NHS in the UK - need info pretty quickly!

This is going to sound very strange, but here  it is. My daughter will be at school in Scotland as an ed abroad student for a few months. We know that she will be covered by the NHS while she is there, per our communications with the University.

Her home University, the University of California, San Diego, is trying to force her to either pay over twelve-hundred dollars to carry the school's insurance (not travel insurance) or to purchase an American health plan to cover her healthcare while in Scotland.  We have rather stridently pointed out that she will have access to better care there on the NHS than she has with her school insurance and that she does NOT need additional private insurance while there.

After explaining what a National Health Service does, they are willing to consider exempting her from having to pay for private insurance during her term there. The catch - they have just asked me to provide a list of what NHS covers!  Telling them "basically everything" has not made the bean-counters upstream happy, so we need to locate a website or a brochure that lists what the NHS Scotland covers. I know it's GPs, Hospitals, etc., but apparently more detail than that is required.

We do need this information rather urgently, as the deadline to waive the additional fee for the unnecessary insurance is early next week. Can anyone point me to info that I can cut and paste or send a link for to her school administration here?

Note that she will also have travel insurance, which includes repatriation, etc. This other insurance they want us to purchase is in addition to the travel insurance.

Appreciate your help! - Mom

If there is a recognised exchange program with the University in Scotland this must have come up before, and presumably the University would be able to help. And surely the school in San Diego must have come across the NHS before?

I'd try to get the 2 schools talking to each other about what has happened in the past. Good luck!

http://www.gov.scot/Topics/Health/Services should pretty well cover it.  As she is in full time education she will get free dental and optical treatment.  Prescription medicines are free in Scotland.

The university pages will have information about which GP practices to register with and info about onsite medical facilities.

http://www.ukcisa.org.uk/International-Students/Study-work--more/Health-and-healthcare/

If there is a recognised exchange program with the University in Scotland this must have come up before, and presumably the University would be able to help. And surely the school in San Diego must have come across the NHS before?

I'd try to get the 2 schools talking to each other about what has happened in the past. Good luck!

Hah. Half of the people I've talked to in the last 48 hours don't know what "national health" means and one didn't know that Scotland was not England. One thought Glasgow was in Ireland.  Apparently this is a brand new problem - according to the people I've finally reached who are sentient - and only exists now because of a recent U. Calif. policy guidance statement issued regarding the Affordable HealthCare Act. 

I have already written to the University in Scotland, thanks, but it does take time to cross desks at a University, so I thought I'd try here.

http://www.gov.scot/Topics/Health/Services should pretty well cover it.  As she is in full time education she will get free dental and optical treatment.  Prescription medicines are free in Scotland.

The university pages will have information about which GP practices to register with and info about onsite medical facilities.

http://www.ukcisa.org.uk/International-Students/Study-work--more/Health-and-healthcare/

Thank you!  I have forwarded this information on, but, actually, I think they want something concise and official that describes coverage, much as a private insurance policy would do when you contract for that. I am assuming that such a document exists, although I can't imagine why it would be necessary (or, wouldn't have until recently!).  I hope I'm wrong and your websites do the trick. Again, thanks.

I had expected better out of a major research university.

Quick question: how long will she be studying in Scotland and which visa will she be applying for?

She will only be covered by the NHS if she is applying for a Tier 4 visa valid for more than 6 months... In which case she will need to pay the NHS Surcharge, which for a Tier 4 visa I believe is £150.

If the visa will be valid for less than 6 months, or she has a student visitor visa, then she will not be covered by the NHS and will need to take out health insurance to cover her in Scotland (if she doesn't have insurance and she needs NHS treatment she will be charged 150% of the regular cost of the treatment) - though regular travel
insurance that covers medical care would be fine for this.


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Quick question: how long will she be studying in Scotland and which visa will she be applying for?  She will only be covered by the NHS if she is applying for a Tier 4 visa valid for more than 6 months... In which case she will need to pay the NHS Surcharge, which for a Tier 4 visa I believe is £150.

If the visa will be valid for less than 6 months, or she has a student visitor visa, then she will not be covered by the NHS and will need to take out health insurance to cover her in Scotland (if she doesn't have insurance and she needs NHS treatment she will be charged 150% of the regular cost of the treatment) - though regular travel insurance that covers medical care would be fine for this.

