Thread: Health Insurance Now Required for Long Stay Expats

Its a sad viscous circle. They offer medical coverage and services that can't be afforded by most so people do whatever it takes to get fixed and run up huge bills. Then when they can't pay them back or off, file bankruptcy. The hospital loses on the fees for services provided and writes it off, the insurance company never paid the claim and yet both still make millions in profit every year..Go figure.

As it happened we were covered under my wife's Thai holiday insurance so were reimbursed anyway.

if your wife had travel insurance why didn't you go to a private hospital for treatment instead of trying to get treated on the nhs?

Originally Posted by bowie

A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —

Other reasons include unaffordable mortgages or foreclosure, at 45 percent;
followed by spending or living beyond one’s means, 44.4 percent;
providing help to friends or relatives, 28.4 percent;
student loans, 25.4 percent; or
divorce or separation, 24.4 percent.

So, we just thrown away that whole "100%" thing?

Originally Posted by taxexile

if your wife had travel insurance why didn't you go to a private hospital for treatment instead of trying to get treated on the nhs?

We first went to A & E as an emergency to see how serious it was, and while there, they organised the procedure for the next day. It couldn't have happened faster. The NHS are fantastic for emergencies, and at that point it looked as though it was all covered by the NHS as an emergency.

The alternative of sorting out pre-authorisation with Thai Bupa (is it called AETNA now?) wasn't really an option. That could have dragged on for ages.

Originally Posted by terry57

It's just a sensational subject

Seems so.

Terry you mentioned you are headed back to lala land.

Let us know what immigration required from you.

mendip

We first went to A & E as an emergency to see how serious it was, and while there, they organised the procedure for the next day. It couldn't have happened faster. The NHS are fantastic for emergencies, and at that point it looked as though it was all covered by the NHS as an emergency.

The alternative of sorting out pre-authorisation with Thai Bupa (is it called AETNA now?) wasn't really an option. That could have dragged on for ages.

thanks for clearing that up, although i am surprised that they followed through and billed you. each time i or my wife have had a hospital visit we are asked if we are normally resident in the uk and they tick the appropriate box, but we have never had to use A&E.

i assume you told them that you were just visiting the UK.

before your wife had the procedure the following day, did they notify you of the actual cost.

^ Yes I told them initially at A & E we were just visiting.

They gave us a rough estimate of cost before the procedure and actual cost was slightly less. At that stage all the medical staff were assuming this was an emergency and that it was therefore covered under free treatment. In fact the medical staff tried very hard for us and the medical report wording made it clear they considered it an emeegency and was very necessary treatment. Even the hospital financial people were on our side and tried to use my wife's Aussie citizenship as cause for free treatment, but our Thai rssidency upset that tactic. I couldn't praise the ground staff at the NHS enough from our experience.

It had to be done, and even if we had no insurance we would have had no choice but go ahead. But 1300 quid was never going to be a problem, but supposing the cost was estimated at tens of thousands and not affordable? I guess the lesson is to make sure medical insurance is valid not only when living in Thailand but also for trips back to your home country.

I've got the letter sent by the NHS stating all the conditions necessary to get free treatment and their recovery procedures if not qualifying. Also the list of excepted conditions that will be treated for free even if you don't qualify for free treatment. I could paste it into a post here when I get to a pc if you think it of benefit, or would that get a bit unwealdy? I'm still pretty new to this forum.

i think that information would be of interest to many members following this thread.

OK then, below is a direct copy of the Word attachment sent by the NHS in association with their invoice.


Further Information

Residency Based Healthcare

The NHS is a residency-based healthcare system and eligibility for free NHS hospital care is based on the concept of “ordinary residence”. If you are ‘Ordinarily Resident’ in the UK you must not be charged for NHS hospital services.

‘Ordinarily Resident’

Ordinarily resident describes someone who is lawfully in the UK; voluntarily; properly settled here for the time being; and in the case of non-EEA nationals subject to immigration control, has Indefinite Leave to Remain (ILR) in the UK.

A person is not ordinarily resident in the UK simply because they have British nationality.

Any person who is not ordinarily resident in the UK is classed as an overseas visitor.

Overseas visitors have to pay for their NHS hospital treatment although some exemptions apply. This is under the ‘Overseas Visitor Hospital Charging Regulations 2015’.

Overseas Visitor Hospital Charging Regulations 2015

These regulations place a legal obligation on our Trust to make reasonable enquiries into the circumstances of those patients who may potentially be classed as overseas visitors, to determine whether they meet one of the categories of exemption or are liable to pay charges. When charges apply, we must make and recover them.

As set out in chapter 2 paragraph 18 of the regulations, it is your responsibility to prove that you are entitled to free NHS hospital treatment.

