Hi, as you say my circumstances make a difference but it seems that the difference is that I am paying UK Class 1 NICS and I believe that anyone who is paying compulsary UK class 1/2 NICS and are resident in any EEA country are not liable to NHS charges. Please see here from the Dept of Health
Appendix 3 to chapter 22 - Patients guide - NHS Trusts - Detailed Guidance
National Health Service Hospital charges to Overseas Visitors - May 1999

1. This Guide summarises the circumstances in which overseas visitors are not liable to pay for National Health Service (NHS) hospital treatment.

2. Under Regulations which first came into effect on 1 October 1982, visitors to the United Kingdom (UK) are liable to be charged for NHS hospital treatment. A visitor is someone not ordinarily resident in the UK. Since 1 April 1989 the amount to be charged has been determined by health authorities, and from 1 April 1991 also by NHS trusts.

3. The charges do not apply to the following people:-

a. anyone who at the time of receiving treatment has been in the UK for the previous 12 months.

b. anyone who has come to the UK to take up permanent residence.

c. anyone who has come to the UK for employment (whether as an employed or self-employed person); this includes students and trainees whose course requires them to spend not less than 12 weeks in employment during their first year and unpaid workers with voluntary organisations providing certain services similar to those of Health Authorities and local authority social services departments.


d. members of HM Forces and other Crown servants and British Council or Commonwealth War Graves Commission staff serving overseas, and others working overseas under arrangements sponsored by HM Government.


e. people working overseas who have had at least 10 years' continuous residence in the UK and have either been working abroad for not more than 5 years, or have been taking home leave in the UK at least once in every 2 years or have a contractual right to do so, or have a contractual right to the cost of their passage to the UK at the end of their engagement.


f. i. nationals of the European Economic Areas (from 1.1.1995, the fifteen European Community member states of Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden and the UK plus Iceland, Liechtenstein and Norway) who are resident in any of them; refugees and stateless persons living in them and the dependants and survivors of these people regardless of their own nationality. (This exemption applies only to treatment the need for which arose during the visit.)


ii. nationals of any European Economic Area country, refugees, stateless persons and their dependants or survivors living in them (as specified in 3fi) who are referred to the UK specifically for treatment with form E112 or E123.


g. nationals (list A) and residents irrespective of nationality (list B) of the following countries with which the UK has reciprocal agreements:-

deleted for brevity

i. who require treatment the need for which arose during the visit to the UK.

ii. who are referred to the UK for treatment (usually only from countries asterisked) under arrangements made by appropriate authorities in those countries.

(NB: Residents of Iceland and Sweden who are EEA nationals are covered by Category 3fi or 3fii; Category 3gi applies to residents of those countries who are not EEA nationals.)

h. seamen on UK-registered ships; offshore workers on the UK sector of the continental Shelf.

i. UK war disablement pensioners and war widows.

j. UK state pensioners living overseas. (This exemption is limited to treatment the need for which arose during the visit.)

k. refugees and others who have sought refuge in the UK.

l. (i) anyone formally detained by the Immigration Authorities

(p) anyone who is a prisoner. (Note: for prisoners on remand, this exemption applies until 12 months after arrival in the UK. For convicted prisoners, this exemption applies until 12 months after arrival in the UK, or 6 months after committal to prison by the Courts, whichever is the earlier.)

m. diplomatic staff at embassies and Commonwealth high commissions in London.

n. EEA nationals working is another EEA member state but paying compulsory UK class I or II national insurance contributions. (See paragraph 3fi above for definition of EEA national.)

o. nationals of countries that are signatories to the European Social Charter but with whom the UK has no reciprocal agreement-currently Cyprus and Turkey. (This exemption is limited to those nationals who are genuinely without resources to pay for medical assistance and the need for the treatment arose during the visit.)

p. NATO service personnel (posted in the UK) not using their own or UK armed forces hospitals.

q. the husband or wife and children (under the age of 16, or under the age of 19 if at school or a college of further education) of any person described above in (a)-(p) and below in (r) and para. 6.

r. anyone who is entitled to receive industrial injury benefit from Israel. (This exemption is limited to treatment the need for which arose during the visit to the UK and in connection with the industrial injury to which the benefit refers.)

4. The charges do not apply to the following services:-
a. treatment in Accident and Emergency departments. (NOTE: a patient who is admitted to hospital as an in-patient, even from an Accident and Emergency department, as would generally happen for serious injuries, is liable to be charged, as would be a patient referred to an out-patient clinic).


b. diagnosis and treatment of certain communicable diseases, including sexually transmitted diseases. (For HIV/AIDS see paragraph 7).

c. compulsory psychiatric treatment (i.e. when the patient is detained, or when it is a condition of a probation order that the patient should receive psychiatric treatment.)

5. There are no NHS charges for certain district nursing, midwifery or health visiting services; for the emergency ambulance service; or for family planning services.

6. A person living here for a settled purpose for not less than 6 months will be accepted as ordinarily resident and therefore not liable to charges under the Regulations. A student enrolled in a course of study, the prescribed duration of which is not less than 6 months, is similarly entitled (see also paragraph 3q above).

7. Free treatment for HIV/AIDS at a special clinic for the treatment of sexually transmitted diseases is limited to a diagnostic test for the evidence of infection with HIV and counselling associated with that test or its result. An overseas visitor with HIV/AIDS referred to a hospital from such a clinic will be liable for charges unless otherwise exempt. Hospital out-patients must pay for any drug or medicine which is designed to treat HIV.

8. Any further advice should be obtained from the Patient Services Manager at the hospital where treatment is to be sought


section n. states

n. EEA nationals working is (sic) another EEA member state but paying compulsory UK class I or II national insurance contributions. (See paragraph 3fi above for definition of EEA national.)

So from reading this for instance if a UK national were working in Spain for a UK company and were paying compulsary UK NICS would be entitled to free NHS care. I believe that this is the section that I would ordinarily fall in apart from the fact that an oil platform on the UK Continental Shelf is outwith the 12 mile territorial waters so therefore is not actually in the UK and therfore not in an EEA country hence section h.

h. seamen on UK-registered ships; offshore workers on the UK sector of the continental Shelf.

With regard to the E106 only being temporary this is only in sofar as being related to recent NICS, if for instance someone who was in employment on leaving the UK to take up residence in Spain and was no longer in employment then the length of time that the E106 would be valid for is related to your recent NICS history. If for instance in my case because I would continue paying UK NICS I could keep re-applying for the E106 at each anniversary of the first one being issued.

As I said I have/am researching this quite deeply as my wife has a number of medical problems not least having had a couple of transplants so although we have the utmost faith in the Spanish health care system would like for her to continue seeing her consultants in the UK for the sake of continuity of care and to that end I will be writing to our Health Board to get a definitive answer.

Obviously everyones circumstances are different but if they fall into any of the catergories stated above i.e paying compulsary UK Class 1/2 NICS then I believe they would be entitled to free UK NHS treatment certainly on a pre-arranged basis.