# Medical Requirements



## Bobby Mou (Jul 3, 2015)

Just arrived in Cyprus and will be here on a permanent basis. Now that Form S1 is no longer available via the NHS for those under 65 (my wife and I are 62 and both retired), does anybody have any advice or suggestions on how to obtain the medical requirements needed when applying for residency status. I have been to the immigration office in Larnaca and they will not accept EHIC cards as proof of medical cover. I don't particularly want to go down the private medical insurance route but if I have to, does anyone have or know a good company/broker in the Larnaca area for medical insurance.


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## David_&_Letitia (Jul 8, 2012)

Bobby Mou said:


> Now that Form S1 is no longer available via the NHS for those under 65 (my wife and I are 62 and both retired), does anybody have any advice or suggestions on how to obtain the medical requirements needed when applying for residency status.


Welcome to the Forum!

This has been discussed numerous times before, so a little research of previous threads can pay dividends. Unfortunately I can't help with insurance companies in Larnaca, but here is some general background information:

http://www.expatforum.com/expats/cy...cyprus/665386-healthcare-getting-started.html

http://www.expatforum.com/expats/cy...s-living-cyprus/776217-medical-insurance.html


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## Baywatch (Mar 30, 2014)

Bobby Mou said:


> Just arrived in Cyprus and will be here on a permanent basis. Now that Form S1 is no longer available via the NHS for those under 65 (my wife and I are 62 and both retired), does anybody have any advice or suggestions on how to obtain the medical requirements needed when applying for residency status. I have been to the immigration office in Larnaca and they will not accept EHIC cards as proof of medical cover. I don't particularly want to go down the private medical insurance route but if I have to, does anyone have or know a good company/broker in the Larnaca area for medical insurance.


The fact that they refuse the EHIC is as it should be. The day you get permission to stay the UK EHIC card is not valid anymore. You should then get a Cypprus EHIC.

You will need private insurance until one of you get state pension


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## Rema (Aug 12, 2012)

Baywatch said:


> The fact that they refuse the EHIC is as it should be. The day you get permission to stay the UK EHIC card is not valid anymore. You should then get a Cypprus EHIC.
> 
> You will need private insurance until one of you get state pension


Anders,

Where do you go to get the Cyprus EIHC from and what paperwork do you need to show?

Thanks


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## Bobby Mou (Jul 3, 2015)

David_&_Letitia said:


> Welcome to the Forum!
> 
> This has been discussed numerous times before, so a little research of previous threads can pay dividends. Unfortunately I can't help with insurance companies in Larnaca, but here is some general background information:
> 
> ...


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## Baywatch (Mar 30, 2014)

Rema said:


> Anders,
> 
> Where do you go to get the Cyprus EIHC from and what paperwork do you need to show?
> 
> Thanks


I went to Citizen Service. I dont remember what paperwork, but because they have you in the system that you have a medical card, I think that is enough


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## madcow (Jan 10, 2010)

I don't think you can get a Cyprus ehic unless you are working and paying contributions .


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## PeteandSylv (Sep 24, 2008)

madcow said:


> I don't think you can get a Cyprus ehic unless you are working and paying contributions .


If you receive a UK state pension you become entitled to healthcare here and can register for this via the Citizen's Advice Office. You then receive a further form, I can't remember the number offhand, from the UK which can be taken to the CAO. They process and return this one to the UK who then issues the EHIC card directly to you.

Pete


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## Baywatch (Mar 30, 2014)

madcow said:


> I don't think you can get a Cyprus ehic unless you are working and paying contributions .


As Pete say, also state pensioners get them


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## David_&_Letitia (Jul 8, 2012)

madcow said:


> I don't think you can get a Cyprus ehic unless you are working and paying contributions .


Correct. So how does an early retiree, resident in Cyprus and who has surrendered their UK issued EHIC access emergency treatment anywhere in the EU?


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## Baywatch (Mar 30, 2014)

David_&_Letitia said:


> Correct. So how does an early retiree, resident in Cyprus and who has surrendered their UK issued EHIC access emergency treatment anywhere in the EU?


You have private insurance I assume. Does it not cover other EU countries?

You can always access it, question is what it will cost.

For me the interesting question is how does a private insured pay for treatments that is not covered because of pre-conditions? Heart surgery is not cheap, or a bypass f.ex.