Exempt treatments:

Certain treatments and services are exempt from charge even if you are established as a charge liable patient. This exemption from charge will apply to the diagnosis of the condition, even if the outcome is a negative result. It will also apply to any treatment provided for a suspected specified condition, up to the point that it is negatively diagnosed. It does not apply to any secondary illness that may be present even if treatment is necessary in order to successfully treat the condition. The conditions to which the exemption applies are:

• Acute encephalitis

• Acute poliomyelitis
• Anthrax
• Botulism
• Brucellosis
• Cholera
• Diphtheria
• Enteric fever (typhoid and paratyphoid fever)
• Food poisoning
• Haemolytic Uraemic Syndrome (HUS)
• Human Immunodeficiency Virus (HIV)
• Infectious bloody diarrhoea
• Invasive group a streptococcal disease and scarlet fever
• Invasive meningococcal disease (meningococcal meningitis, meningococcal septicaemia and other forms of invasive disease)
• Legionnaires’ disease
• Leprosy
• Leptospirosis
• Malaria
• Measles
• Middle East Respiratory Syndrome (MERS)
• Mumps
• Pandemic influenza (defined as the ‘pandemic phase’), or influenza that might become pandemic (defined as the ‘alert phase’) in the world health organization’s pandemic influenza risk management interim guidance
• Plague
• Rabies
• Rubella
• Severe Acute Respiratory Syndrome (SARS)
• Smallpox
• Tetanus
• Tuberculosis
• Typhus
• Viral haemorrhagic fever (which includes Ebola)
• Viral hepatitis
• Whooping cough
• Yellow fever

Immediately Necessary, Urgent and Maternity treatment

These treatments will always be provided regardless of your means to pay but most of the treatment will carry a charge.

If you do not pay:

Under the Immigration Rules a person with outstanding debts of over £500 for NHS treatment that is not paid within two months of invoicing, may be denied a further immigration application to enter or remain in the UK.

Non-clinical information relating to this debt is provided to the Home Office and may be used by them to apply the Immigration Rules. The information will remain active for this purpose until the debt is settled.

An email from the NHS...


Dear Mr Mendip,

Many thanks for your email to the Overseas Visitors Team.

We thank you for your honesty, however based on this information we have to concluded that Mrs Mendip is not an ‘Ordinary Resident’ of the UK and therefore is charge liable for her NHS Hospital Treatment.

We appreciate that you were advised that the treatment was an emergency and required immediate treatment. Accident & Emergency treatment is free for all in the UK but as soon as a patient is admitted as an Inpatient or referred to an Outpatient appointment, that is the point that they become charge liable, as in this case.

I know this is not the news you were hoping for but we have a legal obligation to the Trust to recover funds from patients that are not eligible for free hospital treatment.

We unfortunately cannot send our overseas correspondence via email so we have sent a letter out today advising of the outcome. We will then raise an invoice for the treatment received, our Treasury Management finance team will be able to email this to you.

Any questions, please don’t hesitate to contact us.

Originally Posted by Norton

Seems so.

Terry you mentioned you are headed back to lala land.

Let us know what immigration required from you.

Fook all because I'm on my 2nd year of my Retirement Visa and payed for my last entry Visa.

So my Retirement Visa is dead after this swing and will need renewing.

So now Kuntos want 800 K THB in Aussie bank 38 K AUD and will want an Insurance policy .

I recon I'm gunnar tell em to go fuk themselves and next year get a SETV which will give me 3 months then fook orf for 3 months to Perth and Bali then cum back to the Shit hole on another SETV.

There's next year fooked innit and by then the silly fuk sticks would have changed shit around again.

I'm totally flexible eh and can work around these shitters no problem what so ever.

Being flexible and cashed up means that one can live an exceptional life free from any cuntrys change of rules.

Good innit fukos.

Originally Posted by terry57

Fook all because I'm on my 2nd year of my Retirement Visa and payed for my last entry Visa.

If you do another 1 year extension while you are here, health insurance not reqruired. You have to have 800k baht in Thai bank or show at leaet 65k baht transfered per month into a Thai bank.

Originally Posted by terry57

Na, never happen fuko, if it ever does happen though all of Australians with Supa Funds and others through out the world will all be in the same boat.

People like you who have nothing ain't got a thing to lose though eh.

I wonder if anyone can remember ALLIED STEEL & WIRE Cardiff 2005,the co went bust and not a penny had by the men that worked most of their lives.
PENSION POT ROBBED.

If you're a Brit unless cashed up its madness if live overseas if dont maintain a UK address and have regular trips back so you can game the system as in to make the authorities believe you are resident so get your yearly pension increases and entitlement to NHS. Obviously people who opt to have their pension paid into a Thai bank account are shooting themselves in the foot from the get go.

^ There's definitely another side to that.

