# NHS Healthcare for Expats



## tebo53 (Sep 18, 2014)

Hi,

Having just officially reached retirement age I've just received my S1 healthcare forms and was interested in the following paragraph, which may also be of interest to any retired person worried about the EHIC cover. (Obviously you need to have submitted your S1 for this entitlement to apply)


*Entitlement to medical cover in the UK.* 
The NHS is a residence - based system and moving abroad can mean losing your entitlement to receive healthcare free of charge on the NHS. *However*, as you will have your healthcare paid for by the UK by means of an S1 in your country of residence, from 6th April 2015 your right to return to England for all treatment including elective, has been extended. This means you can access NHS treatment in England as if ordinarily resident (This means treatment will be free unless a statutory charge also applies to residents in England, for example prescription charges). You will not to obtain any kind of authorisation from your country of residence prior to seeking treatment


May be of help to some........

Steve


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## extranjero (Nov 16, 2012)

No wonder the NHS is in a mess if it is paying for expats , and then paying again if they fly over to the UK for treatment as well!


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## xabiaxica (Jun 23, 2009)

Yes, the rules changed April 2015 

BRITISH PENSIONERS RESIDENT IN SPAIN ARE ENTITLED TO FULL ACCESS TO NHS HEALTHCARE IN THE UK


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## Alcalaina (Aug 6, 2010)

extranjero said:


> No wonder the NHS is in a mess if it is paying for expats , and then paying again if they fly over to the UK for treatment as well!


Welcome back!

Do people really "fly over to the UK for treatment"? If they mistrust the Spanish system so much that they would even think of doing that, they could afford to go private, surely? :confused2:

It will be useful for people who spend part of the year in each country though, not having to keep registering and deregistering in Spain.


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## Alcalaina (Aug 6, 2010)

On a related matter, does anyone know if British pensioners resident in Spain are entitled to a free eye test in the UK?


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## xabiaxica (Jun 23, 2009)

Alcalaina said:


> Welcome back!
> 
> Do people really "fly over to the UK for treatment"? If they mistrust the Spanish system so much that they would even think of doing that, they could afford to go private, surely? :confused2:
> 
> It will be useful for people who spend part of the year in each country though, not having to keep registering and deregistering in Spain.


I know people who have been dong it for years - before they (legally) could 

But then they weren't 'resident' despite living here for years

Probably still aren't, since I doubt they realise that it's legal now to do so & if only they were properly registered they'd have the best of both worlds - full healthcare in both countries. No more using the EHIC with :fingerscrossed: that the computer hasn't picked up on the fact that they've been using it frequently over a long period of time.


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## VFR (Dec 23, 2009)

The cost would be a drop in the ocean to the NHS budget (if that) and as said the vast bulk would simply have any medical needs done here.


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## Roy C (Sep 29, 2012)

The nos saves on not having to pay for ex pats healthcare that are under state pension age. Even though most have paid into the system for the majority of their life.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> The nos saves on not having to pay for ex pats healthcare that are under state pension age. Even though most have paid into the system for the majority of their life.


Those under state pension age can work & access healthcare in their country of residence that way, though.

It was only temporary when the UK did issue S1s to those under state pension age. The UK was the only country doing so, as well. No other EU country did.


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## paintersmate (Dec 1, 2015)

There are quite a few British couples living near here that moved here around 13/14 years ago. They all have SIP cards, they say they gave them to all at that time, and all except 2 couples have residencia. They seem to think we are mad to have applied and got it ( for hubby, at least) they think its a waste of time and has tax implications. I tried to explain that, as we have no home now in UK, we live here and isn't it the gripe of most Brits about immigrants (cos thats what we are) coming into UK and putting nothing into UK system and using any services they want? Seems a bit double standards to me


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## snikpoh (Nov 19, 2007)

paintersmate said:


> There are quite a few British couples living near here that moved here around 13/14 years ago. They all have SIP cards, they say they gave them to all at that time, and all except 2 couples have residencia. They seem to think we are mad to have applied and got it ( for hubby, at least) they think its a waste of time and has tax implications. I tried to explain that, as we have no home now in UK, we live here and isn't it the gripe of most Brits about immigrants (cos thats what we are) coming into UK and putting nothing into UK system and using any services they want? Seems a bit double standards to me


Yes it does. 

If they haven't signed on the list of foreigners (aka 'residencia') then they probably haven't done a tax return either - although technically they are automatically tax resident anyway! In that case they are NOT benefiting from the tax advantages in terms of CGT and succession tax (Spanish IHT).


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## baldilocks (Mar 7, 2010)

What about the non-pensioner dependants of UK pensioners who are also included in the S1 in Spain and also get their treatment in Spain paid for?


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## xabiaxica (Jun 23, 2009)

baldilocks said:


> What about the non-pensioner dependants of UK pensioners who are also included in the S1 in Spain and also get their treatment in Spain paid for?


