Living abroad

Ensure you plan ahead

Moving to another country can be an overwhelming experience. Travel arrangements, accommodation and visa or work permit are obvious things to consider when preparing to move, but what about planning for your healthcare?

If you are moving abroad on a permanent basis, you will no longer be entitled to medical treatment under normal NHS rules. This is because the NHS is a residence-based healthcare system. You’ll also have to notify your GP so that you and your family can be removed from the NHS register.

Most people will no longer be entitled to use your UK-issued European Health Insurance Card (EHIC) to access healthcare abroad.

Tip: You should budget for any additional healthcare costs you may face, including health insurance.

Before leaving for your new destination, it's important to check what health services are available to you in that country. Healthcare systems vary from country to country and might not include services you would expect to get free of charge under the NHS. 

In most cases you’ll have to register with the relevant authorities abroad. Once you are registered to work and make National Insurance contributions, you'll be entitled to state-run healthcare on the same basis as a national of that country. However, many countries still expect you to make patient contributions or to join the national health insurance scheme.

Tip: The Foreign and Commonwealth Office (FCO) provides useful information about Help for British nationals living abroad on the GOV.UK website, including what UK benefits are available to Britons living abroad.

However, there are circumstances in which you might be entitled to healthcare paid for by the UK. This depends on whether you want to live abroad permanently, or only work outside the UK for a set period. The assistance available only applies within Europe and can also depend on whether or not you receive a UK State Pension or other UK benefits.

Moving outside the EEA

You will not be covered for healthcare paid for by the UK if you are going to live permanently outside the European Economic Area (EEA).

Planned treatment

If at any time in the future you want to come back to the UK for planned treatment, you must consult your new authorities to find out the options available to you. However, you will be charged in the UK, unless you can provide an S2 (or E112) issued by your country of residence under European reciprocal arrangements.

Living and working abroad 

If you move to an EEA country or Switzerland long-term or plan to work in another EEA country, you'll need to register with the appropriate authorities. Once you are registered to work in the country and make National Insurance contributions, you'll be entitled to state provided healthcare on the same basis as a national of that country.

Check whether there are any other entry requirements for the country you are going to. Look up the country-by-country guide for more guidance on access to healthcare or visit GOV.UK’s section on Help for British nationals living overseas.

If you are a worker seconded abroad to an EEA country or Switzerland for more than two years but less than five years, your employer should contact HM Revenue and Customs (HMRC) for the following forms:

  • A1 - this will show that National Insurance contributions are paid in the UK
  • S1 (previously E106) – this will give you and your family the same medical cover as residents of the country you will be working in

Note: Ensure when you submit the forms you mention relevant family members and dependants.

National Insurance Contributions and Employer Office
HM Revenue and Customs
United Kingdom

Once the S1 form is issued, you’ll need to register it with the appropriate authorities before you register with a local GP surgery.

Tip: If you are sent to work in an EEA country or Switzerland for two years or less you’ll have to apply for a European Health Insurance Card (EHIC), which enables you to access healthcare, with a valid and registered A1 form, while working abroad. For more information, contact HMRC.

Note: the maximum length of time that a UK-issued EHIC is valid for is five years.

Tip: Au pair or nanny – If you are working as an au pair or nanny in an EEA country, you're entitled to an EHIC for a period of up to 12 months. After the 12 months, you must obtain healthcare cover in the country where you are working.

Tip: British Armed Forces – If you are stationed in an EEA country or Switzerland, you and your dependants are entitled to a UK issued EHIC. This means your EHIC will cover you and your dependants if you visit a country other than the one you are stationed in.

UK Pensioners

If you are living in an EEA country or Switzerland and you receive a UK State Pension or long-term Incapacity Benefit, you may be entitled to state healthcare paid for by the UK. You'll need to apply for a certificate of entitlement also known as an S1 form. If you are living in Iceland, Liechtenstein, Norway or Switzerland then the form is called E121.

You can apply for your form via the International Pension Centre on 0191 218 7777. Once issued, register the S1/E121 form with the relevant authority abroad. Often you need to do this before you can register with a GP surgery or obtain a medical card.

Once you have registered your S1/E121 in the country you are moving to, you will be entitled to apply for and use a UK-issued EHIC to access state-funded necessary medical treatment when you visit other EEA countries.

Tip: If you get a UK benefit, such as short-term Incapacity Benefit or Maternity Allowance, your healthcare cover is subject to different rules. The period of your cover and application criteria may differ depending on your particular circumstances. For more information, contact the International Pension Centre (IPC) or the Department for Work and Pensions (DWP).


Last Updated: 01/04/2017 09:00:00
The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website