Living in Spain, self employed in UK

[Ellan_Vannin]

Originally Posted by Stravinsky

Yes if you have proof of Class 1 or class 2, but then you are working in the UK I guess and a UK resident so you'd get it anyway .

There seems to be a bit of confusion here ....... An E106 is soley a "certificate of entitlement to sickness and maternity insurance benefits in kind for persons residing in a country other than the competent country" I.E, it is issued in the UK soley for health care in another country. Its not issued in one country for cover in that same country. Its also a temporary cover form. It will only cover you for up to 2 years in the country you have moved to. On the forum the UK authorities complete your details, and when you get to Spain you go to the local Dept of Seguridad and they endorse your forms and send a copy back to the UK.

I researched it quite thoroughly as well when we moved here and had numerous conversations with DWP as didi many people I know. You need to speak to the Department of Works and Pensions in Newcastle ... I think you might get a different answer, because in all the hundreds of times this has been discussed on various forums that I've seen over the last many years, no one has ever managed to get legal free NHS treatment in the UK whilst they are a resident in Spain.

In point of fact, if you ever go back you have a hell of a job convincing them they you are definately going to be a UK resident, as they think you are just popping back for treatment


Now ....... when you get your E106 registered in Spain and get a temporary SIP card you can then get an EHIC card that will cover you in the UK for emergencies etc when you are on holiday there.

I'd be very interested to see the circumstances and details on the email you got, because it flies in the face of every bit of advice given by the UK authorities so far

Ok, in my circumstances I work on an oil platform in the UK sector of the Continental Shelf if i were to have my home in Spain if my wife were to live in that home and my daughter attended school in Spain I would be classed as resident in Spain due to the double taxation treaty. As I would have to continue paying class 1 NICS in the UK the UK is therefore the competent state responsible for national health care costs. As you say the E106 is soley a "certificate of entitlement to sickness and maternity insurance benefits in kind for persons residing in a country other than the competent country" therefore if you have an E106 it is proof that you are paying NICS or have done until fairly recently so could be used in the absence of any other proof. Incidentaly if you are currently in employment in the UK the E106 is issued by HMRC otherwise by DWP.
Regulations EC No. 1408/71 and 574/72 govern the various rules for benefits and health entitlements and "Regulation 1408/71 allows for reimbursement of costs for certain types of cross-border
care. Frontier workers benefit from a double access to health care, both in the state of residence and in the state of work." Because of this regulation I think that is why the nhs website states "If you have a valid E106, you can still access NHS healthcare." here
Living abroad
and also here Healthcare in Spain I emailed the dept of health to clarify this statement and this was the reply:
Thank you for your email of 10 June to the Department of Health about the form E106.

The NHS remains responsible for the healthcare of the holder of a form E106. Therefore if you wish to return to the UK specifically for treatment you can directly contact a hospital to arrange treatment.

In order to cover yourself for unplanned treatment on a trip to the UK, you will need to carry a Spanish issued European Health Insurance Card (EHIC).

To find out more about the form E106 please contact the Department for Work and Pensions (DWP) which is responsible for issuing the form:

Department for Work and Pensions (DWP)
The Pensions Service
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA
Tel: 0191 218 7777

I hope this information has been of help.

Yours sincerely,

With reference to the EHIC in their answer I think that they are talking about the situation of say an early retiree who has an E106 issued by the DWP and actually think that in the case of an HMRC issued E106 because of ongoing NICS the holder would actually be entitled to a UK issued EHIC.

My situation is fairly unusual in the fact that i would be working on the UK Continental Shelf, however i think there could be similar circumstances whereby if some-one were to move to Spain yet travel back to the uk regularly for employment or self-employment and to have no earnings in Spain that they could be classed a Spanish tax resident due to the double taxation treaty yet as they would be paying UK NICS the UK would be the competent state responsible for their health care payments and could be why the original poster was initially advised to carry on paying UK Tax/NICS.