Yes

The S1 is the key


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## Roy C (Sep 29, 2012)

xabiachica said:


> Those under state pension age can work & access healthcare in their country of residence that way, though.
> 
> It was only temporary when the UK did issue S1s to those under state pension age. The UK was the only country doing so, as well. No other EU country did.


The people who retire early to Spain and the like have to pay for private medical care and if they were to holiday in the UK they would need insurance to cover them for health care if they are no longer resident after paying into the NHS all their working life ( in most cases). Somehow, I don't think that is right that they have to do that in the UK.


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## Lynn R (Feb 21, 2014)

Roy C said:


> The people who retire early to Spain and the like have to pay for private medical care and if they were to holiday in the UK they would need insurance to cover them for health care if they are no longer resident after paying into the NHS all their working life ( in most cases). Somehow, I don't think that is right that they have to do that in the UK.


We both had to, although we did initially get 2 years' state healthcare via the S1 when we first arrived, but had to have private insurance for the next 7 years. We weren't entitled to an EHIC card from either the UK or Spain, either, if we were travelliing, so had to rely totally on private insurance.

I didn't mind that, to be honest. It was our choice to give up work early and stop paying NI, thus contributing less to the UK system than we would have if we'd carried on working until state retirement age. We just thought we were lucky to be in a position to do it.

Now that we are both covered for state healthcare here in Spain because my husband is a pensioner, I would only ever use NHS healthcare in the UK in case of an emergency if I happened to be there. If I were feeling ill the last thing I'd want to do would be to take a plane journey back, and it strikes me that it would be very complicated fitting in all the consultations and tests if I were to need an operation. Having somewhere to stay for what could be a protracted period would be a problem too, as we don't have a property of our own in the UK.


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## Roy C (Sep 29, 2012)

Lynn R said:


> We both had to, although we did initially get 2 years' state healthcare via the S1 when we first arrived, but had to have private insurance for the next 7 years. We weren't entitled to an EHIC card from either the UK or Spain, either, if we were travelliing, so had to rely totally on private insurance.
> 
> I didn't mind that, to be honest. It was our choice to give up work early and stop paying NI, thus contributing less to the UK system than we would have if we'd carried on working until state retirement age. We just thought we were lucky to be in a position to do it.
> 
> Now that we are both covered for state healthcare here in Spain because my husband is a pensioner, I would only ever use NHS healthcare in the UK in case of an emergency if I happened to be there. If I were feeling ill the last thing I'd want to do would be to take a plane journey back, and it strikes me that it would be very complicated fitting in all the consultations and tests if I were to need an operation. Having somewhere to stay for what could be a protracted period would be a problem too, as we don't have a property of our own in the UK.


I have paid over forty years into my NI stamps , so I'm fully paid up at a higher rate and a lot more than a lot of people who use and abuse the system. I have no intentions of travelling back to the UK for health care when we move over next year we will pay into private medical ins, which I also don't have a problem with. 

It just seems unfair for someone once resident in the UK and having paid their bit into the system, should have to take out medical insurance to cover them on a short visit.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> The people who retire early to Spain and the like have to pay for private medical care and if they were to holiday in the UK they would need insurance to cover them for health care if they are no longer resident after paying into the NHS all their working life ( in most cases). Somehow, I don't think that is right that they have to do that in the UK.


It might sound harsh - but they chose to retire early & leave the UK.

I did precisely that & didn't expect the UK to continue funding my healthcare outside Spain - it didn't even occur to me that that would be the case. 

I also worked full time from age 16 until I had my children & my late husband worked full time until we left the UK.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> I have paid over forty years into my NI stamps , so I'm fully paid up at a higher rate and a lot more than a lot of people who use and abuse the system. I have no intentions of travelling back to the UK for health care when we move over next year we will pay into private medical ins, which I also don't have a problem with.
> 
> It just seems unfair for someone once resident in the UK and having paid their bit into the system, should have to take out medical insurance to cover them on a short visit.


atm at least, once you are in receipt of your UK state pension, the UK will then fund your healthcare here

Though that might change in a couple of years. The UK doesn't fund healthcare for people who move to non-EU countries, not even for pensioners, so might stop doing so when it leaves the EU

I think there's some kind of arrangement with Australia & maybe other commonwealth countries


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## Roy C (Sep 29, 2012)

xabiachica said:


> It might sound harsh - but they chose to retire early & leave the UK.
> 
> I did precisely that & didn't expect the UK to continue funding my healthcare outside Spain - it didn't even occur to me that that would be the case.
> 
> I also worked full time from age 16 until I had my children & my late husband worked full time until we left the UK.


I know it's my choice thanks but I'm certainly allowed an opinion which hasn't affected my decision to move. 

Get this: I think if you have paid into a system then if you needed it while visiting that country you should be entitled to it. This is not an expectation it is an opinion.

I will be entitled to the state pension in about eight years,( if that doesn't change again) and get this, I don't have any expectations that after Brexit I will have my health care funded but in my opinion, I think it should be.