I've lived overseas for years and been treated as non-resident for tax. The last thing I'd want is to be regarded as resident in the UK as then all my overseas earnings, capital gains, etc would be subject to UK income tax (if the local tax is less than UK tax). Its a strange situation, on one hand people want to be treated as non-resident to avoid UK income tax and on the other as resident to gain any advantages UK residency offers. I guess you have to weigh up what is best for you personally.

Originally Posted by Mendip

^ There's definitely another side to that.

I've lived overseas for years and been treated as non-resident for tax. The last thing I'd want is to be regarded as resident in the UK as then all my overseas earnings, capital gains, etc would be subject to UK income tax (if the local tax is less than UK tax). Its a strange situation, on one hand people want to be treated as non-resident to avoid UK income tax and on the other as resident to gain any advantages UK residency offers. I guess you have to weigh up what is best for you personally.

I appreciate everyone's circumstances are different but my post was referring to the lower end as in people without much more than a pot to piss in. Obviously if financially secure you have no real worries but having lived in Thailand for 10 years (1999-2009) you see many farangs who are just surviving and too old to go back to work to make money, these are the dudes who should be taking a yearly trip back to Blighty making still registered at an address and with a GP.

Originally Posted by Buckaroo Banzai

If you are on a marriage VIsa or NON O yearly extension the mandated insurance does NOT apply to you.

I had confirmed this a week or so back just our of curiosity. Still good info regardless

Originally Posted by Mendip

The last thing I'd want is to be regarded as resident in the UK as then all my overseas earnings, capital gains, etc would be subject to UK income tax

I work here and get paid in BHT. While I keep a permanent address in the US and Bank accts etc, I prefer to avoid the taxation issue. But I always make over the US allowable amount anyway and have to file. But I am not subject to State/Local/SDI or SS. Just federal. Usually its a wash after all said and done but I still have to file.

Originally Posted by OhOh

What UK laws state an annual confirmation of ones address and GP registration are required?

They don't the point is to game the system in terms of making the authorities believe you are still resident so you get your yearly pension increase as the state pension is frozen if living overseas and also to keep your entitlement for free use of the NHS.

As I understand it the Dept Health committee is to deliberate further and more is to follow. In my experience Thai tend to push out proposed reforms tentatively to gauge the likely reaction and fallout, and I suspect to gain more information to augment their own cognitive powers in order to avoid unintended consequences that might make them look like fools or, worse still, lose them money.

Apropos Britain specifically, the problem that has arisen is that hundreds, if not thousands, senior expats have retired abroad in the past fifteen years plus who did so on the basis that their health, to a certain degree, was safeguarded by their continuing qualification for free NHS care because of their prior UK residence and receipt of their SPA on reaching 65. This concession that endured for over 40 years was withdrawn without warning or any notice in Sept/Oct 2015. I suspect many are now having to review their decision to migrate as it becomes increasingly difficult to obtain medical insurance necessary to qualify for their visa extensions.

In truth only the very rich can relax living here aged 65 years or over. Full medical cover providing treatment for cancer/heart conditions is prohibitively expensive and subject to exclusions but for many unobtainable. Certainly, after 70 you are on your own more or less completely. A simple pacemaker operation is around 500,000 but if cancer strikes requiring the full range of therapies including surgery then one is looking at 2 million plus and rising.

In truth, had I known that Jeremy Cvunt intended to withdraw my NHS cover in the way he did then I too may have organised things differently. Certainly, if the Thai do impose this new immigration tax then we shall carry out our plans to relocate back to UK. I'll be damned I shell out 50,000 baht every year for cover that would scarcely fund treatment for an infected ingrown toenail and a week's stay in Bumrungrad.

What happened to Portugal? House over the road from me up for sale!!!!!

Oddly, the wingman is quite enthused at the prospect of returning full time to Blighty and indicates no great relish at remaining longer than the odd month every year or so here in the LoS whereas the more I dwell on the prospect of doing all those Blighty type things again I feel quite wearisome and feel less inclined to leave - council tax, insurances, heating bills, fat ugly people with bad complexions and worse clothes, grey days, drizzle, petrol prices, stupid restaurant prices for gimcrack food, old shabby people. endless suburbia with sodium lighting and dead silences.
I think I might just stay in Bangkok and re-discover the joys of urban living - getting pissed in the FCCT, days at the swimming club, quiz nights in a Brit bar, having a session in the Tawandang, doing my calisthenics at Lumpini at 1730 hrs wearing my leotard and codpiece, drinking at happy hour in Nana/Soi Cowboy, mooching aimlessly around shopping malls and accompanying the wingman on airings about the town and meeting friends, talking bollocks and then boogieing at the Check-Inn/ Huntsman to the the Flipper band.

Beats a rainy night in Scunthorpe.

Fuck it, I might stay now.