Getting started with NHS

So we will be heading over to Colchester, Essex in mid-August for a lengthy stay (a couple of years).  My husband has dual citizenship (American/Irish).  The rest of us now have our EEA Family Permits.  Our daughter and niece will be attending schools and my husband intends to exercise his treaty rights by working for an employer.

We'll be arriving on August 17th.  Do we need to do anything to register with NHS or elsewhere to be able to use NHS?  I just want to know how to start, and what we can expect at the beginning.

Thanks!

So we will be heading over to Colchester, Essex in mid-August for a lengthy stay (a couple of years).  My husband has dual citizenship (American/Irish).  The rest of us now have our EEA Family Permits.  Our daughter and niece will be attending schools and my husband intends to exercise his treaty rights by working for an employer.

We'll be arriving on August 17th.  Do we need to do anything to register with NHS or elsewhere to be able to use NHS?  I just want to know how to start, and what we can expect at the beginning.

Thanks!

You will need to present your family permits and proof of address (council tax, etc.) to the GP office you wish to register with.

Thank you.  Will a copy of a rental agreement work?  The home we are renting is a private residence and the owners are covering the cost of the utilities.  All we'll have to start with is our EEA Family Permits and a copy of the rental agreement.  We'll have a Barclay's bank account within a week, as well as local mobile account.

I have a follow up question that might be worth a separate thread.  Let's see what happens.  In the event that we need to sign up for private health insurance, I'm curious to know what health insurance policies cost.  I know it depends on coverage, deductibles, etc., but I'm looking for some ballpark estimates.  Two adults (over 50, non-smokers, no pre-existing conditions, healthy) and two teens (non-smokers, no pre-existing conditions, healthy).

I have a follow up question that might be worth a separate thread.  Let's see what happens.  In the event that we need to sign up for private health insurance, I'm curious to know what health insurance policies cost.  I know it depends on coverage, deductibles, etc., but I'm looking for some ballpark estimates.  Two adults (over 50, non-smokers, no pre-existing conditions, healthy) and two teens (non-smokers, no pre-existing conditions, healthy).

http://www.healthinsurancecompare.co.uk/index.php?page=current-offer-lynx&utm_source=112&utm_campaign=804342681&utm_medium=cpc&utm_term=health%20insurance&type=p&creative=193524091323&a=45350700681&placement=&network=search&gclid=CjwKEAjwvYPKBRCYr5GLgNCJ_jsSJABqwfw7MZw_LJlQecLnawkV8V_D86fMgUTZXXapI7f_uSwUtBoCx2_w_wcB

We a policy with Aviva for £80/month which includes dental and vision. We are both over 60.

Hi Farmgirl.

We are in Scotland, so the NHS rules may not be the same here, but...

I had some trouble registering as I was not employed or registered as looking for work (I'm in the "self-sufficient" category), but now am happily in a practice I really like. You will register with someone in your local area - NHS Inform's website has an option to search by post codes.  They may or may not accept you as new patients (they are not required to) if they are a full practice, but when I spoke with NHS Inform about our particular problem I was given the names/contact info for three surgeries within a mile of our home, and told that if none of them would accept us to call a dedicated number they gave us and we would be assigned a GP who would have to accept us. Thankfully, we didn't have to go that route.

Our surgery wanted something with our address on it - utility bill, council tax notice (that came pretty quickly), or a lease. You'll need to bring all your passports, of course. In our case, we were asked to go pick up registration info, and were given an appointment at that pickup to come back to meet with the intake nurse about a week later. Spoke with her for about 20 minutes each, and we're registered. It's been less than two weeks and I'm already getting mail from the NHS asking me to have screening tests done (due to my age).

Health insurance is interesting here. Most of the policies I found when looking for one for my daughter have you use the NHS for emergency care, and go through the NHS surgery GP for the first contact. We settled on Vitality Health, which has a tele-medicine component - you can do a video consult with one of their GPs for minor things and have them phone in prescriptions at no charge.  For most of the other insurances we looked at, if you need specialist consultations, tests or MRI/CAT scans, or non-emergency hospitalization, that's where the private insurance kicks in.  At least with the plans we found to look at, there is a "core" cover for hospitalizations, and then you add additional services on a sort of cafeteria plan (they are really big on selling cancer care, which is a bit odd to us and makes us wonder about NHS cancer care?).

