Using the NHS in a post-levy Britain

Am on a spousal visa that was issued two years before the NHS levy became A Thing, but not able to apply for FLR(M) until later this autumn. Haven't had a cervical screening in ages, and appointment is with a clinic rather than my GP's office, so they won't be familiar with me as a patient. Has anyone who's grandfathered-in had any hassles in the post-levy era?

I.e. On a scale of 1 to Completely Ballsed Up, how acutely do I need to be prepared with passport/visa, letter of invitation for screening, NHS number, printout of the legislation saying I'm OK if before 6 April, willingness to submit DNA samples, demonstration of my Morris dancing skills, etc.?

You'll be fine to get your cervical screening.  Non-issue.  I wouldn't think you will have any issue at all or be asked anything (I would think the scrutiny will be with people when they initially register with a GP).

You will, however, have to pay the levy upon renewing your visa.  It's £500 on top of the visa fee.   

You'll be fine to get your cervical screening.  Non-issue.  I wouldn't think you will have any issue at all or be asked anything (I would think the scrutiny will be with people when they initially register with a GP).

You will, however, have to pay the levy upon renewing your visa.  It's £500 on top of the visa fee.   

Yeah, have the money all saved for it, just afraid they'll want a receipt that I don't yet have because I'm caught in the interstitial period -- and I fear the poor NHS staff aren't going to be particularly well-trained as immigration officials even though they now have to act as if they're UKVI heavies.

I had trouble after I first came over at Royal Free. Was referred from GP to hospital for X-ray of a nasty chest infection (had to be signed off work and all), and Royal Free sent me home, coughing, in the pouring rain, with the Overground shut (meaning 40 minutes on a bus instead of 12 on the train), to retrieve paperwork that could prove I was allowed to use services. First-world problems, I'm keenly aware, but it's made me paranoid about being caught without a battery of evidence in my defence, in triplicate and signed by the Queen's corgis.

Thanks for the reassurance -- to screenings and preventive health management!

Yikes!

Well, to be sure you have everything they could want, I would bring your passport with visa sticker (or BRP) with the issue date.  You could also bring a printout showing the IHS beginning for applications after April 6, 2015. 

That's shocking that the Royal Free treated you like that, hms!  I can understand why you are edgy about the screening.  My impression has been that the tricky point for us homeless critters is going to be hospital appointments.  The GP's surgeries don't really seem to care and we still have the right to hospital treatment if we're run over by a bus or whatever.  But tests and hospital consultations are going to get tough.

and we still have the right to hospital treatment if we're run over by a bus or whatever. 

Nope, never have been, unless you are one of the people who can use all the NHS for free.

Run over by a bus.
ambulance to A&E: free,
looking at you in A&E: free
operation to repair where the bus ran over you: billed
stay on a ward: billed
physio: billed
any more xrays or xrays while you are on a ward: billed
all aftercare: billed.

Basically, only the cheaper stuff is free. Only A&E treatment is free and the ambulance to A&E.

There are already posts on this NHS now checking. One Brit visiting with her US child, didn't bother with insurance as they thought they would just use A&E for free medical care. Needed treatment, went to A&E, on a ward for 1 night for observation and received a bill of just over 1k (the 50% was added). She said the staff memeber that billed her was shocked to find that this should have always been billed.

Now all the NHS trusts are aware of what they can bill for and get that money back for their budget. They can add 50% to the bill from and keep that too for their trust if there is no insurance.

If there as still some NHS staff can't be bothered to do the work to bill someone, then they won't keep their job for long as their trust will be fined and they lose all the money from their budget that they should have billed for.

The 4 countries always bill each other anyway if they give treatment to another countries patient. i.e. I live in England and can use the NHS free but if I am visiting Wales and need treatment, then NHS Wales bill NHS England for my treatment. If I was living in Wales and used their NHS, then they don't bill NHS England because NHS Wales use their budget to pay for me.

Although NHS Wales have said they will not allow patients in Wales to go to England for their operations to jump the Welsh queues as too many were doing it.

That's shocking that the Royal Free treated you like that, hms!  I can understand why you are edgy about the screening.  My impression has been that the tricky point for us homeless critters is going to be hospital appointments.  The GP's surgeries don't really seem to care and we still have the right to hospital treatment if we're run over by a bus or whatever.  But tests and hospital consultations are going to get tough.

It's not among my favourite moments of living here. Thankfully, it's not a regular occurrence -- and, being hyper-aware of the immigration atmosphere and rules, I at least understand why they were so by-the-book. Thing is, if I'd just lied on the Royal Free form and said I'd been in the country longer than 6 months, they'd have taken me and my referral order without a second thought. Only the honest get caught out by something like that.