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## xabiaxica (Jun 23, 2009)

Roy C said:


> I know it's my choice thanks but I'm certainly allowed an opinion which hasn't affected my decision to move.
> 
> Get this: I think if you have paid into a system then if you needed it while visiting that country you should be entitled to it. This is not an expectation it is an opinion.
> 
> I will be entitled to the state pension in about eight years,( if that doesn't change again) and get this, I don't have any expectations that after Brexit I will have my health care funded but in my opinion, I think it should be.


Absolutely

You're entitled to your opinion & I'm entitled to mine

We just don't happen to agree


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## Roy C (Sep 29, 2012)

xabiachica said:


> Absolutely
> 
> You're entitled to your opinion & I'm entitled to mine
> 
> We just don't happen to agree


I have to agree with that.


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## tebo53 (Sep 18, 2014)

baldilocks said:


> What about the non-pensioner dependants of UK pensioners who are also included in the S1 in Spain and also get their treatment in Spain paid for?


It does state that anyone who gets healthcare paid for through the S1 is entitled.


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## Megsmum (Sep 9, 2012)

Roy C said:


> I have paid over forty years into my NI stamps , so I'm fully paid up at a higher rate and a lot more than a lot of people who use and abuse the system. I have no intentions of travelling back to the UK for health care when we move over next year we will pay into private medical ins, which I also don't have a problem with.
> 
> It just seems unfair for someone once resident in the UK and having paid their bit into the system, should have to take out medical insurance to cover them on a short visit.


What happened to that proposal...if you had contributed for 7 years plus you were entitled to cover in the UK?



Roy C said:


> I know it's my choice thanks but I'm certainly allowed an opinion which hasn't affected my decision to move.
> 
> Get this: I think if you have paid into a system then if you needed it while visiting that country you should be entitled to it. This is not an expectation it is an opinion.
> 
> I will be entitled to the state pension in about eight years,( if that doesn't change again) and get this, I don't have any expectations that after Brexit I will have my health care funded but in my opinion, I think it should be.


If health cover is stopped for pensioners post brexit, and not covered here in Spain when we officially retire in years, we will have to return back to the UK, we could not afford Private costs. As I work , we are covered at the moment, hopefully when officially retired:fingerscrossed: As you may have noticed it is my only issue with the Brexit thing, with regards to how it affects us on a personal level


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## Roy C (Sep 29, 2012)

cambio said:


> What happened to that proposal...if you had contributed for 7 years plus you were entitled to cover in the UK?
> 
> 
> 
> If health cover is stopped for pensioners post brexit, and not covered here in Spain when we officially retire in years, we will have to return back to the UK, we could not afford Private costs. As I work , we are covered at the moment, hopefully when officially retired:fingerscrossed: As you may have noticed it is my only issue with the Brexit thing, with regards to how it affects us on a personal level


I also do hope that they will continue to pay for the healthcare we invested in during our working lives. I think it is a moral obligation to tell you the truth but even in the UK they are now cutting back on the NHS as outlined today. Another five years of Tory rule preparing the NHS for privatisation.


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## jojo (Sep 20, 2007)

Roy C said:


> I also do hope that they will continue to pay for the healthcare we invested in during our working lives. I think it is a moral obligation to tell you the truth but even in the UK they are now cutting back on the NHS as outlined today. Another five years of Tory rule preparing the NHS for privatisation.


 The way I look at it is, we pay national insurance contributions. We also pay house insurance, car insurance...... all cover stops when we stop paying in and leave them. I know its not quite the same, but its not that dissimilar either. 

Jo xxx


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## Roy C (Sep 29, 2012)

jojo said:


> The way I look at it is, we pay national insurance contributions. We also pay house insurance, car insurance...... all cover stops when we stop paying in and leave them. I know its not quite the same, but its not that dissimilar either.
> 
> Jo xxx


So with your rule. most pensioners who no longer pay into the system should lose their healthcare.


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## jojo (Sep 20, 2007)

Roy C said:


> So with your rule. most pensioners who no longer pay into the system should lose their healthcare.


 Like I say, its not quite the same in that respect, but the basic insurance principle is that you are covered while you pay in. British NHS is also based on residency, unlike most EU countries, whereby you have to pay in to be eligible. 

Jo xxx


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## jojo (Sep 20, 2007)

..... I'm not disagreeing with you by the way, its just....its how it is and when you think about how much money we've all paid for things like car, house insurance over the years......Its something we simply have to live with.

Jo xxx


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## Roy C (Sep 29, 2012)

Jo, you have a choice as in whether to pay car insurance or not, with National Insurance or tax, you don't have that choice.