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## David_&_Letitia (Jul 8, 2012)

Baywatch said:


> You have private insurance I assume. Does it not cover other EU countries?
> 
> You can always access it, question is what it will cost.


Yes, we have private health insurance, which gives us cover abroad, but that's a separate issue, as whether we have private health or travel insurance or not, we are *entitled* to emergency healthcare in the EU at the same level as a local. However, in order to access this emergency treatment in Cyprus we need to show an EHIC. This is the card which the NHS would have us believe that we should surrender and because we don't pay into the social fund, Cyprus would not issue.


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## Baywatch (Mar 30, 2014)

David_&_Letitia said:


> Yes, we have private health insurance, which gives us cover abroad, but that's a separate issue, as whether we have private health or travel insurance or not, we are *entitled* to emergency healthcare in the EU at the same level as a local. However, in order to access this emergency treatment in Cyprus we need to show an EHIC. This is the card which the NHS would have us believe that we should surrender and because we don't pay into the social fund, Cyprus would not issue.


But Cyprus cant issue an EHIC because you don't pay into the system. I am sure it is the same in all EU countries


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## David_&_Letitia (Jul 8, 2012)

Baywatch said:


> But Cyprus cant issue an EHIC because you don't pay into the system. I am sure it is the same in all EU countries


Yes Anders, I know.

I am trying to illustrate the anomaly that according to the NHS site given by Madcow, anyone planning to live in Cyprus should surrender their EHIC. Once in Cyprus, unless paying into the social fund, that person cannot be issued an EHIC by Cyprus. The net result is that they will not have an EHIC when travelling to another EEA country.

Bottom line? If you have a valid and in-date UK issued EHIC you are not going to easily just surrender it!


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## Baywatch (Mar 30, 2014)

David_&_Letitia said:


> Yes Anders, I know.
> 
> I am trying to illustrate the anomaly that according to the NHS site given by Madcow, anyone planning to live in Cyprus should surrender their EHIC. Once in Cyprus, unless paying into the social fund, that person cannot be issued an EHIC by Cyprus. The net result is that they will not have an EHIC when travelling to another EEA country.
> 
> Bottom line? If you have a valid and in-date UK issued EHIC you are not going to easily just surrender it!


I understand what you mean but still I think it is quite normal that you either pay in to the health insurance and get an EHIC, or use your private insurance. Totally normal in My book.


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## madcow (Jan 10, 2010)

Thanks for sharing David , if I was in your situation I also would not give up the ehic .

Thankfully my wife is an oldie so I am covered under her S1 .


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## Pparker (Apr 7, 2015)

Baywatch said:


> I understand what you mean but still I think it is quite normal that you either pay in to the health insurance and get an EHIC, or use your private insurance. Totally normal in My book.


that sounds reasonable,
but what is supposed to happen if a person is in a car accident & goes or is taken to hospital for EMERGENCY TREATMENT does the injured person need any paperwork to enable his injury to be seen to ?


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## Baywatch (Mar 30, 2014)

Pparker said:


> that sounds reasonable,
> but what is supposed to happen if a person is in a car accident & goes or is taken to hospital for EMERGENCY TREATMENT does the injured person need any paperwork to enable his injury to be seen to ?


I am sure not.


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## expatme (Dec 4, 2013)

Your European Health Insurance Card (EHIC) lets you get state healthcare at a reduced cost or sometimes free. It will cover you for treatment that is needed to allow you to continue your stay until your planned return. It also covers you for treatment of pre-existing medical conditions and for routine maternity care, as long as you're not going abroad to give birth".

Source:

http://www.nhs.uk/NHSEngland/Healthcare ... tries.aspx


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## Veronica (Apr 5, 2008)

When my previous EHIC expired last year I had to send to the UK for a new one. The rules have changed and you get it from your home country. It does not however cover you for treatment here but you need it if you travel anywhere else abroad or to the UK.
If I remember rightly I got a form from the citizens centre in Paphos and I had to send that to the UK. The citizens centre gave me the address I had to send it to.


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## Veronica (Apr 5, 2008)

This does of course only apply to those of us who are permanent residents here.


