What is comprehensive sickness insurance?

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Part of UK and EU law, comprehensive sickness insurance is a form of medical health insurance required across the EU.

The UK Home Office defines comprehensive sickness insurance as ‘any form of insurance that will cover the costs of the majority of medical treatment’ in the UK.

Guidelines specify that the health insurance cover should not contain significant exemptions but, somewhat confusingly, it ‘may contain certain exemptions’.

As a guide, AXA PPP – the UK’s second largest private medical insurer – advise foreign nationals purchasing private medical insurance to be compliant with visa requirements by purchasing a policy that includes:

  1. Some outpatient cover
  2. Full cancer cover

The policy should ideally be free from the six-week wait cost-containment option.   

If you are EU citizen who is either visiting or living in the UK you should be aware of this requirement. You should also consider the implications of this cover if you are considering applying to secure your residential status in the UK.

Who needs comprehensive sickness insurance?

You will need comprehensive sickness insurance if you are:

  1. An EU student and you are currently living and studying in the UK
  2. An EU citizen classified as ‘self sufficient’ – where your income is not reliant on employment (or self employment) To be defined as self sufficient you must have access to savings, or receive a source of income from a source such as a rental property. If you are supported by a spouse or partner you can also be classified as self sufficient
  3. A family member of an EU citizen whose permission to reside in the UK depends on the statuses above
  4. A family member of a British citizen returning to the UK from elsewhere in the EU, who does not intend to work once they return

Do I need comprehensive sickness insurance if I live in the UK permanently?

If you are an EU citizen living in the UK, you may assume that you have an automatic right to medical treatment from the NHS.

The reality is, however, somewhat more complicated, as the law states certain requirements which you must meet in order to be classified as living in the UK in accordance with the law.

You must meet one of the below criteria to be ‘legally’ resident in the UK and entitled to NHS-funded medical treatment:

  1. Employed
  2. Self-employed
  3. A student with comprehensive sickness insurance
  4. ‘Self sufficient’ with comprehensive sickness insurance
  5. A family member of someone who is classified as ‘self sufficient’

If you live in the UK for five years under any of the above circumstances, you are then entitled to seek ‘permanent residence’ status from the UK Home Office. If this is granted, you will receive either:

  1. A document certifying permanent residence
  2. A permanent residence card

If you wish to apply for British citizenship, it is mandatory to first be granted permanent residence status.

If you need medical treatment at an NHS clinic or hospital and you do not meet the above criteria you will usually be able to show your passport or national identity card as a valid form of ID. These will not be sufficient if you want to apply for permanent UK residence, or you need a document confirming your right to reside in the UK.

How do you know if your health insurance policy is comprehensive?

Unfortunately, there is no standard ‘comprehensive’ sickness insurance policy. We are able to advise on the most suitable private health insurance policy for you, with the most comprehensive cover.

Is there an alternative to private medical insurance?

If you are employed or self-employed in the UK, your national insurance (NI) contributions entitle you to NHS medical treatment.
If you hold a European Health Insurance card – or the previous E111- issued by a state other than the UK, you can use this whilst seeking NHS treatment if:

  1. You’re applying for a document certifying permanent residence or a permanent residence card once you have lived in the UK for five years
  2. You’re applying for a document confirming your right to be in the UK – such as a registration certificate or residence card – before you have lived in the country for five years

Will I still need comprehensive sickness insurance after Brexit?

After Brexit, future EU nationals won’t be required to prove they have valid comprehensive sickness insurance if they apply to reside in the UK on a long term basis.

‘Settled status’ will replace the current ‘permanent residence’ status and the UK government has confirmed that those granted ‘settled status’ will not require comprehensive sickness insurance.

It is expected than these new regulations will come into force from summer 2019, although this is subject to the agreement of other EU member states.

It is yet to be confirmed whether these changes will affect those EU citizens already living in the UK or only those who move to the UK in the future.

If you need any additional information on comprehensive sickness insurance or you’d like to discuss your existing health insurance policy, get in touch with our specialist team of insurance brokers who will be happy to help you.