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## Megsmum (Sep 9, 2012)

jojo said:


> ..... I'm not disagreeing with you by the way, its just....its how it is and when you think about how much money we've all paid for things like car, house insurance over the years......Its something we simply have to live with.
> 
> Jo xxx


You can not compare NI payments for a lifetime of working and the stopping of healthcare to, house insurance. People based life decisions based on the fact that they were told they would have health cover when retired. On that basis the unemployed and those too sick to work should not get benefits or health cover as they are not paying in. However I foresee changes within the UK system as well, and I will be interested to hear how the British Public feel when their right to health cover changes from free ( even though they will still be paying NI) to pay as you go. I am sure they will all agree with your sentiment, it's just like house insurance

Roy
It is a worry, but it's an unknown, I am fairly convinced there will be various ways around the issue


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## ccm47 (Oct 15, 2013)

Personally I think this is a Win-Win situation.

Pensioners gain by being able to benefit from the healthy climate of Spain, which generally leads to better sustained fitness. Whilst at the same time having reassurance that when visiting the UK they can go to any doctor, or hospital, without having to fill in reams of paperwork. I believe they have to be able to prove they are in receipt of a UK pension though.
Pensioners are also encouraged to move from the UK, freeing up housing stock, as they know they can return if that's what they eventually want to do, without serving a 6 month waiting time for NHS entitlement.

NHS gains by having fewer pensioner patients permanently on the books draining resources , also not paying GPs for patients who may have been on the books but only put in a very occasional appearance. (Yes the doctors lose).


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## Roy C (Sep 29, 2012)

ccm47 said:


> Personally I think this is a Win-Win situation.
> 
> Pensioners gain by being able to benefit from the healthy climate of Spain, which generally leads to better sustained fitness. Whilst at the same time having reassurance that when visiting the UK they can go to any doctor, or hospital, without having to fill in reams of paperwork.* I believe they have to be able to prove they are in receipt of a UK pension though.
> *Pensioners are also encouraged to move from the UK, freeing up housing stock, as they know they can return if that's what they eventually want to do, without serving a 6 month waiting time for NHS entitlement.
> ...


Why?
Surely it would be better to prove they have paid enough into the system ie stamps to get something back, not necessarily pensioners?


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## Alcalaina (Aug 6, 2010)

ccm47 said:


> Personally I think this is a Win-Win situation.
> 
> Pensioners gain by being able to benefit from the healthy climate of Spain, which generally leads to better sustained fitness. Whilst at the same time having reassurance that when visiting the UK they can go to any doctor, or hospital, without having to fill in reams of paperwork. I believe they have to be able to prove they are in receipt of a UK pension though.
> Pensioners are also encouraged to move from the UK, freeing up housing stock, as they know they can return if that's what they eventually want to do, without serving a 6 month waiting time for NHS entitlement.
> ...


I agree with you.

Re proof, isn't the possession of a British EHIC issued by the DWP proof enough? They ony issue them to pensioners and their dependents.

Only asking because I'm going to England on Monday for a while, and might need some treatment!


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## Alcalaina (Aug 6, 2010)

Roy C said:


> Why?
> Surely it would be better to prove they have paid enough into the system ie stamps to get something back, not necessarily pensioners?


No Roy, the NHS is based on need, not whether or not you've paid in advance. It's still a collective service, paid for by society as a whole. Not a commodity that you purchase.

And long may it remain so.


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## xabiaxica (Jun 23, 2009)

Alcalaina said:


> I agree with you.
> 
> Re proof, isn't the possession of a* British EHIC issued by the DWP proof enough*? They ony issue them to pensioners and their dependents.
> 
> Only asking because I'm going to England on Monday for a while, and might need some treatment!


Should be enough - but take your S1 with you too. That's what they are supposed to ask for


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## baldilocks (Mar 7, 2010)

I have NHS hearing aids but can't use them here because of the loud noises (the dogs barking in particular) and they need the maximum volume to be clipped. I wonder if I go to UK, they will adjust them for me.


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## Megsmum (Sep 9, 2012)

I think it is important to differentiate between

Health care for retirees post-Brexit - Which I believe should continue, for various reasons
as on the "other" thread

Healthcare for returning to the UK for Holidays etc Which I do not think should be the case. You move away from your country of residence why should they pay cover for your odd trip home.

No matter where you live in the world, you go on holiday you get insurance cover, just because you once lived there does not give you a lifetime of ad hoc medical cover.


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## Megsmum (Sep 9, 2012)

xabiachica said:


> Should be enough - but take your S1 with you too. That's what they are supposed to ask for


What happened to the 7 year thing mentioned last year. IF you had paid 7 years you get cover... or is that just for pensioners.....


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## Roy C (Sep 29, 2012)

I think it is a point of principle. In my own circumstances I will not need to rely on the UK providing healthcare for us however if they did it wouldn't be refused. I don't understand people on here objecting to that, especially as many have received free healthcare themselves at below retirement age. The cost of supplying healthcare for UK expats returning for a holiday would be quite low, however i understand from a previous post they would get treatment. What is the difference between a pensioner's dependent getting treatment and an expat below retirement age and not a dependent getting treatment? I have no objection to anyone getting treatment under the NHS but whats good for the goose....

