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Pensioners: Health Services

Question for Department of Health

UIN HL4559, tabled on 10 January 2017

To ask Her Majesty’s Government what are the current arrangements for quantifying and registering EU/EEA pensioners living in the UK and those close to pensionable age, for the purposes of reclaiming their healthcare costs from their home countries; what were the total costs and payments last year to those countries, and what are their plans to reform the UK counting system.

Answered on

19 January 2017

Under the relevant European Union regulations, European Economic Area (EEA) countries and Switzerland are obliged to pay for the healthcare costs of those in receipt of state pension or other certain exportable benefits in their countries (based on pension and benefit eligibility, not nationality), but who live elsewhere in the EEA or Switzerland, including the United Kingdom.

EEA state pensioners moving to the UK, unless insured by the Republic of Ireland, need to apply for an S1 form in their own country. Once issued, the form is registered by being sent to the Overseas Healthcare Team at the Department for Work and Pensions to be processed.

EU rules set out the framework for determining which EEA country is ‘responsible’ for an individual under EU law. This is commonly referred to as ‘insurability’. The UK has a residency-based healthcare system which means that “insurability” is generally determined by residency (being “ordinarily resident”). Ordinarily resident means, broadly speaking, living in the UK on a lawful basis and properly settled for the time being, which would include EEA and Swiss residents below their respective state pensionable age but not in receipt of state pensions.

We do not make payments to EEA member states for their state pensioners living in the UK but we claim from those member states for those in receipt of EEA member state pension. The table below provides information about how much was paid to the UK for individuals in receipt of state pension from another EEA country or Switzerland.









Czech Republic


Denmark (Waiver)1


Estonia Waiver 2


Finland 3








Hungary (Waiver) 3
















Malta (Waiver)3




Norway (Waiver)2




















Source: Resource Accounting and Budgeting exercise. Totals are based on estimates of the costs of EEA healthcare claims made annually for the purposes of provisions made in the Department of Health accounts in accordance with Treasury resource accounting rules.

Notes: Waiver is an agreed intentional relinquishment of healthcare costs between Member States.

1 Denmark – Full waiver

2 Estonia and Norway – Waiver, excepting former Article 22.1c (patient referral) & Article 55.1c (industrial injury) claims

3 Finland, Hungary and Malta – Waiver, excepting former Article 22.1c (patient referral) claims

Since its inception in 2013, the Department of Health’s Visitor and Migrant NHS Cost Recovery Programme has been working to design and implement key improvements to ensure that those people who should pay for National Health Service care in England are identified and charged. The Department has also been working closely with the NHS to improve rates of recovery where these healthcare costs are the responsibility of other member states of the EEA via the European Health Insurance Card, S1 and S2 mechanisms.