# American moving to UK- do we need expat health insurance?



## 95107 (May 4, 2010)

We are moving from the U.S. to Edinburgh for work later this year.

Obviously, we will register with NHS. Will we still need some type of commercial health insurance? What happens when I travel outside the UK on work projects? What about if we have a family holiday outside the UK? We expect to spend part of summer 2011 back in the United States. Do we need to maintain some level of insurance (ie, catastrophic coverage) in order to avoid being told we have a "gap in coverage?"

Advice/links greatly appreciated -- thank you!


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## Bevdeforges (Nov 16, 2007)

If you're working in the UK, you and your family will have NHS or other coverage. For foreign travel, most folks take a travel policy - either for each trip or an annual policy if you'll be traveling frequently.

Within the EU, you can get a EHIC (I think it's called now - European Health Insurance Card) in order to be eligible for the local health care services if needed. The travel insurance normally includes expatriation coverage, so that you can be evacuated back home (i.e. to the UK) once you're in stable enough condition to travel.

Travel insurance plans are usually offered by travel agents when you book your holidays, or you can look into any number of companies that offer multi-trip policies based on your country of residence and where you will be traveling. 

One "surprise" for many expats is how expensive it can be to get a travel coverage for a trip to the US - as opposed to travel coverage limited to Europe (where you have some reciprocity with the local health care systems). I know it was an eye-opener for me!
Cheers,
Bev


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## 95107 (May 4, 2010)

*Thanks-- I'll start looking into this*

Thank you for taking the time to explain this-- I'll start looking into it. I'm sure my employer will have some suggestions for a good insurer or travel agency-- they probably have one they rely on for most scheduled travel. And I'll be ready for the fees associated with travel back to the US 

Adam



Bevdeforges said:


> If you're working in the UK, you and your family will have NHS or other coverage. For foreign travel, most folks take a travel policy - either for each trip or an annual policy if you'll be traveling frequently.
> 
> Within the EU, you can get a EHIC (I think it's called now - European Health Insurance Card) in order to be eligible for the local health care services if needed. The travel insurance normally includes expatriation coverage, so that you can be evacuated back home (i.e. to the UK) once you're in stable enough condition to travel.
> 
> ...


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## Joppa (Sep 7, 2009)

Bevdeforges said:


> Within the EU, you can get a EHIC (I think it's called now - European Health Insurance Card) in order to be eligible for the local health care services if needed.


You may not be eligible for UK EHIC if you are not a British citizen or married to one. Even if you manage to get your card, some European countries may not recognise it if you aren't a EU national or a dependant/family member of one. So get travel insurance in any case, and don't rely on EHIC for all your health needs in Europe - this advice goes for British citizens as well, as EHIC doesn't cover all health-related cost outside UK (e.g. many countries including France operate on reimbursement system, and it's rarely 100%) and repatriation (back to UK) isn't included.


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## Bevdeforges (Nov 16, 2007)

Joppa said:


> You may not be eligible for UK EHIC if you are not a British citizen or married to one. Even if you manage to get your card, some European countries may not recognise it if you aren't a EU national or a dependant/family member of one. So get travel insurance in any case, and don't rely on EHIC for all your health needs in Europe - this advice goes for British citizens as well, as EHIC doesn't cover all health-related cost outside UK (e.g. many countries including France operate on reimbursement system, and it's rarely 100%) and repatriation (back to UK) isn't included.


I don't believe it is legal within the EU to take nationality into account for providing medical coverage. The OP should be covered in the UK after he has started working there (and paying into the system). If he qualifies under one of those "loopholes" whereby the employer pays for his US benefits for the first couple years, then all bets are off.

I'm not certain how the short-term (i.e. travel) coverage works with the EHIC - whether the coverage is provided by the country you're visiting or by your home country. But I have filed a couple claims against my French health coverage for medical bills incurred in the US while traveling. 

Travel health insurance normally takes into account what country you have your national coverage in and where you'll be traveling, so if you take out a single trip policy for a trip to another European country, coverage should be considerably cheaper than for a trip to, say, the US. Or, if you plan to travel extensively, go for an annual travel plan (usually the cost of 3 to 4 single trip policies) that covers all areas you are likely to visit.

One caveat - employers may not always cover travel health insurance when you're traveling on business. That's where an annual policy could come in very handy. (Had a UK boss get sick one time while in the US, and it was a real zoo trying to get him in to see someone and then get the treatment paid for other than out of pocket.)
Cheers,
Bev


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## Joppa (Sep 7, 2009)

Bevdeforges said:


> I don't believe it is legal within the EU to take nationality into account for providing medical coverage.


Most EU countries do cover non-EEA nationals if in possession of an EHIC (i.e. resident and contributing to state health scheme within EEA), but some do not, e.g. Hungary. Switzerland, which recently joined EHIC scheme, doesn't cover non-EEA nationals unless they are stateless or refugees.



> I'm not certain how the short-term (i.e. travel) coverage works with the EHIC - whether the coverage is provided by the country you're visiting or by your home country.


EHIC entitles you to the same level of health care available to locals, and you either claim reimbursement from the state insurance scheme before leaving the country or pay a subsidised cost direct to service providers such as doctors, clinics and hospitals. Coverage is given by local providers. Only when you cannot obtain reimbursement locally (e.g. you have to return home immediately), you can submit your claim to your national health scheme provider (such as NHS) on your return. This can take a long time to be processed, and exchange rate movement can work against you.


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## 95107 (May 4, 2010)

Thanks to everyone who contributed. I'll speak with my employer about health insurance options when I have to travel, especially to the U.S.


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## i4u.jack (Aug 10, 2010)

Is there any difference between the health insurance provided by the travel insurance agencies and the simple health insurance


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