# Health insurance



## RiverSider (May 2, 2017)

I have health insurance in the US and am also covered by the NHS in the UK. Do I need health insurance to cover the transatlantic flight or does my US policy or the NHS cover the flight? And does anyone even sell flight-only health insurance? Many thanks, in advance, for any guidance...


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## twostep (Apr 3, 2008)

Have you contacted your insurance carriers with specifics?


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## RiverSider (May 2, 2017)

twostep said:


> Have you contacted your insurance carriers with specifics?


My US insurer said: "I don't know". They said they'd get back to me but, after chasing, I'm still waiting.


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## twostep (Apr 3, 2008)

RiverSider said:


> My US insurer said: "I don't know". They said they'd get back to me but, after chasing, I'm still waiting.


Why do you not just get travel insurance? I cannot imagine a carrier covering you for just a few hours of flight. We had a similar case between Japan and Europe and that is what the poster did.


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## RiverSider (May 2, 2017)

twostep said:


> Why do you not just get travel insurance? I cannot imagine a carrier covering you for just a few hours of flight. We had a similar case between Japan and Europe and that is what the poster did.


Well, if I get the usual travel insurance for, say, three months, and then if I get sick in the US I have two insurers for the same claim. And I've discovered before that having two insurers for one claim (and one of them always asks) is sure way to mountains of muddle and delays.


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## twostep (Apr 3, 2008)

RiverSider said:


> Well, if I get the usual travel insurance for, say, three months, and then if I get sick in the US I have two insurers for the same claim. And I've discovered before that having two insurers for one claim (and one of them always asks) is sure way to mountains of muddle and delays.


Travel may not cover you in the US depending on your status. Just cancel when you do not need it anymore.


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## cirrus (Aug 2, 2014)

RiverSider said:


> I have health insurance in the US and am also covered by the NHS in the UK. Do I need* health insurance to cover the transatlantic flight* or does my US policy or the NHS cover the flight? And does anyone even sell flight-only health insurance? Many thanks, in advance, for any guidance...


 If you just need insurance to cover the flight, have a think about purchasing the tickets by a good gold or platinum card which will repatriate you.
I always felt comfortable with this arrangement.


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## RiverSider (May 2, 2017)

cirrus said:


> If you just need insurance to cover the flight, have a think about purchasing the tickets by a good gold or platinum card which will repatriate you.
> I always felt comfortable with this arrangement.


That's a good idea... And I just heard on the radio that some bank accounts offer worldwide travel insurance as a benefit... NatWest, for example...


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## cirrus (Aug 2, 2014)

In case you are not aware:
If you are a resident of the US, you cannot be a resident of the UK and therefore not covered by the NHS.
You may want to check this out.
I did have a cheap Bronze policy with UHC and it did cover vacations but only for accidents and emergencies. My away visits were at least 5 months so with experiences of US insurance, I would not want to test that one.


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## twostep (Apr 3, 2008)

cirrus said:


> In case you are not aware:
> If you are a resident of the US, you cannot be a resident of the UK and therefore not covered by the NHS.
> You may want to check this out.
> I did have a cheap Bronze policy with UHC and it did cover vacations but only for accidents and emergencies. My away visits were at least 5 months so with experiences of US insurance, I would not want to test that one.


Plenty of dual citizens US/UK on this forum and others. What do you base your statement on?


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## mamasue (Oct 7, 2008)

sorry.... duplicate.


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## mamasue (Oct 7, 2008)

In case you are not aware:
If you are a resident of the US, you cannot be a resident of the UK and therefore not covered by the NHS.




twostep said:


> Plenty of dual citizens US/UK on this forum and others. What do you base your statement on?




Quite simply...... if you're not a UK resident, ie, have lived out of the UK for a certain amount of time..... you're not entitled to NHS any more.... despite the fact that you may have paid in all your life.....simple fact.


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## twostep (Apr 3, 2008)

mamasue said:


> In case you are not aware:
> If you are a resident of the US, you cannot be a resident of the UK and therefore not covered by the NHS.
> 
> 
> ...


Thank you Mamasue - I was thinking about citizenship.


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## cirrus (Aug 2, 2014)

twostep said:


> Plenty of dual citizens US/UK on this forum and others. What do you base your statement on?


Fact


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## Crawford (Jan 23, 2011)

RiverSider said:


> I have health insurance in the US and am also covered by the NHS in the UK. Do I need health insurance to cover the transatlantic flight or does my US policy or the NHS cover the flight? And does anyone even sell flight-only health insurance? Many thanks, in advance, for any guidance...


If you have medical insurance in the US then presumably you are resident in the US.

If so, you are not eligible for NHS cover in the UK as that is for *residents of the UK.*

Maybe you can explain how you have apparently have both.

From a practical point of view if you were to get ill on the plane flying to the US and required medical treatment/hospitalisation in the US, then your US provider will pay for the expenses. Similarly, if you were to get ill flying to the UK then, if you required medical treatment in the UK that would be covered by the NHS (if you were eligible for it i.e as a resident of the UK).

On the plane you are not going to get much more than palliative care, oxygen maybe and CPR if required. I have not heard that airlines charge for this "Good Samaritan" assistance.


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## RiverSider (May 2, 2017)

Thank you, Crawford. I think I need to understand the concept of residency better. I have a green card, I pay income and property taxes in the UK and US, have bank accounts and credit cards in both countries, I'm on the roll of my UK GP, I've just voted in the UK local elections, I have US health insurance... 

I want to get this right. Is there somewhere online that summarises the rules in the simplest terms?

Many thanks...


