The number of such individuals is said to be relatively small, but some say the change will force many of them to turn to private medical insurers, at least until they reach retirement age and are able to qualify for state services again.
The discontinuation of free healthcare for such non-working but not-yet-retired British expats is one of a number of proposed cost-saving measures being considered by the UK's cash-strapped National Health Service.
At issue in particular is something called a Residual S1 Form, or simply S1 Form, which currently is available to “early retirees” who have made National Insurance contributions while still living in the UK, and who have gone, or are going, to live in another European Economic Area (EEA) country.
For such individuals, UK-funded healthcare has been, and for the moment still is, available to them and their dependents for a limited period of time – up to a maximum of 2.5 years – while they “become established” in their new country.
In order to qualify for the full 2.5 years of coverage available to them, they would be expected to have paid National Insurance contributions for the three years preceding the time for which they are seeking to be covered.
Once a Residual S1 Form is issued to such individuals, they are responsible for registering it with their local authorities, in order to ensure they are entitled to be on the books of their new local GP’s surgery, according to an explanation on the NHS's website.
The free healthcare provided to expats over retirement age in EEA countries would not be affected by the proposed changes, nor would that available to Britons travelling in the EU, while still UK resident, who require emergency care under the so-called European Health Insurance Card.
1 April date mooted
According to market reports, the date for ending the use of Residual S1 forms has been set for 1 April, but a spokesperson for the Department of Health was unable to confirm this, and was able to provide little information beyond a prepared statement. This statement said only that the "changes" – which are not otherwise explained – will "only apply to new applications", and that "all existing Residual S1 forms will remain in place and continue to be valid until their cessation date".
"We are committed to ensuring that the NHS is sustainable and fair for the British taxpayer," the statement added.
"We are continuing to work through the operational implications of the change."
Once this work has been completed, a more detailed announcement will be made, the Department of Health spokesperson said.
'Take advice'
A spokesperson for MediCare International, the UK-based international private medical insurer, said that given the uncertainty, those planning to move abroad from the UK "should seek advice before leaving, to make sure they have cover in place for the destination they are going to".
Paul Weigall, group sales and marketing director for InterGlobal, another provider of medical insurance internationally, noted that the elimination of the free healthcare option for expat Britons below retirement age is likely to be met with "mixed reviews" in some popular retirement areas of France and Spain, particularly among some expats who will feel they are entitled to free healthcare "because they have paid National Insurance for all of their lives".
"Others will understand that if you're leaving the shores of the UK, then you would expect to have to pay [for healthcare] or insure your healthcare needs out of your own pocket," Weigall added.
One compensation for those who stump up for an international private healthcare policy, at least, is that "they may find they get treated more quickly, and have access to better doctors and medical facilities" than if they went the S1 Form route, Weigall noted.
Footing expats' healthcare costs
The move to force expat Britons living in Europe who are not yet old enough to retire to either get a job – through which the right to access state healthcare normally would be provided – or foot their own healthcare costs reflects a growing trend around the world by governments to find a fair way of seeing to it that the healthcare needs of their resident expat populations are provided for.
As reported here last year, Dubai's Health Authority last year unveiled a new law that will require employers in the emirate to provide their expatriate staff with health insurance; Abu Dhabi, one of the other UAE emirates, introduced mandatory health insurance in 2007.
Kuwait last year was reported to have begun banning foreigners from one of its major public hospitals at certain times of day, in an effort to ease overcrowding, and talked of increasing the fees it charges expatriates for healthcare services.
For multi-national insurance companies the trend is a welcome one, as tough times in such mature home markets as Europe have caused some people to give up their private health insurance coverage, or cut back on it, and rely more on their state healthcare systems.
To read about how InterGlobal has made major changes to its range of healthcare offerings for expatriates, in order to boost, and thus improve, its coverage of cancer care, click here.
To read about Medicare International's new range of benefits for all its international policies, click here.
To find out which East African insurance provider Bupa International announced last year it was to partner with, in order to sell its products into such markets as Kenya, click here.