Or maybe I'm just thick.


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## ccm47 (Oct 15, 2013)

Alcalaina said:


> I agree with you.
> 
> Re proof, isn't the possession of a British EHIC issued by the DWP proof enough? They ony issue them to pensioners and their dependents.
> 
> Only asking because I'm going to England on Monday for a while, and might need some treatment!


The link to the current NHS advice is here,
Moving abroad - Healthcare abroad - NHS Choices

It has clearly changed from the guidance I received just a year ago. Indeed my local hospital said if I needed advice or treatment whenever I went back I would just have to give them my patient no. but that may not be the case for every hospital.


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## Lynn R (Feb 21, 2014)

Roy C said:


> I think it is a point of principle. In my own circumstances I will not need to rely on the UK providing healthcare for us however if they did it wouldn't be refused. I don't understand people on here objecting to that, especially as many have received free healthcare themselves at below retirement age. The cost of supplying healthcare for UK expats returning for a holiday would be quite low, however i understand from a previous post they would get treatment. What is the difference between a pensioner's dependent getting treatment and an expat below retirement age and not a dependent getting treatment? I have no objection to anyone getting treatment under the NHS but whats good for the goose....
> 
> Or maybe I'm just thick.


If you continued living in the UK until state retirement age, you'd still have to pay NI contributions until then even though you've already exceeded 40 years of contributions. The system doesn't take into account how many years you have paid for, nor how much in cash terms you have paid in relative to others. It's residence based, and if you don't live there you don't get it, until you or your spouse become a state pensioner. Some of us did get the S1 cover in the past, for a strictly limited time, but that has now been withdrawn. I suppoose that is somewhat unfair to those early retirees who came after us, but rules do change - just look at the situation now whereby people who retired in April this year and after can be receiving much higher state pensions than those who were already retired.

As Alcalaina said, it's a collective system. No different from me having helped to pay for other peoples' children to be educated although I don't have children of my own.

You'll have a much bigger problem if the Government do decide to stop paying for the healthcare of state pensioners and their dependents in EU countries as a consequence of Brexit, and we all have to continue funding our own healthcare throughout our retirement, or move back to the UK. Perhaps they might even say that anyone already in receipt of that cover would retain it, but no further S1s would be issued. That too wouldn't really be fair to those who might wish to retire abroad in the future, but I'm sure the Government would say "tough luck".

The whole system is riddled with inconsistencies. Pensioners in some countries get their healthcare paid for, whilst in others they don't. Pensioners in some countries get annual pension increases, others don't.


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## Megsmum (Sep 9, 2012)

> You'll have a much bigger problem if the Government do decide to stop paying for the healthcare of state pensioners and their dependents in EU countries as a consequence of Brexit, and we all have to continue funding our own healthcare throughout our retirement, or move back to the UK. Perhaps they might even say that anyone already in receipt of that cover would retain it, but no further S1s would be issued. That too wouldn't really be fair to those who might wish to retire abroad in the future, but I'm sure the Government would say "tough luck


and I suspect, for anyone not in receipt of cover at the moment, their number one concern


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## Lynn R (Feb 21, 2014)

cambio said:


> and I suspect, for anyone not in receipt of cover at the moment, their number one concern


I'm afraid I can only see things going in one direction, and that is that what we get back in relation to what we have paid in is only going to get less, not more. That is true of pensions just as much as it is as of healthcare and benefits.


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## Roy C (Sep 29, 2012)

Lynn R said:


> *If you continued living in the UK until state retirement age, you'd still have to pay NI contributions until then even though you've already exceeded 40 years of contributions. *The system doesn't take into account how many years you have paid for, nor how much in cash terms you have paid in relative to others. It's residence based, and if you don't live there you don't get it, until you or your spouse become a state pensioner. Some of us did get the S1 cover in the past, for a strictly limited time, but that has now been withdrawn. I suppoose that is somewhat unfair to those early retirees who came after us, but rules do change - just look at the situation now whereby people who retired in April this year and after can be receiving much higher state pensions than those who were already retired.
> 
> As Alcalaina said, it's a collective system. No different from me having helped to pay for other peoples' children to be educated although I don't have children of my own.
> 
> ...


I don't agree with the above line, I'm an early retiree now, I pay tax on my pension but not NI contributions.


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## Lynn R (Feb 21, 2014)

Roy C said:


> I don't agree with the above line, I'm an early retiree now, I pay tax on my pension but not NI contributions.


I meant if you continued working in the UK, you'd still have to continue paying NI contributions until you reached state retirement age, even though you've already paid in for more than 40 years. There's no minium number of years you need to have paid NI for to be eligible for healthcare, but there's no maximum number either.

I wonder if, in future, some kind of (reduced) NI contribution might be demanded from pensioners, on a means tested basis. It would be one way of increasing funding for the NHS, from the demographic group who probably use it the most.