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Hi. Thanks for writing. That is actually not correct, according to the University of Glasgow website. Students on short-term study visas are covered. http://www.gla.ac.uk/international/support/livinginuk/nhs/

"Non-EEA students with "Short-term study visa -  Non-EEA students coming to study in the UK for less than 6 months using the "Short-term study visa" route do not have to pay the IHS but are entitled to free NHS treatment if in Scotland."  She wouldn't have NHS hospitalization coverage in other UK countries, but she has her travel insurance for those type of emergencies. In Scotland, she's covered.

Hi. Thanks for writing. That is actually not correct, according to the University of Glasgow website. Students on short-term study visas are covered. http://www.gla.ac.uk/international/support/livinginuk/nhs/

"Non-EEA students with "Short-term study visa -  Non-EEA students coming to study in the UK for less than 6 months using the "Short-term study visa" route do not have to pay the IHS but are entitled to free NHS treatment if in Scotland."

Okay, this is all rather confusing because there some government and NHS websites that state that only students in the UK on Tier 4 visas valid for more than 6 months are eligible for free NHS care and that students on student visitor visas have to pay for treatment.

However, I have found a couple of Scottish university websites that say that NHS care is free to ALL full-time students in Scotland, so there is a lot of contradictory information out there.

For example, the University of Aberdeen website explicitly states that people on student visitor visas are NOT entitled to free NHS care:

Some of those who are exempt from paying the immigration health surcharge will not be entitled to free National Health Service (NHS) treatment. This group includes visitors and short-term students. If you need to receive NHS medical treatment (other than accident & emergency services), you will be charged 150% of the actual cost. You should ensure that you obtain medical insurance before travelling to the UK.

(http://www.abdn.ac.uk/study/international/visa-information.php#visacost)

The UKVI website doesn't say anything about Scotland in particular, but just states that for the whole of the UK:

You’ll be able to use the National Health Service (NHS) if you’re exempt from paying - except if you’re on a visitor visa or any visa that will only last for 6 months or less (that you applied for from outside the UK). You’ll have to pay for care you get through the NHS at the point you use it.

(https://www.gov.uk/healthcare-immigration-application/when-you-need-to-pay)

And the general NHS website only says that people studying for more than 6 months are entitled to free NHS care:

Students
People following a course of study that lasts at least six months or a course that is substantially funded by the UK, Welsh, Scottish or Northern Ireland Governments are entitled to free NHS treatment.

(http://www.nhs.uk/ipgmedia/National/Macmillan%20Cancer%20Support/assets/OverseasvisitorsAguidetohospitaltreatmentintheUKMCS5pages.pdf)

We'll check with the school. The U. Glasgow website says that as long as she's a full-time student and in Scotland, she is covered.  Also http://www.ukcisa.org.uk/International-Students/Study-work--more/Health-and-healthcare/Free-hospital-treatment-in-Scotland-after-6-April-2015/

Full-time students -  If you are a full-time student in the UK:

    You will qualify for free NHS hospital treatment on the same basis as anyone who is ordinarily resident in the UK, from the beginning of your stay until (normally) one month after your course ends. However, the Scottish Government has assured UKCISA that if you have paid the immigration health surcharge then your entitlement will continue until the end of your stay. Please ask the International Student Adviser at your college or university to telephone UKCISA if you ever have a problem with this.
   
Short-term students (not Tier 4) and student visitors  - For any periods when you are not a full-time student in the UK, you should take out private medical insurance (unless you have paid the immigration health surcharge).


Clear as mud, isn't it?  Apparently the rules in Scotland are not the same as the rules in the rest of the UK?

Yeah, that's the thing - because Scotland has its own government sometimes things are different there than in the rest of the U.K., but unfortunately that's not made clear on the other UK websites.

I saw that UKCISA page earlier and when I first read it I assumed it meant the same as the other sites... But actually thinking about it since I posted, it seems that Glasgow Uni may be correct and the info on Aberdeen's site is wrong.

It's just difficult to know exactly what's correct and what isn't when even the universities themselves are contradicting each other!


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Interesting, isn't it? When I look on the Aberdeen website referenced above I find

Imigration Health Surcharge

As of 6th April 2015 international students have to pay an immigration health surcharge in order to apply for a Tier 4 visa. The amount paid as an immigration health surcharge will depend on the maximum length of leave that can be granted and not on the course dates on the confirmation of acceptance for studies. The surcharge is £225 per year of study. The total amount has to be paid upfront in order to receive a visa. The same surcharge has to be paid for each dependant.

