NHS insurance card

heart AF Ablation surgery

Good luck with the surgery Durhamlad! 

Despite my bad fax experience detailed above I have been very impressed with the NHS since returning in 2016, but have learned that it is best to be "a bit of a bother" to move things along.  It took longer than it should have to get referred to the arrhythmia clinic for an irregular heart beat but once there, and that wonderful hospital number in hand, they have been great.

My wife noticed a mole on the back of my shoulder that had been growing and changing shape so she "strongly suggested" to me that I go see a GP.  I made an appointment and went down ready to argue my case but the Dr looked at it and not only agreed with my wife but said that there 2 others he was suspicious of and referred me to the cancer unit at my local hospital (where I already have a hospital number). The skin consultant saw me about 10 days later and said that they were probably okay but would incise them and have them tested. 2 weeks later that was done in a local minor injuries unit (free parking - Yay!!).

Good luck with the surgery Durhamlad! 

Thanks very much, I am looking forward to getting this done. The op takes about 2 hours, instruments inserted through a large vein in the groin, and it is a mandatory overnight stay for observation. I am fortunate to be so close to a large regional heart centre.

My degree and career has been in Electrical Engineering so I find it ironic that I am suffering with an electrical problem in the heart and will be operated on by a cardiac electrophysiologist. (I am age 63 and this started shortly after my 60th birthday)

Thanks very much, I am looking forward to getting this done. The op takes about 2 hours, instruments inserted through a large vein in the groin, and it is a mandatory overnight stay for observation. I am fortunate to be so close to a large regional heart centre.

My degree and career has been in Electrical Engineering so I find it ironic that I am suffering with an electrical problem in the heart and will be operated on by a cardiac electrophysiologist. (I am age 63 and this started shortly after my 60th birthday)

Promise to let us know that all went well.

And I completely agree.  The NHS is great - if you advocate for yourself.  I've learned it's okay to be the squeaky wheel. 

After fighting for 7 years for a dermatology referral, I've finally been in front of a dermatologist who took one look at me (red head, covered in moles, grew up in Florida, history of melanoma on both sides, two myself, and my uncle is terminal with melanoma) and said, "It took you a long time to get here but we won't let you out of our sight now."  and they've even referred me for genetic testing as they are studying more about melanoma and genes (much like the breast cancer gene).  I go every three months now. 

I provided my visa vignette when I came over in 2010 on my work visa.  No one ever asked to see subsequent BRP's or anything else - ever. 

Sirius told me in the past that the NHS system and Home Office system "talk" to each other and the HO updates would have passed automatically to the NHS.

The changes to the NHS came in from April 2015, under the Immgiration Act 2014. You arrived in in 2010 on an Intra-Company Transfer visa, when UK law at the time said that everyone lawfully in the UK could have bill free NHS.

For the Tier 2 (Intra-Company Transfer) visas from April 2010, the UK no longer allowed these to settle in the UK (have ILR). A 12 month cooling off period outside the UK was brought in if they wanted to return to the UK on Tier 2 General visa (a visa does lead to ILR).  There was an exception for those who applied for their ICT visa between April 2010 and 2011 if they wanted a Tier 2 General (lead to ILR) but not much of one as they had to find a work sponsor and pass the RLMT. And I believe those on the Intra-Company Transfer visa did not pay the IHS until April 2016?

From 2015, UKVI have used a banner system on the NHS SPINE system on the patients name, so that the NHS can know if the person is trying to use the NHS without paying. Green banner and red banner. No banner, the NHS staff can phone UKVI to see what their status is in the UK.

So... from 2016, when a Tier 2 (Intra-Company Transfer) expires, UKVI will change the banner on their details on the NHS SPINE system to red, to show they must now pay if they overstay. But it will remain green if they put in an in time application to switch (in country) to  FLR(M) and stay green if that visa is approved, until the end of that FLR(M).

I don't know your timeline for when you married a Brit and applied to switch (in country) to FLR(M), but that is what happened from the dates above.

For those that overstay, UKVI requested their details from the NHS. It was something like 5,000 illegals were caught by UKVI this way in the first 10 months of 2016.

It doesn't work very well for those in the UK on EU rules. e.g. a non-EEA citizen could turn up with an EU "RC" but that becomes invalid if their EEA citizen sponsor has stopped being a "qualified person". The NHS has no way of knowing that they must be billed unless the holder tells them and the same with employers if they have turned up at work. The UK did bring in a laws so that illegally working is now a criminal offence for the person doing it, but that Act arrived at the same time as the UK voted to leave the EU, and those that were not lawfully in the UK then rushed to make sure they were. 

I didn't disagree with any of this, but once you have proved your right to NHS care the first time and received an NHS number, and proved your identity and received a hospital number on your first visit, are you saying that you have experience that you are required to produce your BRP every subsequent visit or call to the GP or hospital?

For example, today I called the hospital to inquire about the results of a biopsy I had done recently. They asked for my NHS number and then my hospital number. If I had been an immigrant are you saying that they would also have asked for details from my BRP?