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## Roy C (Sep 29, 2012)

Lynn R said:


> I meant if you continued working in the UK, you'd still have to continue paying NI contributions until you reached state retirement age, even though you've already paid in for more than 40 years. There's no minium number of years you need to have paid NI for to be eligible for healthcare, but there's no maximum number either.
> 
> *I wonder if, in future, some kind of (reduced) NI contribution might be demanded from pensioners, on a means tested basis. It would be one way of increasing funding for the NHS, from the demographic group who probably use it the most.*



Although I'm usually in favour of means tested benefits, I think this one would be wrong, as in the UK we receive less pension than most of our neighbours. It would be better if they stopped financing wars and bankers and spent our money on healthcare.


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## Alcalaina (Aug 6, 2010)

Lynn R said:


> I wonder if, in future, some kind of (reduced) NI contribution might be demanded from pensioners, on a means tested basis. It would be one way of increasing funding for the NHS, from the demographic group who probably use it the most.


No, I don't think that would happen because pensioners have so much electoral clout.

More likely is that they will start offering offering more pensioner-friendly private insurance schemes, while simultaneously running down the NHS so only the very poorest have to use it, the ones with no choice.


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## Lynn R (Feb 21, 2014)

Roy C said:


> Although I'm usually in favour of means tested benefits, I think this one would be wrong, as in the UK we receive less pension than most of our neighbours. It would be better if they stopped financing wars and bankers and spent our money on healthcare.


Well, I agree with you there, but it's not exactly been the direction of travel for the past few decades, has it? Spending money on public services, including health, has been consistently demonised and the great British public (well, the majority of them) have happily gone along with it.


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## Lynn R (Feb 21, 2014)

Alcalaina said:


> No, I don't think that would happen because pensioners have so much electoral clout.
> 
> More likely is that they will start offering offering more pensioner-friendly private insurance schemes, while simultaneously running down the NHS so only the very poorest have to use it, the ones with no choice.


Pensioner friendly private insurance scheme would be so expensive that very few pensioners would be able to afford them. For a short time they tried that with products intended to allow people to pay into schemes which would cover their residential care costs if they needed it, but they didn't last long as they simply weren't viable given the amount of money the care costs.

Apart from elective surgery like hip and knee replacements a lot of the healthcare needs of elderly people aren't catered for by the private health sector in the UK. There's no money in it for them.

Look at this summary of what private medical insurance in the UK covers - acute, curable conditions and elective surgery:-

http://www.netdoctor.co.uk/health-s...19/what-does-private-medical-insurance-cover/

Long term chronic conditions such as diabetes (and dementia) and emergencies like heart attacks and strokes - they are left to the good old NHS.


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## Alcalaina (Aug 6, 2010)

Lynn R said:


> Pensioner friendly private insurance scheme would be so expensive that very few pensioners would be able to afford them. For a short time they tried that with products intended to allow people to pay into schemes which would cover their residential care costs if they needed it, but they didn't last long as they simply weren't viable given the amount of money the care costs.
> 
> Apart from elective surgery like hip and knee replacements a lot of the healthcare needs of elderly people aren't catered for by the private health sector in the UK. There's no money in it for them.
> 
> ...


Yes, at the moment. But I'm talking about _new_ forms of insurance or co-payment schemes that are aimed specifically at pensioners with pre-existing conditions. Pensioners are a reasonably affluent group overall, and if it comes to a decision between forking out £100 a month to go private and get your same-day test results within 48 hours, or waiting three months for the test then another month for the results ... It's already happening.


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## Megsmum (Sep 9, 2012)

I remember back in 197&%&%& writing a paper for one of my nursing exams on the ageing population. We knew this many many years ago, but it is not sexy politics so heads were firmly in the sand.

It is predicted that the Over-65s will make up one in five people in every region of England apart from London by 2024.

That's HUGE pension and healthcare costs, that have to come from somewhere. Are we going to ask the young to pay for this as well?

I do not like it, but health cover free at the point of use will have to go eventually, as will pension payments. There is obviously a sea change ahead and some of us are going to get caught up in it. There will have to be some form of co-payments. I have no ideas how it will work, I just hope we can afford it.


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## Lynn R (Feb 21, 2014)

cambio said:


> I remember back in 197&%&%& writing a paper for one of my nursing exams on the ageing population. We knew this many many years ago, but it is not sexy politics so heads were firmly in the sand.
> 
> It is predicted that the Over-65s will make up one in five people in every region of England apart from London by 2024.
> 
> ...


I noticed in the reports a week or so on the proposals put forward (not for the first time) by a Lib Dem spokesperson, Norman Lamb, for a new hypothecated tax to fund the NHS included the fact that one of the perceived advantages would be that pensioners would also pay it, if their incomes were high enough to be taxable. That's only another form of getting some contribution from pensioners towards the cost of the NHS, besides the reduced NI contributions I suggested earlier. 