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## Bevdeforges (Nov 16, 2007)

The US rules are pretty simple - if you have a valid Green Card you are considered resident in the US (certainly for tax purposes). The UK rules are, as I understand, considerably more complex - running into hundreds of pages. HM Revenue & Customs: Service unavailable may help.
Cheers,
bev


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## cirrus (Aug 2, 2014)

Bevdeforges said:


> The US rules are pretty simple - if you have a valid Green Card you are considered resident in the US (certainly for tax purposes). The UK rules are, as I understand, considerably more complex - running into hundreds of pages. HM Revenue & Customs: Service unavailable may help.
> Cheers,
> bev


With due respect I cannot imagine any rules being more complex than the IRS and the USCIS.
If you are a British National, you are entitled to NHS the moment you arrive in the UK providing you are going to reside in the country, i.e. pay your taxes and have an address with utility bills.
Anyway, that is how I understand it.


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## Bevdeforges (Nov 16, 2007)

cirrus said:


> With due respect I cannot imagine any rules being more complex than the IRS and the USCIS.
> If you are a British National, you are entitled to NHS the moment you arrive in the UK providing you are going to reside in the country, i.e. pay your taxes and have an address with utility bills.
> Anyway, that is how I understand it.


Yes, but "residence" for purposes of the NHS is not the same as "resident" for purposes of taxation in the UK. The question here is can the OP maintain residence in two countries simultaneously?
Cheers,
Bev


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## cirrus (Aug 2, 2014)

Bevdeforges said:


> Yes, but "residence" for purposes of the NHS is not the same as "resident" for purposes of taxation in the UK. The question here is can the OP maintain residence in two countries simultaneously?
> Cheers,
> Bev


The answer is no

I looked into that one years ago with being a dual resident in France and the US. 
You can of course be a dual status resident for US tax purposes.


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## Bevdeforges (Nov 16, 2007)

cirrus said:


> The answer is no
> 
> I looked into that one years ago with being a dual resident in France and the US.
> You can of course be a dual status resident for US tax purposes.


Yup. That's how I read things, too. The only "catch" is that you are supposed to "check out" of the UK system when you take up residence elsewhere. (There is some form to file to officially notify them of your non-resident status.)
Cheers,
Bev


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## cirrus (Aug 2, 2014)

Bevdeforges said:


> Yup. That's how I read things, too. The only "catch" is that you are supposed to "check out" of the UK system when you take up residence elsewhere. (There is some form to file to officially notify them of your non-resident status.)
> Cheers,
> Bev



Thanks, I did not know that


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## Crawford (Jan 23, 2011)

RiverSider said:


> Thank you, Crawford. I think I need to understand the concept of residency better. I have a green card, I pay income and property taxes in the UK and US, have bank accounts and credit cards in both countries, I'm on the roll of my UK GP, I've just voted in the UK local elections, I have US health insurance...
> 
> I want to get this right. Is there somewhere online that summarises the rules in the simplest terms?
> 
> Many thanks...


Are you working in both UK and US? ... and paying income taxes in both? A most unusual situation. 

I too have property in the UK and have bank accounts and credit/debit cards in UK - however I am not classed as resident (domiciled) in the UK as I live and work in the US.

For tax purposes however I am considered resident as I have a property in the UK, and pay taxes on my property rental.

I too can vote in UK elections.

Knowing how the UK health system works, I could, quite easily, get NHS treatment free if I were to travel back to the UK for any length of time, but I would not do so as not being resident in the UK I am not eligible for such treatment.


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## RiverSider (May 2, 2017)

So... I'm still not quite clear: is the best advice to rely on health insurance in the US, NHS in the UK and take out travel insurance for each individual flight and cancel it on arrival? Is that what everyone does? Thanks, everyone.


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## twostep (Apr 3, 2008)

My US carrier covers trips. Booking tickets via cards offering coverage - read the fine print first. They tend to repatriate if treatment cannot provided on a certain level.


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## Crawford (Jan 23, 2011)

RiverSider said:


> So... I'm still not quite clear: is the best advice to rely on health insurance in the US, NHS in the UK and take out travel insurance for each individual flight and cancel it on arrival? Is that what everyone does? Thanks, everyone.


No..... if you are resident in the US for tax purposes, then you take out travel insurance to travel to the UK and the travel insurance covers you for medical treatment in the UK.

You don't use the NHS except for emergency treatment (which is free in the UK as long as you don't get hospitalisation)


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## Bevdeforges (Nov 16, 2007)

RiverSider said:


> So... I'm still not quite clear: is the best advice to rely on health insurance in the US, NHS in the UK and take out travel insurance for each individual flight and cancel it on arrival? Is that what everyone does? Thanks, everyone.


Let's put it another way - if you have US medical insurance, you have to read the fine contract to find out whether or not you have coverage (emergency or otherwise) when you travel outside the US. Some policies include overseas coverage, others don't. There simply is no "standard" US health insurance contract unless you have US Medicare coverage, which does absolutely nothing for you outside the US.

NHS coverage is based on residence in the UK, but I have no idea how that is determined.

If you get sick while on the plane, it depends entirely on where you receive treatment as to what insurance applies. If they land in the US and rush you to hospital there, it's your US coverage. If they land in the UK, then you would be treated like any other sick tourist there.
Cheers,
Bev


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## Raria (May 10, 2017)

Crawford said:


> Are you working in both UK and US? ... and paying income taxes in both? A most unusual situation.
> 
> I too have property in the UK and have bank accounts and credit/debit cards in UK - however I am not classed as resident (domiciled) in the UK as I live and work in the US.
> 
> ...


Most countries have fairly strict rules about claiming residency. Normally its where you spend more than 183 days in the last year. You clearly can't do that for two countries.


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