Not saying that you are wrong just that I have not seen folks report that level of scrutiny by the NHS.

For those with a BRP, even if they don't produce that, the hospital can see if their banner on the system has turned red and they must now pay.

It's different for you as you are a British citizen and then can see if you are residing in the UK. You cannot be an overstayer in your own country.

I didn't get a new GP for years when I moved areas and I had told my previous GP I was moving out the area.  Years later, I needed to get a prescription and went to a walk in centre and took evidence I was a BC and residing in the UK, but they didn't need the evidence of residing as they said they could see that on their linked system.

The  Brit behind me in the queue, was told she must pay as they said the system showed was not a resident. She tried arguing that she was but they said until she brought that proof, they would bill her. She said she would be back in a few minutes with that evidence, but did not return. I don't know what the receptionist was looking at, but they got it right.

The best of for your surgery.

For those with a BRP, even if they don't produce that, the hospital can see if their banner on the system has turned red and they must now pay.

It's different for you as you are a British citizen and then can see if you are residing in the UK. You cannot be an overstayer in your own country.

I didn't get a new GP for years when I moved areas and I had told my previous GP I was moving out the area.  Years later, I needed to get a prescription and went to a walk in centre and took evidence I was a BC and residing in the UK, but they didn't need the evidence of residing as they said they could see that on their linked system.

The  Brit behind me in the queue, was told she must pay as they said the system showed was not a resident. She tried arguing that she was but they said until she brought that proof, they would bill her. She said she would be back in a few minutes with that evidence, but did not return. I don't know what the receptionist was looking at, but they got it right.

The best of for your surgery.

Once again I totally agree with you. The fact that they have the person’s record flagged on a banner supports my view that once you are registered they are not going to ask to see your BRP every time you go to the doctor or a hospital. Your NHS number will surely either flag you as eligible or not.  Only when you are flagged as ineligible will you need to show proof of eligibility or am I missing the point of this SPINE database.

To answer the original question is it correct to say that immigrants are never issued with an NHS insurance/eligibility card that they have to produce every time they go to the doctors like in the USA?

I’m really not trying to be difficult here just trying to understand myself what BRP holders have to expect. When I first registered with the NHS in 2016 I had to prove eligibility that first time because I did not have an NHS number as it had been 30 years since I lived here and I had not been eligible to use the NHS. I could leave the country again and once I stopped paying UK taxes by registering as non-resident with HMRC I would lose my eligibility to the NHS. While living in that other country if I returned on holiday and tried to use the NHS I could expect my access be denied since I would be flagged as non resident even though I am a UKC.

Thanks for the best wishes for my surgery.

Once again I totally agree with you. The fact that they have the person’s record flagged on a banner supports my view that once you are registered they are not going to ask to see your BRP every time you go to the doctor or a hospital. Your NHS number will surely either flag you as eligible or not.  Only when you are flagged as ineligible will you need to show proof of eligibility or am I missing the point of this SPINE database.

To answer the original question is it correct to say that immigrants are never issued with an NHS insurance/eligibility card that they have to produce every time they go to the doctors like in the USA?

I’m really not trying to be difficult here just trying to understand myself what BRP holders have to expect. When I first registered with the NHS in 2016 I had to prove eligibility with passport and utility bills that first time because I did not have an NHS number as it had been 30 years since I lived here and I had not been eligible to use the NHS. I could leave the country again and once I stopped paying UK taxes by registering as non-resident with HMRC I would lose my eligibility to the NHS. While living in that other country if I returned on holiday and tried to use the NHS I could expect my access be denied since I would be flagged as non resident even though I am a UKC.

Thanks for the best wishes for my surgery.

Once again I totally agree with you. The fact that they have the person’s record flagged on a banner supports my view that once you are registered they are not going to ask to see your BRP every time you go to the doctor or a hospital. Your NHS number will surely either flag you as eligible or not.  Only when you are flagged as ineligible will you need to show proof of eligibility or am I missing the point of this SPINE database.

To answer the original question is it correct to say that immigrants are never issued with an NHS insurance/eligibility card that they have to produce every time they go to the doctors like in the USA?

I’m really not trying to be difficult here just trying to understand myself what BRP holders have to expect. When I first registered with the NHS in 2016 I had to prove eligibility that first time because I did not have an NHS number as it had been 30 years since I lived here and I had not been eligible to use the NHS. I could leave the country again and once I stopped paying UK taxes by registering as non-resident with HMRC I would lose my eligibility to the NHS. While living in that other country if I returned on holiday and tried to use the NHS I could expect my access be denied since I would be flagged as non resident even though I am a UKC.

Thanks for the best wishes for my surgery.

I went to A&E last year without knowing my NHS number of having my BRP card with me and I had no trouble getting treatment. They simply asked me my name and address, I have a maiden name I'm listed under for my BRP but I am registered as my married name with my surgery.

I was pretty out of it at the time as I had extremely low blood pressure from beta blockers. It was a really tough day.