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## Baywatch (Mar 30, 2014)

Veronica said:


> When my previous EHIC expired last year I had to send to the UK for a new one. The rules have changed and you get it from your home country. It does not however cover you for treatment here but you need it if you travel anywhere else abroad or to the UK.
> If I remember rightly I got a form from the citizens centre in Paphos and I had to send that to the UK. The citizens centre gave me the address I had to send it to.


I think this is only for UK. When I got mine they did it here, and I know that in Sweden and Germany it is the same, you get the EHIC from where you are insured, in this case in Cyprus


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## Baywatch (Mar 30, 2014)

Veronica said:


> When my previous EHIC expired last year I had to send to the UK for a new one. The rules have changed and you get it from your home country. It does not however cover you for treatment here but you need it if you travel anywhere else abroad or to the UK.
> If I remember rightly I got a form from the citizens centre in Paphos and I had to send that to the UK. The citizens centre gave me the address I had to send it to.


I really dont know Veronica. If you read the official EHIC application site from the UK government you can't get an EHIC if you are NOT a UK resident

https://www.ehic.org.uk/Internet/startApplication.do

In my opinion this means that you should get a Cyprus one


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## PeteandSylv (Sep 24, 2008)

Baywatch said:


> I really dont know Veronica. If you read the official EHIC application site from the UK government you can't get an EHIC if you are NOT a UK resident
> 
> https://www.ehic.org.uk/Internet/startApplication.do
> 
> In my opinion this means that you should get a Cyprus one


Quite so and if you look back I already posted on how this was done.

Pete


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## David_&_Letitia (Jul 8, 2012)

Baywatch said:


> I really dont know Veronica. If you read the official EHIC application site from the UK government you can't get an EHIC if you are NOT a UK resident
> 
> https://www.ehic.org.uk/Internet/startApplication.do
> 
> In my opinion this means that you should get a Cyprus one


I'm not 100% certain, but I don't think that is correct Anders.

As I read it, if you are a UK State pensioner and have an S1, you are entitled to a UK issued EHIC.

Extract from the NHS website:
*
Pensioners and early retirees living abroad
*
*The NHS is a residence-based healthcare system. Therefore, once you have moved permanently away from the UK, you are no longer entitled to medical treatment under normal NHS rules.
However, if you are living in another EEA country and you receive a UK State Pension, or any other benefit that can be paid to you when you move abroad (exportable benefit), you may be entitled to state healthcare paid for by the UK. You will need to apply for an S1 form (certificate of entitlement) from the International Pension Centre, which can be reached on 0191 218 7777. Once issued, register the S1 form with the relevant foreign authorities before you register with your local GP surgery.
Once you have registered your S1 abroad, you will be entitled to apply for and use a UK-issued EHIC to access necessary state-funded medical treatment when you visit other EEA countries outside the country in which you are currently residing, including when you return to the UK*

Source:

EHIC for pensioners and early retirees - Healthcare abroad - NHS Choices


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## PeteandSylv (Sep 24, 2008)

The regulations for this are far too complicated and I tend to think the posts on here are saying similar things but not quite expressed correctly.

The EHIC for UK residents abroad physically comes from the UK but must be applied for in the country of residence. I believe this is because the country of residence is in fact entering a contract with the UK to reclaim the costs of treatment. This is why our application was submitted via the Citizen's Advice Office who sent it to the appropriate ministry in Cyprus who then sent it to the UK who then sent us the EHICs.

1. The UK issues a form to you saying the EHIC can be applied for (S1?) and the person is eligible.
2. Cyprus receives this from you with application for the EHIC (Citizen's Advice)
3. Cyprus verifies residency status and eligibility also checking you are registered for healthcare here.
4. Cyprus sends this to the UK confirming eligibility etc.
5. The UK sends the EHICs directly to you. These state they are UK EHICs thus establishing that the UK will reimburse costs to the claiming EU country.

I do not know whether cross charges actually take place or countries work on a knock for knock basis but that is the system outline as I understand it and has seemed to take place for us.

Pete


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## expatme (Dec 4, 2013)

The rules are realy quite simple; I you reacieve a state pension your EHIC comes from the UK. If you are not in receipt of a UK state pension it comes fro the country of residence.


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## PeteandSylv (Sep 24, 2008)

expatme said:


> The rules are realy quite simple; I you reacieve a state pension your EHIC comes from the UK. If you are not in receipt of a UK state pension it comes fro the country of residence.