The next two-plus years aren't going to be great from a logistical standpoint, but at least I'll have a receipt in a couple months as back-up. Might get a printout tattooed on my thigh, just in case I have an emergency and am too incapacitated to produce my 'papers, please'.

Thing is, if I'd just lied on the Royal Free form and said I'd been in the country longer than 6 months, they'd have taken me and my referral order without a second thought. Only the honest get caught out by something like that.

That's where the BRPs will come in as they record who can have free NHS, end of visa date. They BRP will need to be shown to avoid being billed.

The next two-plus years aren't going to be great from a logistical standpoint, but at least I'll have a receipt in a couple months as back-up. Might get a printout tattooed on my thigh, just in case I have an emergency and am too incapacitated to produce my 'papers, please'.

You might just have to take some papers with you. Brits too will need to prove they are residing in the UK and not just visiting, if the system can't trace them. I've already seen a Brit being told they will be billed unless they bring papers to prove they are residing. She never came back with her papers "in 10 minutes".

No person will be refused urgent life saving treatment, but they will now be billed if they aren''t allowed to use the NHS for free. If you sponsor someone to visit, make sure they have insurance to pay so that you don't receive their bill if they leave and don't pay.

TBH, I think more EU citizens and their families members are going to be caught by this checking system as they could easily lie before, knowing the UK didn't have the means to check if the EU citizen is in work.

That's where the BRPs will come in as they record who can have free NHS, end of visa date. They BRP will need to be shown to avoid being billed.

You might just have to take some papers with you. Brits too will need to prove they are residing in the UK and not just visiting, if the system can't trace them. I've already seen a Brit being told they will be billed unless they bring papers to prove they are residing. She never came back with her papers "in 10 minutes".

No person will be refused urgent life saving treatment, but they will now be billed if they aren''t allowed to use the NHS for free. If you sponsor someone to visit, make sure they have insurance to pay so that you don't receive their bill if they leave and don't pay.

TBH, I think more EU citizens and their families members are going to be caught by this checking system as they could easily lie before, knowing the UK didn't have the means to check if the EU citizen is in work.

I fully understand all that, and yet none of that information would make a whit of difference in an emergency. Maybe I could have a body-mod to create a secure flesh pocket for the BRP, so they can extract it instead of sending someone in with a calculator. Because that's the only way I can see carrying my BRP -- you know, the tiny, plastic lifeline that stands between me and a whole lot of time, money and effort wasted to continue living my normal, everyday life -- on my person as an everyday occurrence. Or, as I said, I can face down the next 2.5 years knowing that the long, logistical nightmare will soon be over.

Maybe we should all wear dogtags with the BRP info on them.  I'm sure eventually we'll all be chipped like animals.

Maybe we should all wear dogtags with the BRP info on them.  I'm sure eventually we'll all be chipped like animals.

Feels that way sometimes, doesn't it? It doesn't make me feel a whit better to know that British and EU citizens are also going to be hassled. Certainly doesn't save on already-bloated NHS administration costs, so I assume the point is to make receiving healthcare so onerous that people just don't bother. Which will only cost the NHS exponentially more when patients present requiring more intensive management, because they put it off when interventions could have been minimal or preventive. But I digress ...

Yeah. 

Sorry that you have been hassled at Royal Free! That is enough to make one nervous! My husband is on a spousal visa (we came back last year June) registered with GP and referred to two consultants within four months of arrival. He was never asked about his status. I did notice though that on the form I completed this year for a dental referral I was asked if I had been resident for over a year so it shows they are now tightening up. I had actually been here for eleven months and that was accepted as I was never asked for more information.

My wife just arrived back from Addenbrookes after a routine scan.   She took her US passport with the visa in it and explained that we had paid the health surcharge in order to obtain the visa.

Addenbrookes is now requesting that I send them a copy of my payslip.    I have no idea why they need this but I will send them a copy and see what happens.

I have no idea why prior poster was asked if they had been resident for a year.   I'm not aware of any NHS services that are withheld for the first year of residency.

My wife just arrived back from Addenbrookes after a routine scan.   She took her US passport with the visa in it and explained that we had paid the health surcharge in order to obtain the visa.

Addenbrookes is now requesting that I send them a copy of my payslip.    I have no idea why they need this but I will send them a copy and see what happens.

I have no idea why prior poster was asked if they had been resident for a year.   I'm not aware of any NHS services that are withheld for the first year of residency.

I reckon it's down to the fact healthcare professionals and admins aren't immigration experts, but have become immigration officers due to this government's latest, incomprehensibly inefficient Dirty Immigrants law. I'm sorry you're both having to face yet more frustration and paperwork just to carry on with normal, everyday living.