I went to A&E last year without knowing my NHS number of having my BRP card with me and I had no trouble getting treatment. They simply asked me my name and address, I have a maiden name I'm listed under for my BRP but I am registered as my married name with my surgery.

I was pretty out of it at the time as I had extremely low blood pressure from beta blockers. It was a really tough day.

I’m pleased to hear that under those circumstances you didn’t have to fight with the admin aspects  as well.

There is no card to prove access to the NHS like the US insurance cards. They took a photocopy of my BRP and the proof of address when I registered, and I received my NHS # a few weeks later in the post. My resident UKC husband has never been asked for anything except proof of address. Insurance cards were a completely foreign concept to him!

Good luck with surgery durhamlad, a number of my friends have had that and it helped them so much!

Sent from my Pixel C using Tapatalk

I’m pleased to hear that under those circumstances you didn’t have to fight with the admin aspects  as well.

Nope, no trouble at all. The worst thing was all of their failed attempts to draw blood throughout the 12 hours I was there. 🙄

I hope your surgery goes smoothly! Any surgery can be a bit rough on the psyche.

I personally got a paper card with my NHS number on it, I know it's not a usual thing. I don't even know where I put it for safe keeping. Haha.

Once again I totally agree with you. The fact that they have the person’s record flagged on a banner supports my view that once you are registered they are not going to ask to see your BRP every time you go to the doctor or a hospital.

I can’t see why they would have to show that Trust their BRP every time, or where it says they should.

When the government put up a web site to ask what people wanted to see changed, the NHS tab had a lot of suggestions on stopping NHS abuse.  People also put links up to threads on immigration and expat sites, where the NHS was openly being talked about.

How hospitals never check their status in the UK if they can get a referral from a GP, as many hospitals assume the GP has checked, was on those links and how that meant they could avoid paying for their treatment. Now the hospital will use the BRP to check their status and they will also be in the loop for any changes in that persons status.g. SPINE, hotline to UKVI to check, advise UKVI of those trying NHS fraud, advise UKVI of outstanding NHS debt etc. T

Another abuse on those links was… don't bother with buying insurance when you visit the UK, just visit A&E and use that for free.

A&E  is only for-

"genuine life-threatening emergencies, such as:

    loss of consciousness
    acute confused state and fits that are not stopping
    chest pain
    breathing difficulties
    severe bleeding that cannot be stopped
    severe allergic reactions
    severe burns or scalds
    stroke
    major trauma such as a road traffic accident"
https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/when-to-go-to-ae/

A&E staff said they have people arriving who are not an emergency and some of these are visitors who did not bother with insurance. They now add 50% to their bill as not everything is free when they visit A&E.

The government have already run a consolation on ending free emergency treatment for NHS England for those who cannot use the NHS bill free under the rules. They said this is another NHS change they will be looking at making, to add to the changes previous governments have already made to protect the NHS.

The first person I saw get 50% added to their bill after the new law came in in April 2015, was a British citizen who was visiting from the US. They said they never bothered with insurance for the family when they visited as they always went to A&E for anything for free, but that year A&E checked and they ended up with the 50% too and got a 1k bill.

I can’t see why they would have to show that Trust their BRP every time, or where it says they should.

When the government put up a web site to ask what people wanted to see changed, the NHS tab had a lot of suggestions on stopping NHS abuse.  People also put links up to threads on immigration and expat sites, where the NHS was openly being talked about.

How hospitals never check their status in the UK if they can get a referral from a GP, as many hospitals assume the GP has checked, was on those links and how that meant they could avoid paying for their treatment. Now the hospital will use the BRP to check their status and they will also be in the loop for any changes in that persons status.g. SPINE, hotline to UKVI to check, advise UKVI of those trying NHS fraud, advise UKVI of outstanding NHS debt etc.

Some more data...

As I've mentioned before, when I first came back in 2016 and registered to get my new NHS number I had to show my passport and utility bill and since then never been questioned.

I just got my paperwork in the post yesterday for my outpatient surgery next week. This is the same hospital I have visited 6 times in the last 18 months including outpatient surgery 4 weeks ago (different department). This time the paperwork includes a letter asking that when I arrive to bring a recent utility bill to show residence plus something to show my right to be here such as a passport, birth certificate, etc, and the letter also points out that being a British Citizen does not give the right to free healthcare, you also have to be Ordinarily Resident.

It's good to know that they now do check from time to time even with "regulars", and also that they give warning ahead of time, as most folks don't carry around proof of where they live along with their passport. (Driver's licence was not listed as proof of address).

It's good to know that they now do check from time to time even with "regulars", and also that they give warning ahead of time, as most folks don't carry around proof of where they live along with their passport. (Driver's licence was not listed as proof of address).

Some of the "regulars" at a hospital, might have been illegal in the UK for years and before the Immigration Act 2014, found it easy to avoid paying for their treatment.

As UKVI now write to DVLA so that they can revoke the UK driving licence of those that no longer have lawful status in the UK and haven't left, I wonder if this is why they won't use a DL?