We took out a plan for my adult daughter that covers everything the company offered (other than dental) and it's costing us just a bit over 50 pounds a month.  Beware the pre-existing conditions thing - unlike under the ACA, if you've been treated for/diagnosed with/had symptoms of anything in the last 5 years that is one of those ongoing things (like diabetes or high blood pressure) you will probably not be covered for it on the policy. 

We are sending in for my daughter's  residency card, so we'll find out in the next several months if they consider Vitality Health Insurance (which pretty much mirrors most of the rest of them) to be "CSI"  or if we'll have to go back to one of the really expensive "expat" insurance companies.  Could never find any serious guidance other than that whatever insurance you choose, it has to cover you for the "majority" of any medical needs you may have.

Hopefully someone down in England will chime in and give you more localized advice.  Good luck with it. (We really like our surgery, very efficient, very pleasant place. Not at all like the doctor's office factory we were used to "back home".)

Hi Farmgirl.

We are in Scotland, so the NHS rules may not be the same here,

Some are UK wide rules and changed as the UK as a whole, but exceptions can usually be decided be each country for their own NHS.

The IHS, the cost of the IHS, free consultation at a GP but not free treatment, which EU rules to follow and how to follow them, the agreement to give free healthcare to Irish citizens who live in the UK,  reciprocal health agreements with other countries, etc are UK wide.

Exceptions tend to be things like, free contraception (but not abortions), free treatment for sexual diseases and certain illness that might be harmful for the citizens of that country and each NHS can list the ones they want to. These exemptions can be added or removed by that country. i.e. NHS England added, children who are taken into care, victims of female genitalia and removed failed asylum seekers.  It could be that these can (or can't) get bill free use in N.I., Scotland or Wales.

The only thing that is set in stone in the UK for the NHS as a whole, is that free use of the NHS is only for those with British citizenship/ILR who reside in the UK. The 2014 law that saw the end of free NHS for all those legally residing in the UK, changed the definition of "ordinary resident" for the NHS. Laws can be changed, but they take a long while to do this (the 2014 law took 2 years) Everyone else using the NHS bill free, are doing so under various agreements/EU laws etc.

http://www.healthinsurancecompare.co.uk/index.php?page=current-offer-lynx&utm_source=112&utm_campaign=804342681&utm_medium=cpc&utm_term=health%20insurance&type=p&creative=193524091323&a=45350700681&placement=&network=search&gclid=CjwKEAjwvYPKBRCYr5GLgNCJ_jsSJABqwfw7MZw_LJlQecLnawkV8V_D86fMgUTZXXapI7f_uSwUtBoCx2_w_wcB

We a policy with Aviva for £80/month which includes dental and vision. We are both over 60.

Can you tell me a bit more about your policy with Aviva?  Curious about deductibles, co-pays, what is and isn't covered.  Are you happy with it?

We can't really do an estimate until we've got ourselves settled into our new place. 

Can you tell me a bit more about your policy with Aviva?  Curious about deductibles, co-pays, what is and isn't covered.  Are you happy with it?

We can't really do an estimate until we've got ourselves settled into our new place.

You can get a quote
http://www.healthinsurancesolutions.co.uk/aviva-health-insurance/
I'm sure their T&Cs will be on their site somewhere.

The EU Directive only requires you to have a CSI each and the funds to show that your husband is self sufficient and can afford to keep his family in the UK without public funds ( taking UK benefits) to be a self sufficient qualified person. Self Sufficent qualified persons need funds, CSIs and cannot take any benefits from that country.

Unlike other EEA countries, at the moment the UK will still pay for the healthcare of any qualified person, as a Brit can have, even for those who must have a CSI for each family member. It's a throwback to when the NHS was free to anyone who was living in the UK legally.

Can you tell me a bit more about your policy with Aviva?  Curious about deductibles, co-pays, what is and isn't covered.  Are you happy with it?

We can't really do an estimate until we've got ourselves settled into our new place.

No pre-existing conditions need to be listed but if you request treatment then they will check your NHS record and if you have already received treatment within 2 years of starting the policy for the condition it won't be covered.

The GP is the gateway to a specialist, and must do the referral.

£500 deductible.

There are 2 private hospitals near us but if we can also choose to be in an NHS hospital.

Vision only covers new lenses and frames if there has been a change in prescription, and the eye test itself is not covered. (Free for us being over 60 and my eye test a couple of months ago showed no change)

We will be making our first dental claim in a couple of weeks so I'll find out how easy that turns out to be.