[Stravinsky]

Originally Posted by Ellan_Vannin

Ok, in my circumstances I work on an oil platform in the UK sector of the Continental Shelf if i were to have my home in Spain if my wife were to live in that home and my daughter attended school in Spain I would be classed as resident in Spain due to the double taxation treaty. As I would have to continue paying class 1 NICS in the UK the UK is therefore the competent state responsible for national health care costs. As you say the E106 is soley a "certificate of entitlement to sickness and maternity insurance benefits in kind for persons residing in a country other than the competent country" therefore if you have an E106 it is proof that you are paying NICS or have done until fairly recently so could be used in the absence of any other proof. Incidentaly if you are currently in employment in the UK the E106 is issued by HMRC otherwise by DWP.
Regulations EC No. 1408/71 and 574/72 govern the various rules for benefits and health entitlements and "Regulation 1408/71 allows for reimbursement of costs for certain types of cross-border
care. Frontier workers benefit from a double access to health care, both in the state of residence and in the state of work." Because of this regulation I think that is why the nhs website states "If you have a valid E106, you can still access NHS healthcare." here
Living abroad
and also here Healthcare in Spain I emailed the dept of health to clarify this statement and this was the reply:
Thank you for your email of 10 June to the Department of Health about the form E106.

The NHS remains responsible for the healthcare of the holder of a form E106. Therefore if you wish to return to the UK specifically for treatment you can directly contact a hospital to arrange treatment.

In order to cover yourself for unplanned treatment on a trip to the UK, you will need to carry a Spanish issued European Health Insurance Card (EHIC).

To find out more about the form E106 please contact the Department for Work and Pensions (DWP) which is responsible for issuing the form:

Department for Work and Pensions (DWP)
The Pensions Service
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA
Tel: 0191 218 7777

I hope this information has been of help.

Yours sincerely,

With reference to the EHIC in their answer I think that they are talking about the situation of say an early retiree who has an E106 issued by the DWP and actually think that in the case of an HMRC issued E106 because of ongoing NICS the holder would actually be entitled to a UK issued EHIC.

My situation is fairly unusual in the fact that i would be working on the UK Continental Shelf, however i think there could be similar circumstances whereby if some-one were to move to Spain yet travel back to the uk regularly for employment or self-employment and to have no earnings in Spain that they could be classed a Spanish tax resident due to the double taxation treaty yet as they would be paying UK NICS the UK would be the competent state responsible for their health care payments and could be why the original poster was initially advised to carry on paying UK Tax/NICS.

I can only assume as you say, that your special circumstances must make a difference, for I honestly assure you there is no way I can get any kind of care back in the UK, and that goes for everyone I ever met or come accross in forums. In fact I went back last year and had to see a doctor, and I was charged £30 for a 5 minute consultation

Conversely the Valencia region just tightened up on their health care regulations and most early retirees here are faced with no health care anywhere, unless they go private

I hear what you are sating about the E106 form, but as I said before this is a temporary cover form I believe designed to give you temporary cover whilst you settle and get work in a new country and once that runs out you have no cover anywhere unless you work, and thats confirmed in the links you kindly gave

[Ellan_Vannin]

Originally Posted by Stravinsky

I can only assume as you say, that your special circumstances must make a difference, for I honestly assure you there is no way I can get any kind of care back in the UK, and that goes for everyone I ever met or come accross in forums. In fact I went back last year and had to see a doctor, and I was charged £30 for a 5 minute consultation

I hear what you are sating about the E106 form, but as I said before this is a temporary cover form I believe designed to give you temporary cover whilst you settle and get work in a new country and once that runs out you have no cover anywhere unless you work, and thats confirmed in the links you kindly gave

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.

[Stravinsky]

OK I'm not doubting what you say, please trust me on that.
All I'm telling you is what ACTUALLY happens to people here. They dont get NHS health care, and the reason is they live in Spain and aren't entitled to it any more

Before I came here I used to hear pf people who had become ill, and had to flee back to the UK for treatment only to be told they couldn't have it.

I cant explain, and sorry to say I haven't time to post stuff up as I am flying bacl to the UK shortly, all I can say is be sure you find out in practice what happens from a Spanish gestoria.

[Maya01]

Originally Posted by Ellan_Vannin

I have been researching this quite deeply and there are circumstances whereby you can be Spanish resident and still legally access the NHS. This is the case if you have an E106 issued by the UK whereby the NHS remains responsible for the health care of the holder, you can then return to the UK specifically for treatment and can contact the hospital directly to arrange treatment.
I have this in writing in an email from the Dept of Health.
It would also seem that you can still legally access the NHS if you are still paying compulsary Class 1 or Class 2 NICS and all you would need is proof of your employment although I have yet to get this confirmed in writing but anyhow if this was the case you could get an E106.

Thanks for tip and sorry for the delay in replying (Telefonica - need I say more!). Anyway, none of the UK tax, NI, health care, etc, applies to us since my husband changed fully to the Spanish Autonomo and Social Security system over 2 years ago. I suppose it would make a difference if we were to move back to the UK but that's highly unlikely (I never say never ).

Maya