I'm sure it wouldn't be electorally popular, but by and large pensioners' incomes and benefits have been protected over the last few years whilst working people have seen their wages frozen, univeersity tuition fees introduced and increased, childcare costs skyrocket, etc. and I don't think that can carry on much longer.


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## Megsmum (Sep 9, 2012)

Lynn R said:


> I noticed in the reports a week or so on the proposals put forward (not for the first time) by a Lib Dem spokesperson, Norman Lamb, for a new hypothecated tax to fund the NHS included the fact that one of the perceived advantages would be that pensioners would also pay it, if their incomes were high enough to be taxable. That's only another form of getting some contribution from pensioners towards the cost of the NHS, besides the reduced NI contributions I suggested earlier.
> 
> I'm sure it wouldn't be electorally popular, but by and large pensioners' incomes and benefits have been protected over the last few years whilst working people have seen their wages frozen, university tuition fees introduced and increased, childcare costs skyrocket, etc. and I don't think that can carry on much longer.


Prescriptions is another issue, a minor contribution should also be paid by pensioners tough but signs of the times,


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## VFR (Dec 23, 2009)

cambio said:


> Prescriptions is another issue, a minor contribution should also be paid by pensioners tough but signs of the times,


Yes tough times indeed.
Guess someone has to pay for the Billions (500+) used to bail out the banks & god knows how many Billions (at least another 400 ?) for Trident that will never be used.
And this untold cost that may be more than all of the above ?

respected Telegraph business journalist Liam Halligan wrote of

“….the spiralling cost of the UK’s unfunded public sector pensions….This vital issue is bubbling close to the top of the political agenda and there it should stay, until a solution is found. The taxpayer liability involved is the same size, or even bigger, than the UK’s official national debt….It is disgraceful that, in one of the world’s most sophisticated countries, arguably the centre of the global asset management industry, years of Whitehall buck-passing and obfuscation have resulted in us running a public sector pension scheme that is almost entirely unfunded. As long as the civil servants involved clung on to their public sector pension entitlements, why should they care? The same goes for successive governments. Politicians have repeatedly ducked this issue – at least those from the main parties…”


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## baldilocks (Mar 7, 2010)

VFR said:


> Yes tough times indeed.
> Guess someone has to pay for the Billions (500+) used to bail out the banks & god knows how many Billions (at least another 400 ?) for Trident that will never be used.
> And this untold cost that may be more than all of the above ?
> 
> ...


Because they have nice cushy pensions as well?


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## mono (Jan 22, 2016)

Britain is a rich country. It is only us peasants who are poor and have to pay disproporTionately to our earnings. Gordon Brown brought in taxation for pensioners. For a number of years we have been paying tax at the same rate and with the same personal allowance as the working peasants


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## Lynn R (Feb 21, 2014)

mono said:


> Britain is a rich country. It is only us peasants who are poor and have to pay disproporTionately to our earnings. Gordon Brown brought in taxation for pensioners. For a number of years we have been paying tax at the same rate and with the same personal allowance as the working peasants


The poorest pensioners, just like the poorest workers, don't pay tax because their incomes are below the personal allowance. As for the rest of us, who have reasonable incomes in retirement from occupational pensions and/or investments, I don't see why pensioners should be treated more favourably than anyone else with the same level of income, especially as our outgoings are lower than they are for younger working people who are bringing up families (paying high childcare costs and helping their kids through university), repaying the cost of student loans which we never had to, paying travel to work costs and maintaining a working wardrobe, paying prescription charges, etc.


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## extranjero (Nov 16, 2012)

Lynn R said:


> The poorest pensioners, just like the poorest workers, don't pay tax because their incomes are below the personal allowance. As for the rest of us, who have reasonable incomes in retirement from occupational pensions and/or investments, I don't see why pensioners should be treated more favourably than anyone else with the same level of income, especially as our outgoings are lower than they are for younger working people who are bringing up families (paying high childcare costs and helping their kids through university), repaying the cost of student loans which we never had to, paying travel to work costs and maintaining a working wardrobe, paying prescription charges, etc.


 Pensioners can't supplement their income with overtime, don't get bonuses, or have any chance of significant rises 
My measly NHS pension did not increase last year
My tiny annuity is the same for life
The state pension increase, though protected, was not much, unless you have a very high state pension, (which some do.)
Pensioners do often help children and grandchildren with holidays, school and university expenses etc, not all baby boomers are rich!
Care home fees are astronomical, and penalise those who have saved
Most aren't on gold plated pensions, and receive state pensions which are among the lowest in Europe
I agree with some that TV Licence concession, free prescriptions, WFA and free bus travel should be means tested to income( not savings)
No pensioner who gets more in pension than someone on the average wage needs them.
Limiting family benefit to the first two children, tackling tax avoidance, decreasing benefits so that no one is better off than those in work, would raise millions, as would limiting foreign aid to countries which don't need it.
Not to mention the gravy train which is the House of Lords, and don't forget bankers bonuses!


