactly what to do and had all of the paperwork), and it's widely *perceived* that if you're an immigrant with a NI number, you must have it because you're working.  It's also necessary to have the number to make NI contributions, obviously.  Whether it's legal/right or not, that's what the GPs in my area do.  My wife was not allowed to sign up for a GP until she had a NI number; my daughter (a minor) was allowed to sign up immediately on account of her age.  We showed her visa and my (NHS consultant!) contract to GPs, to no avail; our difficulty in this regard may be due to the fact that my wife and I have different last names.

The loophole in the process is this--if you go to a JobCentre and show a visa that entitles you to work, they will help you obtain a NI number, even if you're unemployed.  My NI application was painless via my HR dept., compared to my wife's application process via JobCentre (she's unemployed, on a Tier 1 Dependent visa), which was quite the hassle.  Chances are good that if you show the GP/hospital your NI number, no further questions will be asked.  Physicians have better things to do than define your visa status!

As you know, a National Insurance number has nothing to do with whether you are entitled to NHS services or not. I don't agree that chances are that showing your NI number should allow you to register at a surgery.  Many people who use the NHS do not have an NI. I don't think that people should set out to get an NI number with the intent of being able to sign up at a GP, because it might not work. Showing a visa that entitles you to NHS service is what anyone should do, and calling the local trust if it doesn't work would be my next recommendation.

I lived in Edinburgh and both my husband and I signed up without a problem at our surgery. We did not need to show our NI numbers.  In fact, my husband did not even have an NI number when we signed up at our first surgery in London.

I do, however, agree that physicians shouldn't be determining your visa status - that's the job of the staff at the surgery.

Geeta--three surgeries in Edinburgh asked my wife for a NI number, in July 2009: Bruntsfield, Morningside, and Warrender Park.  GPs tell me that they'll often ask for it; when I've run into GPs socially and asked them why they ask for it, the reasoning I'm given is, "I don't know what their visa is, but if their visa allows them to access my surgery, their visa will allow them to have an NI number."

I agree it's not right for surgeries to do it.  Nevertheless, that is what at least some of them are doing, at least in Edinburgh.

GPs tell me that they'll often ask for it; when I've run into GPs socially and asked them why they ask for it, the reasoning I'm given is, "I don't know what their visa is, but if their visa allows them to access my surgery, their visa will allow them to have an NI number."

But that's not necessarily true.  If you read this whole thread, you will see that the question has arisen as to whether or not a person on a Tier 1 visa who is not employed is allowed to use the NHS.  The rules actually state that unless you are working, you are not meant to use the NHS on this visa.  So in that case, this person could easily go get an NI number as they would be looking for work, but if they were not employed, they could not use the NHS.

This has been discussed on the board previously. I don't know if it is a change but the rules state that you either have to be employed or a resident for 12 months to qualify. Spousal visas are a bit different where the visa holder is the spouse of a person already eligible so their eligibility is from the first day they arrive. Tier 2's are sponsored and already have employment so they're covered as well, Tier 4 students are covered if their program is longer than 6 months or if less than 6 months it must be government funded. It seems that Tier 1's are the only ones left out if they do not have employment.

An extensive discussion of this can be found here: http://talk.uk-yankee.com/index.php?topic=55928.0