We really hope that we don't ever need to use it for serious health issues, but after being used to pay $856/month in the USA plus $1,500 deductible, $30 per GP visit and 20% co-pay on treatment it all seems to be such good value.

This is what we were told by the government official on eligibility for care by the NHS:  "Access to NHS services in the UK is based on residency status. As an EU national exercising your treaty rights to take up residency in the UK you can be treated as ordinarily resident from day 1 of your arrival in the UK.... On this basis you are entitled to register with a GP for primary care services and access NHS secondary care on the same basis as anyone ordinarily resident in the UK."
Unfortunately, not every GP's receptionist seems to know that.  So go with something official that states your status, when you go. I have to wonder what's going to be the case after Brexit?

Aviva - wow, those are nice premiums, if it covers both of you, Durhamlad.  The Daughter's has a zero excess (by our choice) but we do pay for that. And the plan then covers all health, but no dental (except emergency reconstruction) or vision.  All the plans I looked at require emergency services be handled at a NHS hospital - but then allow you to be transferred to one of their hospitals once you are stable and the private insurance takes over.  The plan we went with had a couple of different lists of hospitals, but also a service where they could have their people recommend the most appropriate place to use, and would make the referrals for us for specialists, if needed, rather than our having to sort them out ourselves. While I have misgivings about all that, we went with it and it did lower our premiums. The outpatient cover seemed pretty standard across the board as to what was offered by the companies. I did hear more than once the premiums would be impacted by where you live.

There was also much to-do about "cancer cover" from all the companies I talked with (about 6?) so I have to wonder about NHS care for cancer treatments? Is it somehow lacking, or are people just really stampeded here over that particular disease?

Those premiums do include both of us, and I don't recall any details about cancer, except the usual caveat that you had to have been cancer-free before starting insurance.

Yesterday we went to a private dentist strongly recommended by good friends of ours and was suitably impressed. Initial consultation was free except for a full set of X-rays which cost  £7. He then spent plenty of time going over the images with me, very complimentary about the state of my oral health (for someone in their 60's).

Wow, that's great!  I'm dreading having to find a dentist here in Glasgow... don't need one now but I'm also in my 60s and although I've had routine cleanings and all that, the teeth went through a lot of years with no care at all (as happens when one is a poor student in the US of A).  I've got enough resin and sealants in there to cover the space shuttle now. 

Wow, that's great!  I'm dreading having to find a dentist here in Glasgow... don't need one now but I'm also in my 60s and although I've had routine cleanings and all that, the teeth went through a lot of years with no care at all (as happens when one is a poor student in the US of A).  I've got enough resin and sealants in there to cover the space shuttle now. 

Nan, you should find a dentist now.  Then if/when you have a dental emergency, you'll be all set with one you know already.

A lot of them are private, my old dentist went private so I left the practice on principle but I have a really great dentist at a NHS practice now.  A friend of mine stayed with the private practice and she's happy with that.   It's nice to have the choice. 

This is what we were told by the government official on eligibility for care by the NHS:  "Access to NHS services in the UK is based on residency status. As an EU national exercising your treaty rights to take up residency in the UK you can be treated as ordinarily resident from day 1 of your arrival in the UK.... On this basis you are entitled to register with a GP for primary care services and access NHS secondary care on the same basis as anyone ordinarily resident in the UK."

Hmmm. that's a bit sneaky of them as they should really make it clear that "ordinarily resident" for the NHS, are now only those with British citizenship and ILR: the definition was changed under The Immigration Act 2014. This is why they were able to bring in the Immigration Health Surcharge for those with a visa of more than six months and those with visas of less than 6 months pay at point of use with 50% added to their bill if they don't have insurance, instead of continuing to give these people free access to the NHS.

I just checked the NHS England site again and thankfully NHS England seem to have updated their site now; which should stop those on other forums telling people that they can still use the NHS for free because they/their baby born in the UK will be "ordinarily resident" and can have free use of the NHS.
http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/moving-to-england/Pages/moving-from-outside-the-eea.aspx

I have to wonder what's going to be the case after Brexit?

Whatever it may be, it will be very easy to do with the two new Immigration Acts (laws) 2014 and 2016.

Even without Brexit, lots of changes came in/are coming in for EEA nationals and their family members in the UK, and under the Immigration Act 2016 too.