Healthcare When You Work Outside the UK
When you go to work abroad, you leave the NHS far behind. So what are your options if you fall ill?
The European Health Insurance Card (EHIC)
The European Health Insurance Card (EHIC) guarantees that any European citizen travelling abroad in another EHIC country will receive state health care identical to that received by the local citizens of that country. All countries in the EEA plus Switzerland participate in the scheme. The EEA countries are all EU countries plus Liechtenstein, Norway and Iceland.
This may sound like an émigré’s dream. Go anywhere, and get free medical treatment just like in Britain, without any red tape. Alas, it’s not that simple.
The important clause to note is that the medical treatment received is equivalent to that received by the citizens of whichever country you are in. Although all EHIC countries have state health care systems, there are many differences between them. Many do not have coverage as broad as that provided in Britain. For example, dental treatment may not be covered in some countries. Even where the same medical care is provided, it may not be free like it is in Britain. Many other European countries charge patients something for their treatment, even if the government picks up most of the bill. For this reason, you may want to look into health insurance options once you settle in another country. In some cases, where you receive medical treatment abroad and have to pay for it, the British government will partially reimburse you when you return home.
It’s also very important to note that the EHIC is not really designed for long-term emigrants. It is designed for holidaymakers and short-term residents. If you’ve decided to live in another country on a long-term basis, you need to make sure that you are paying into that country’s national insurance scheme. In fact, you actually lose your eligibility for free health treatment in Britain if you live outside the UK for more than three months.
To get an EHIC card, you need to apply for one. You can do this online, by calling 0845 606 2030 or via a form which you can get from your local Post Office. It costs nothing but needs to be renewed every few years.
Health Treatment Abroad
Politicians routinely boast that Britain’s health care system is the best in the world. If you believe them, you could be concerned about the quality of the treatment you might receive when working abroad. However, most serious international comparisons, including those conducted by the World Health Organisation, put Britain’s NHS fairly far down the list when the quality of health coverage is ranked across developed countries. If you’re living abroad, therefore, particularly in Europe, there’s a good chance that the treatment you receive will be better than what you’d get back home.
Apart from quality issues, though, there are many variations across the world in the way healthcare services are delivered, some of which may strike British people as odd. For example, in Spain, it is customary for patients staying in a hospital to have food and bedpan arrangements taken care of by their relatives rather than the nurses. If you’re working abroad, and your relatives are back home, this can obviously be a problem. In other countries, the custom may be for you to pay for your health treatment directly and then request reimbursement from the government. For this, you need to keep all receipts and be sure in the first place that the health provider you are dealing with operates within the government system, since there will also be separate private healthcare providers too.
Outside of Europe, Britain maintains reciprocal agreements with a number of other countries to guarantee that Britons abroad can receive urgent medical care. Exactly what treatment you can receive, and which parts of it you need to pay for, vary slightly from country to country. In most cases, your British passport is all that’s required for you to receive coverage. It should be noted, however, that these reciprocal arrangements are designed for Britons staying abroad on a short-term basis. If you’re living and working in the country, you really need to integrate yourself into the local state insurance system, or take out private medical insurance.
Healthcare Abroad – Conclusion
When you’re young and healthy, it’s all too easy to neglect the subject of healthcare abroad. Illness can strike at any time, though, and, who knows, you may want to settle and grow old there, so it’s best to make sure you have treatment options available. Your EHIC card will cover you for the first few weeks or months in your new country. Thereafter, you should make sure that you are integrated into the local social insurance system. Consider taking out private insurance too if you feel it is necessary.