For more information on the NHS health surcharge, please visit the UKVI website. NHS treatment will remain free at the point of use for students. For more information on this, please click here.

At that last "click here" the link takes one to "the rules" for England, not Scotland. Coding error there, I think?

I think it must be that Scotland has decided to cover all its international students on short term study, separate from the rest of the UK. However, for those on a tier 4 of longer than 6 months, there is no work around available for the IHS since everything visa related must go through the central government. As far as I can tell, the tier 4 6 months or more rules are identical since there is no mechanism for differentiation among the different countries of the U.K.  However, since Scotland does has some devolved powers regarding their NHS, they have decided to make life a little easier for those students who would not have had to pay the IHS in the first place.


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http://www.ukcisa.org.uk/International-Students/Study-work--more/Health-and-healthcare/Free-hospital-treatment-in-Scotland-after-6-April-2015/

    You will qualify for free NHS hospital treatment on the same basis as anyone who is ordinarily resident in the UK,

Except that from 6 April 2015, under the Immigration Act 2014, the UK changed who they will now give free healthcare to. "ordinarily resident" was basically changed to "settled". Settled = those that have permanent residence in the UK, i.e. British citizenship or Indefinate Leave to Remain.

From the 6 April 2015, the UK will no longer give free NHS to those who are just a resident in the UK.  Some will have to pay each time they use the NHS and will need insurance: *others with visas of over six months, pay a health surcharge to then have free use of the NHS while their visa is valid.

I don't know if the Scottish NHS will still give free NHS to foreign students? The English NHS won't anymore: the foreign student either pays via their IHS if they have a visa of more than six months, or if no IHS,  they pay at point of use with 50% added if they don't have insurance. 

The University of Cambridge laying it out clearly,
http://www.internationalstudents.cam.ac.uk/arriving/pre-arrival-information/healthcare
but all the Scottish univesity sites I have looked at are not clear at all.

* EDITED to say a visa of over six months

Thanks, all, for your comments.
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Yes, we have had confirmation that it's different in Scotland for short-term visitor students than in the rest of the UK. Tier 4 has to pay the (incredibly cheap) fee for a year's worth of healthcare - quite a bargain there - and applies across all the countries in the UK (as far as I can tell).

Quite frankly, even if she had to pay the incredibly low fee on entry for the 5 months she'll be there I'd be happy.  Her USA school is asking for her to pay about 750 pounds to have insurance for those five months that won't pay in advance, but only would reimburse her for any expenses she incurs after she submits a claim for that expense.  To waive having to purchase this insurance (which is in addition to the travel insurance she already has for cover) the school insists on the criteria listed below. We need to find some sort of document that shows that the NHS meets or exceeds them. If you can point us to a document that shows that, it would be REALLY helpful!  Thanks.

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To satisfy the UC’s health insurance requirement for enrolled students, the plan held by the student must be:
1)  A Medi-Cal [my note - this is the California program for the medically indigent and the coverage provided is the absolute minimum of care - people die on this plan for lack of care], Medicare or Tricare/military insurance policy or a Covered California plan,
OR
2) An employer-sponsored group health plan or individual plan that meets the following criteria:
a) Has unlimited lifetime benefits
b) Has an annual out-of-pocket maximum of up to $6,600 for an individual but no more than $13,200 for a family. Deductibles, copayments and coinsurance paid by the member accrue toward meeting the out-Of-pocket maximum. A higher out-of-pocket maximum is allowed if the subscriber has a Health Savings Account (HSA) or a Health Reimbursement Account (HRA).
c) Covers the following services (ACA Essential Health Benefits):
(i) Preventive health care services, including an annual physical exam, preventative immunizations and laboratory/diagnostic tests to help determine your state of health
(ii)Chronic disease management for such conditions as asthma, diabetes or other chronic medical conditions
(iii)Hospital stays for medical and surgical care
(iv)Hospital stays for mental health and alcohol/drug abuse conditions, covered the same as any other medical condition
(v) Doctor office visits for medical, mental health, and alcohol/drug abuse conditions
(vi) Emergency room services
(vii) Diagnostic services including laboratory tests
(viii) Medications prescribed by a doctor (including contraceptives)
(ix) Pre-natal and maternity care, with no pre-existing condition limitation