No it's no that simple and if you read my stage by stage explanation you would see that the application for the EHIC when you are resident out of the UK is a more complex process.

I think what people are looking for is explanation of how to do this in practice not quick one sentence statements that get nothing done.

Pete


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## Veronica (Apr 5, 2008)

You NEED an EHIC to access treatment in the UK if you are there on holiday etc. 
When I went to try to renew mine here the citizens centre said you no longer get them from here but have to apply to the UK. That is what I did and I got my new EHIC from the UK. 
I can only go by my own experience.


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## PeteandSylv (Sep 24, 2008)

Veronica said:


> You NEED an EHIC to access treatment in the UK if you are there on holiday etc.
> When I went to try to renew mine here the citizens centre said you no longer get them from here but have to apply to the UK. That is what I did and I got my new EHIC from the UK.
> I can only go by my own experience.


Fair enough, then the system has changed from when we got ours. Hopefully it is simpler with a lower administrative burden.

Pete


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## expatme (Dec 4, 2013)

PeteandSylv said:


> No it's no that simple and if you read my stage by stage explanation you would see that the application for the EHIC when you are resident out of the UK is a more complex process.
> 
> I think what people are looking for is explanation of how to do this in practice not quick one sentence statements that get nothing done.
> 
> Pete


Peter the facts are there just get the latest info and you will see how very simple it is, It is as I stated. My wife and I having gone through the process.


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## Veronica (Apr 5, 2008)

Perhaps when you are in receipt of a UK pension, they already know you live here and so don't need all the forms that they might need if you are not yet a pensioner?


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## RMcC (Dec 31, 2013)

We are currently trying to source medical insurance for us both to meet the rules for immigration. we have encountered a few problems that we could or did not forsee and it has left us in a bit of a worrying position.

The insurance company have insisted that Mildred has a further chest xray in 3-6 months time as a very small and insignificant( radioligist words not mine) amount of fluid was detected in one of her lungs. The insurance company will not provide cover until she has a chest xray in 3 months showing this has cleared up. I have requested they confirm Mildreds insurance and treat the fluid as a pre exsisting condition but at present they are refusing.
I have been asked to have an ultrasound scan to confirm what the doctor stated as abnormal hardness in my lower abdomen, I suspect this is scar tissue from the keyhole entry point of my prostate surgery 2 years ago.

While I suspect my ultra sound will clarify matters and the Insurance company will them accept me, it still leaves Mildred exposed with no cover at all.

This is where I believe there to be a flaw in the EHIC system as we could only obtain an EHIC card with an expiry date of our departure from the UK. You cant get Travel insurance to cover you as we have no planned return date, and now that we cant (or are experiencing problems)get Private medical insurance we are very exposed should anything major happen. Surely it would make more sence to have an EHIC expire when you obtain private medical insurance or gain residency.

If the insurance company insist on a clear xray for Mildred in 3-6 months time we will have missed our 90 day limit to apply for residency - or can we apply within the 90 days but have to wait until we both have medical insurance before we can finalise residency.


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## Baywatch (Mar 30, 2014)

RMcC said:


> We are currently trying to source medical insurance for us both to meet the rules for immigration. we have encountered a few problems that we could or did not forsee and it has left us in a bit of a worrying position.
> 
> The insurance company have insisted that Mildred has a further chest xray in 3-6 months time as a very small and insignificant( radioligist words not mine) amount of fluid was detected in one of her lungs. The insurance company will not provide cover until she has a chest xray in 3 months showing this has cleared up. I have requested they confirm Mildreds insurance and treat the fluid as a pre exsisting condition but at present they are refusing.
> I have been asked to have an ultrasound scan to confirm what the doctor stated as abnormal hardness in my lower abdomen, I suspect this is scar tissue from the keyhole entry point of my prostate surgery 2 years ago.
> ...


Apply within 90 days. Then you will get a list of documents you need. Tell them that you want the appointment as late as possible. If you dont have the insurance ready for the appointment just make another one. It is no problem.


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## David_&_Letitia (Jul 8, 2012)

Baywatch said:


> Apply within 90 days. Then you will get a list of documents you need. Tell them that you want the appointment as late as possible. If you dont have the insurance ready for the appointment just make another one. It is no problem.


