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Working abroad: entitlement to healthcare paid by the UK

Working for a UK employer or self-employed

If you are going to work in the European Economic Area (EEA) or Switzerland, and continue to pay compulsory UK National Insurance (NI), you may be entitled to healthcare paid for by the UK. This will include any dependants that go with you.

You will be treated on the same basis as a resident of  that country. Make sure you check any country-specific information before travelling to see what healthcare is covered.

Use the Country-by-country guide and select a EEA country from the list for detailed information.  

Working abroad for one year or less

If you are working abroad for a year or less, you will need form A1 (or E101 if you are going to Iceland, Liechtenstein, Norway or Switzerland) to show that you continue to pay compulsory tax and NI in the UK. To apply for an A1 (or E101) your employer needs to contact HM Revenue and Customs (HMRC).

HMRC
Charity, Assets and Residence
Room BP1301
Benton Park View
Newcastle upon Tyne
NE98 1ZZ

Additionally, you will need to apply for a European Health Insurance Card (EHIC), which enables you to access healthcare while working abroad.

You can apply for a second period of up to 12 months in case your stay unexpectedly lasts longer then one year. If your application is successful, another A1 (or E102) will be issued. Make sure your EHIC is renewed as well. For more information, contact HMRC.  

Working abroad for over two years

If you are working abroad for two years or more (maximum of five years), your employer should contact HM Revenue and Customs (HMRC) for the following forms:

  • A1 (or E101): this will show that tax and NI contributions are paid in the UK.
  • S1 (or E106): this will give you and your family the same medical cover as residents of that country.

HMRC
Charity, Assets and Residence
Room BP1301
Benton Park View
Newcastle upon Tyne
NE98 1ZZ

Check any country-specific information before travelling to see what healthcare is covered. Use the Country-by-country guide and select a EEA country from the list for detailed information.  

Working as an 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.

Apply online for your EHIC now.

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 allows you to visit another country other than the one you are stationed in.

Apply online for your EHIC now.

Comments

5 Comments

Our rules

Comments are personal views. Any information they give has not been checked and may not be accurate.

Barnabubble said on 29 August 2012

I moved to Girona, Spain with my wife and two small children just over two years ago and are legal residents here and are almost fully integrated apart from healthcare - which has had a huge affect on us. I work for a UK company on a tiny salary (its my start up company) as a remote worker and currently only target UK business. As we have not paid into the Spanish Social Security system we have been denied healthcare and just cannot afford private family cover (my little girls needed vaccines last year so thank God for nan and grandad helping with the costs). The HMRC have been really difficult (International Case Workers I feel do not understand either their roles fully or our situations) and my local tax office here in Spain said I need an S1 Certifcate. Still not issuing an S1 as they say I do too much 'work' in Spain and not back in the UK enough so referred me to Madrid and this was a disaster as Madrid now say I need to pay tax here, register my company etc etc and as a start up with almost no business coming in and no salary in year one at all this is not possible and I felt wrong so I appealed and reapplied for a new application for an S1. The latest letter from my usual International Caseworker just doesnt understand the difference between residency and work. Work is where you take income regardless of where I live so whilst I make calls, emails etc here in Spain my income is levied from UK. So now I am too scared to return the form again for fear of refusal and a protracted case again. Even my Spanish lawyer who I sought help from doesnt understand why this is an issue or our private Dutch GP who issued my childrens Vaccines. I have heard since that Ana Mato the Spanish Health Minister has just passed a new Law effective from 1 Sept 2012 that all legal residents of Spain that earn under 100,000€ per year can now claim free healthcare. Off to the local Social Security office Monday to push again. Will keep you posted if I pursue breach of Human Rights!

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Austin Allegro said on 02 August 2011

Remote worker, you're right that nobody seems to know about this. My current situation is this: HMRC says I have to pay tax in the UK. Hungarian authorities say I can get reciprocal care with an A1 form only. NI people however say I can't have an A1 form because my contract is longer than two years. So it looks like the only option is to contribute to the Hungarian state system, but that's all done through their tax system, which I don't pay into! Further clarification has been requested from NI but I'm not holding my breath.

I met a fellow expat who says he got round it by simply not telling HMRC or NI that he had moved abroad (using his parents' address as his permanent UK address), and paying for private medical insurance in Hungary.

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remote worker said on 14 June 2011

I have exactly the same situation as Austin Allegro, and would say that after 5 years you are normally entitled to full healthcare as a permanent resident of that country.

Tax & NI situation though is difficult and AA is the first person I have met in the same situation, so wish we could discuss...

However the problem now is that EHIC is emergency only, E101 is no use as it only tells my country of residence that i have paid NI in UK and do not need to pay here as well, and E106 is only really available after 2 years. Also I cannot renew my EHIC as it only allows a UK address.

So having paid significant employee and employer contributions over the years, I am entitle to nothing, and no one can offer any advice, and certainly not consistent advice....

I also like the fact that these comments are reviewed every 2 years!!! and it's late as next review is due 2 months ago.

The information, advice, documentation, clarity and general helpfulness on this subject is absolutely dreadful, no one seems to have a clue what to do when moving, and although people I call are helpful, none of the information is right when you take it to the next step / or present it in the country of residence...

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Austin Allegro said on 30 March 2011

So what happens if you are posted abroad for more than two years? I am resident for tax in the UK but living in another EU country on a remote working, internet based job for a British company. I could (hopefully) be doing this for another 20 years. But all the info suggests you can only get an A1 for up to five years.

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nv_bg said on 16 February 2011

The information on this page is out of date as of May 2010.
The A1 form can now be issued that will last for 2 years without needing to be extended after 12 months.

HMRC claim that in order to get an S1 form your will need to have been sent abroad for more than 2 years but a maximum length an initial A1 can be issued for is 2 years.
This means that people on a 2 year secondment are stuck with having just an EHIC card. Far from ideal.

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Last reviewed: 23/06/2011

Next review due: 23/06/2013

Apply for a free EHIC 

The EHIC is entirely free of charge. However, other, unofficial, websites may charge you if you apply through them. Apply now for your free EHIC.

If you're having difficulties with the online application form, to update your personal details, or to replace a lost or stolen card, call the automated EHIC application service on 0300 3301350.

For general enquiries about the EHIC or claim refunds, call the Overseas Healthcare Team on 0191 218 1999. If calling from abroad ring +44 191 218 1999.

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