COMPREHENSIVE MEDICAL INSURANCE – AN OVERVIEW FOR EEA NATIONALS

24 Oct 2016, 48 mins ago

EEA nationals must have a comprehensive sickness insurance covering the costs of most of the medical treatment they may need whilst in the UK. In most cases where the EEA national is staying in the UK on a temporary basis he will be covered under the European Health Insurance from another EEA member state and will have been issued the European Health Insurance Card (EHIC) by that state. The state that issued the card will cover the cost of treatment.

On 6 April 2015 the amended Immigration (European Economic Area) Regulations 2006 came into force. It is now required under Paragraph 4(2)(b) of the amended Regulations that those EU nationals wishing to rely on their status as either a self-sufficient person or a student in order to remain in the UK under Paragraph 4(1)(c) and (d) of the Regulations, must not only hold a comprehensive medical insurance for themselves but also for their family members for the duration of their residence in the UK. This amendment is not an innovation by the UK Home Office; it mirrors closely Article 7 of the Citizen’s Directive, 2004/58/EC, which established in 2004 a pan-European requirement for the family members of EEA nationals to have comprehensive sickness cover in place to qualify for a right of residence in another Member State.

An original and valid European Health Insurance Card (EHIC), S1, S2, S3 and an original private health insurance policy document are accepted as proof of comprehensive sickness insurance. It might be useful to also provide a ‘statement of intent’ confirming that the EEA national has no intention to stay in the UK permanently.

The EEA national and their family member will have the required “comprehensive sickness insurance” if they hold any form of insurance that will cover the costs of the majority of medical treatment they may receive in the UK. The comprehensive sickness insurance does not include access to the UK’s National Health Service, as such. Neither does it include cash back health schemes, such as dental, optical, or prescription charges. Travel insurance policies fall also outside of the insurance. If the EEA nationals do not have the necessary insurance, they could be charged to access medical treatment whilst in the UK.

It is not possible to apply for the European Health Insurance Card (EHIC) in the UK. It must be obtained before traveling to the UK. Despite being potentially covered by the insurance, without the card the EEA national could be charged for using the NHS unless, of course, he has alternative comprehensive sickness insurance.

EU nationals and their family members will be required to provide proof of comprehensive sickness insurance cover when applying for a document confirming right of residence in the UK or making any other immigration applications to remain in the UK. Failure to provide this evidence will result in the applications being refused. Those covered under the European Health Insurance and wishing to remain in the UK will need to obtain additionalinsurance. If a student or a self-sufficient person applies for permanent residency, the applicant will need to show that he had comprehensive sickness insurance at all times during his stay in the UK.

Recent reports have revealed uncertainty surrounding the meaning of “comprehensive cover” and exactly what this requirement entails.

The most reliable guidance on the matter can be found in the European Economic Area nationals qualified persons guidance – version 3.0 – 7 April 2015, issued by the Home Office.

The guidance further states that when considering whether sickness insurance is comprehensive, a proportionate approach must be taken – if the policy covers applicants in the majority of circumstances, the cover should be accepted as comprehensive.

It has been widely suggested that in order to avoid any difficulties, EU nationals residing in the UK as self-sufficient people or students should ask insurers for the most comprehensive cover available.