I think that this is good advice, as you are fulfilling the requirement to register within 90 days but just delaying the actual interview, at which you provide the necessary documentation.

The problem is the clearly the risk of a further 3 months without either private medical insurance or EHIC in the event of an unforeseen event...


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## David_&_Letitia (Jul 8, 2012)

RMcC said:


> This is where I believe there to be a flaw in the EHIC system as we could only obtain an EHIC card with an expiry date of our departure from the UK. You cant get Travel insurance to cover you as we have no planned return date, and now that we cant (or are experiencing problems)get Private medical insurance we are very exposed should anything major happen. Surely it would make more sence to have an EHIC expire when you obtain private medical insurance or gain residency.


This is certainly a flaw in the EHIC system.

Given the fact that you did everything correctly and above board, it may be an idea to contact the NHS Business team on their official Facebook page. Their responses are pretty quick. I would suggest that, given the current situation, they may agree to extend your EHIC cover for the period of time between now and establishing Mildred's policy ie 3-6 months. Certainly worth a shot as nothing ventured, nothing gained.

https://www.facebook.com/NHSBSAEuropeanHealthInsuranceCard?ref=ts&fref=ts


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## Talagirl (Feb 24, 2013)

Just been doing a bit of research and the Government website article mentions four months rather than three months to make the application for residency.

APPLICATION FOR ISSUE OF REGISTRATION CERTIFICATE OF UNION CITIZEN AND HIS/HER FAMILY MEMBERS ALSO EU CITIZENS - MEU1

1.	The application for the issue of a Registration Certificate is submitted by a European Union citizen and family members who are also citizens of a Member State, within four months from the date of entry into the Republic.

CIVIL REGISTRY AND MIGRATION DEPARTMENT - Migration Section

As mentioned in earlier posts as soon as you make an appointment at the Immigration Office you are in the system. Good advice from Baywatch.

Unfortunately not found anything yet with regards to health cover.


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## Baywatch (Mar 30, 2014)

Talagirl said:


> Just been doing a bit of research and the Government website article mentions four months rather than three months to make the application for residency.
> 
> APPLICATION FOR ISSUE OF REGISTRATION CERTIFICATE OF UNION CITIZEN AND HIS/HER FAMILY MEMBERS ALSO EU CITIZENS - MEU1
> 
> ...



The problem with four month is that you are theoretically illegal in the country from the 91 day. But nothing will happen, they will not kick you out


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## Veronica (Apr 5, 2008)

I have looked at the back of my new EHIC and it gives the government website you need for renewing your EHIC


Apply for a free EHIC card - Healthcare abroad - NHS Choices

When you look at the section on applying for an EHIC if you live abroad it very clearly states that if you are in receipt of a government retirement pension you have to apply to the UK.


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## RMcC (Dec 31, 2013)

David_&_Letitia said:


> This is certainly a flaw in the EHIC system.
> 
> Given the fact that you did everything correctly and above board, it may be an idea to contact the NHS Business team on their official Facebook page. Their responses are pretty quick. I would suggest that, given the current situation, they may agree to extend your EHIC cover for the period of time between now and establishing Mildred's policy ie 3-6 months. Certainly worth a shot as nothing ventured, nothing gained.
> 
> https://www.facebook.com/NHSBSAEuropeanHealthInsuranceCard?ref=ts&fref=ts


David,

I have already contacted EHIC via facebook and they confirmed that our EHIC cards expire the day we leave the country. Their answer is we should have taken out private medical insurance before leaving the UK


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## RMcC (Dec 31, 2013)

Talagirl said:


> Just been doing a bit of research and the Government website article mentions four months rather than three months to make the application for residency.
> 
> APPLICATION FOR ISSUE OF REGISTRATION CERTIFICATE OF UNION CITIZEN AND HIS/HER FAMILY MEMBERS ALSO EU CITIZENS - MEU1
> 
> ...


many thanks, this is most helpful


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## RMcC (Dec 31, 2013)

Baywatch said:


> Apply within 90 days. Then you will get a list of documents you need. Tell them that you want the appointment as late as possible. If you dont have the insurance ready for the appointment just make another one. It is no problem.


Thanks, I believe this is the path we will be taking if we do not get a positive outcome from the insurance company.


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