Healthcare does matter, especially in retirement.
Private health cover can be a great solution – however, there are a few things to consider before splashing out on private insurance, which could bring your healthcare bills down or, in some cases, almost entirely eliminate them.
Paperwork to keep your healthcare abroad costs manageable
If you are retiring to an EU country and are eligible for a UK state pension, almost certainly you are entitled to the same level of public healthcare the local residents have. Such health services will be provided by your new country’s health institutions and paid for by the UK.
You will also be able to return to the UK for any treatment you need if you prefer so. Keep this in mind when researching your private healthcare options.
To be able to get the best value for money healthcare in your new country of residence, you need to sort out some paperwork.
Before you leave the UK:
- Obtain your UK issued European Health Insurance Card (EHIC);
- Apply for an S1 Form from the Department for Work and Pensions.
When you’re abroad:
- Register your S1 form with the local authorities;
- Apply for the locally issued EHIC for your travels around the EU (including back in the UK);
- If registering your S1 form requires obtaining residency, you can cover yourself for this period through local private healthcare companies. Local private health insurance is cheaper than international.
European Health Insurance Card – EHIC
The European Health Insurance Card covers EEA citizens for immediate and unplanned healthcare needs during their visits in any EEA country.
What EHIC covers
It allows you to get state medical treatment on the same basis as residents of the country you’re visiting. You may need to pay upfront and then reclaim some or all of the costs.
The EHIC is not an alternative to travel insurance and does not cover private treatment or evacuation to your home country.
It is a short-term solution aimed at tourists and other visitors staying for up to three months. The EHIC helps you to access healthcare if you get ill or have been in an accident. It also covers treatment of a chronic or pre-existing medical condition that becomes necessary during your visit.
With the EHIC you can access the provision of oxygen and kidney dialysis, although you’ll have to pre-book these treatments before you arrive.
When using your EHIC to access healthcare make sure you’re not booked with a private healthcare provider. Private services are not covered by the EHIC.
How long you can use your EHIC
EHIC is a temporary solution. After three months in a country, you should register with the healthcare authorities and access general healthcare as a resident.
How to apply for an EHIC
You can apply for or renew an EHIC using the official EHIC online application form.
An EHIC is free of charge! Don’t apply through any sites that charge you for application.
EHICs are residency-based. Once you become a resident in your new country, apply for the locally-issued EHIC – it will cover you during your travels within the EEA.
S1 form for state healthcare
If you retire in an EEA country or Switzerland and are in receipt of the British state pension, you are entitled to state healthcare in the country of your residence, paid for by the UK.
You are also free to use UK healthcare if you choose.
This might change after Britain officially leaves the EU but, for now, the current agreements remain in place.
To be eligible you have to apply for a certificate of entitlement – the S1 form (formerly known as E106 or E109).
Forms are available from the UK government site.
Once you’ve been issued with one, you can register it with the relevant healthcare authority in your new country.
In most instances, you have to go through this process before being allowed to register with a GP, obtain a medical card or free healthcare in your new country of residence.
Once you’ve been issued with and registered your S1, you can apply for a locally issued EHIC.
If you are not eligible for S1 form
If for any reason you can’t apply for an S1 form (for example, if you are retiring early), have a look whether you can join your new country’s public healthcare system for a fee. Some countries allow that.
In Spain, for example, you can register for a government-run scheme called Convenio Especial. It will allow you to access public healthcare and other social security benefits for a basic monthly fee of €60 for the under 65s and €157 for over 65s. However, you can only do it after you’ve been a resident for a year.
To cover the gap, look first at what local private health providers offer.
Local private health insurance for expats
If you want or need to have private health cover, don’t rush to buy an international plan. You may find more competitive deals offered by insurers in your new country of residence.
Try to get privately insured as early as possible – that is, before you turn 65. After that, it’s both difficult and expensive. And do make sure your insurer won’t bump you off their health insurance the moment you turn 65!
If, as a retiree, you’re moving to a country that offers free or subsidised healthcare, you may be able to buy top-up insurance for a better level of, or extended, care and service.
As a rule, top-ups are much cheaper and, in most cases, will cover all co-payments and additional services.
International health insurance for expats
If you are 65 and over, not many local private insurers will be ready to give you health cover – and those that on offer are quite pricey.
In this case, it might be useful to compare local and international health cover quotes.
Choosing health insurance: how not to overpay
1: The bigger your excess, the lower the monthly cost.
Therefore, if you think you can afford to pay something every time you need treatment, talk to each insurer you approach to see how much you could shave off your monthly/ annual fee.
2: The narrower your coverage, the more affordable your insurance.
Restrict your coverage to your new country of residence to get a cheaper quote.
3: Paying for some treatments out-of-pocket.
Opting to pay for prescriptions, dental and optical treatment yourself can reduce your insurance premium. It would be wise, however, to research how much such treatments could cost you on a pay-as-you-go basis in your new country to decide which is cheaper: paying a higher premium or choosing to pay out of your own pocket.