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## Megsmum (Sep 9, 2012)

extranjero said:


> Pensioners can't supplement their income with overtime, don't get bonuses, or have any chance of significant rises
> My measly NHS pension did not increase last year
> My tiny annuity is the same for life
> The state pension increase, though protected, was not much, unless you have a very high state pension, (which some do.)
> ...


Yep My NHS Gold plated pension...............what a joke


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## Lynn R (Feb 21, 2014)

I have a Civil Service pension, but it's not gold plated either, just under 2k per year. The average pension paid out to all public sector workers isn't gold plated at all, it is the ones paid to high earning senior managers which grab all the headlines and people believe everyone who ever worked in the public sector is coining it in.

However, I have another final salary pension (not public sector) which takes me above the personal tax allowance in the UK, plus in 6 years time I will have a state pension (if anybody is still getting one of those in the UK) plus a SIPP pension I paid additional voluntary contributions into for several years to provide an additional pension.

I don't think anybody in a similar position should expect to receive favourable taxation treatment simply because they are a pensioner.

Pensioners in the UK can, if they wish, take on part time jobs to supplement their income and many do, B&Q and the supermarkets employ quite a lot of them, so I disagree that they can't increase their incomes if they need to/want to - but they'll pay more tax on that extra income, of course.

Pensioners don't have to pay NI any more, of course, which is another deduction coming out of working people's wages.


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## extranjero (Nov 16, 2012)

cambio said:


> Yep My NHS Gold plated pension...............what a joke


When I say measly, I really mean measly- less than £200 a month!


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## Lynn R (Feb 21, 2014)

extranjero said:


> When I say measly, I really mean measly- less than £200 a month!


That being the case, with your state pension and a small annuity, your income won't be taxable in the UK, will it?


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## extranjero (Nov 16, 2012)

Lynn R said:


> I have a Civil Service pension, but it's not gold plated either, just under 2k per year. The average pension paid out to all public sector workers isn't gold plated at all, it is the ones paid to high earning senior managers which grab all the headlines and people believe everyone who ever worked in the public sector is coining it in.
> 
> However, I have another final salary pension (not public sector) which takes me above the personal tax allowance in the UK, plus in 6 years time I will have a state pension (if anybody is still getting one of those in the UK) plus a SIPP pension I paid additional voluntary contributions into for several years to provide an additional pension.
> 
> ...


Some pensioners do take on part time jobs, but they are hard to find nowadays, and many pensioners for health reasons cannot work
There are of course some very rich pensioners, but I bet most are on a poor- modest income
Pensioners seem to have become a whipping boy lately, and their protection resented
Some have to pay a lot out of their pensions for social care, help in the home etc
They are not asking for favourable tax treatment, but it would be wrong to deny those on modest incomes their few " perks"


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## extranjero (Nov 16, 2012)

Lynn R said:


> That being the case, with your state pension and a small annuity, your income won't be taxable in the UK, will it?


It just nudges above the level


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## Lynn R (Feb 21, 2014)

extranjero said:


> The state pension increase, though protected, was not much, unless you have a very high state pension, (which some do.)
> /QUOTE]
> 
> The increase on the basic state pension this year was 2.9% which was pretty good in comparison to the salary increases that most workers would have got - those in the public sector especially. Aren't NHS workers, for example, getting no more than 1% for this year and the next couple?
> ...


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## Lynn R (Feb 21, 2014)

extranjero said:


> Some have to pay a lot out of their pensions for social care, help in the home etc


Then the fairest way to deal with that would be to make those expenses allowable against tax, not to give everybody additional tax allowances even though they may not be paying for those things because they don't need them - not all pensioners do. My aunt is 92, lives alone with no paid for help apart from someone to maintain her garden every fortnight. It's her choice to carry on living in a 3 bed house with a garden she can't look after herself any more, so why should other taxpayers subsidise that?


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## Alcalaina (Aug 6, 2010)

Just to say I managed to register temporarily at a GP surgery where I am staying in England for a few weeks, just with my EHIC and NI number. No S1 document needed. And the arrangement doesn't cover eye tests, pensioners have to pay full rate.


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## Roy C (Sep 29, 2012)

Lucky for some.


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## Alcalaina (Aug 6, 2010)

Roy C said:


> Lucky for some.


I am in the UK because my mum has just died and I have to arrange the funeral. I have an infection in my toe which needs to be treated urgently so I can wear shoes without pain. So no, I don't feel very lucky. Just grateful.


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## Roy C (Sep 29, 2012)

Alcalaina said:


> I am in the UK because my mum has just died and I have to arrange the funeral. I have an infection in my toe which needs to be treated urgently so I can wear shoes without pain. So no, I don't feel very lucky. Just grateful.


I am sorry to hear about your mother passing and offer my condolences, however my remark was not aimed at you directly it was more in relation to this thread and certain categories from the UK originally who are afforded the NHS on a return visit. I hope your condition improves.


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