Healthcare Part 1 – the EU countries

I received a very interesting question recently, one that I thought I might address on this blog as I’m sure many will be interested in the answer: it deals with medical coverage in countries abroad.

The writer says that “A subject which I need to address is a medical one as I am diabetic and require medication which at the moment I get from the N H S. Could you please tell me where I can find out which countries I could live in and still get NHS-funded treatment without returning to the UK every 3 weeks?”

I am assuming that this person means funding by the British National Health Service and this being the case, the quick answer is “none”. Once you leave the UK to reside elsewhere permanently you are no longer permitted to use the NHS. In future, because of spiralling costs, this is going to be far more strictly regulated than it is at present.

HOWEVER, the EU countries and Switzerland have national health systems that provide free or low cost health care for those contributing to their social security systems plus dependants. The system also caters for pensioners and this includes those from other EU countries.

If, as a EU member country resident, you are visiting the country, you will be able to access emergency care on showing your EHIC (European Health Insurance Card). For details of the EHIC please see below. UK nationals over 60 and for some people who qualify for invalid benefits will need the appropriate form (E121 or E106) to access free health care.

Comparisons, they say, are odious, but I recommend that even within the EU you look very carefully into the level of medical care compared to the NHS before you move. Don’t sign buy a property abroad and later find that there isn’t a doctor or hospital within miles for instance. There are many English-speaking and foreign doctors in resort areas and major cities of many countries but not necessarily so in the more rural areas. Find out if there are expats living nearby and try to find out what they think of the local medical facilities – or maybe your estate agent can help here?

I am going to outline very briefly a number of options on offer in a few of the more popular countries chosen by Brits for emigration:

Greece’s public health system (IKA) is more or less indicative of EU medical offerings and provides free or low cost health care for those who contribute to Greek social security, plus their families and retirees (including those from other EU countries). Members are charged 25 per cent of the actual cost of prescriptions, although there are higher charges for non-essential medicines plus substantial contributions for many services, including spectacles, dentures and other treatment.

Pensioners who intend to take up residence in Greece and who are entitled to free medical treatment in the United Kingdom also enjoy this facility in Greece. They should take the form E121, which is issued by their local Department of Health Office in the United Kingdom before relocation, to their local IKA office.

A person who was unemployed in the UK and coming to look for work in Greece is entitled to free medical treatment in Greece if he/she produces form E119 to their local IKA office. This should also be obtained before leaving the UK - it is issued by their local Department of Health Office in the U.K. In both the above cases IKA will exchange the form for a medical booklet.

But here is the worrisome factor: Novo Nordisk, a Danish company and the world's leading supplier of insulin for diabetics is withdrawing its state-of-the-art medication from Greece.

A spokesman for the Danish pharmaceutical company said it was because the price cut by the Greek Government would force its business in Greece to run at a loss – and it is already owed so much money by them.

Spain
As with the UK, Spain has a national health system which provides services as detailed above for Greece.

France
If you live AND work in France you will need to affiliate as a resident and in this case you should make provision to contribute financially. As a retiree you can affiliate to the system using an E121 form via the Caisse Primaire Assurance Maladie (CPAM). You can get this form from the Dept. for Work and Pensions (DWP) in Newcastle upon Tyne (take a look at www.dwp.gov.uk) As long as you are in receipt of the state pension in the UK this form will be valid.

Once you get to France you should take this form, along with proof of residence in France and a form of identity, to your local CPAM office. Most towns in France have this office but if in doubt, ask at your local mairie. Once you are affiliated to the system you will be issued with a Carte Vitale (green card) which you have to take with you when you visit the doctor or hospital.

For those under retirement age, it is not possible to affiliate to the French system unless you have an E106 form, again available from the DWP. This is relevant for those who are not planning to work in France and is valid for up to 2 years, after which it is wise to take out private health insurance until you reach state retirement age or you are there for 5 years, after which you will be able to affiliate to the system.

Many French citizens "top up" their state benefit so that they can have full use of the system as, unlike in the UK, in France treatment (whether private or public) is not free at the point of delivery. Even if you subscribe to the Sécurité sociale, on seeing a doctor or specialist (specialiste) you first pay the full bill (tarif) and are then reimbursed at a later date (about 10 days). Generally speaking, Sécurité sociale refunds 70 per cent of the cost of a visit to a médecin traitant (a GP or family doctor) and most specialistes.

Next week I will outline a couple of non-EU countries and tell you how they work.

Kim

The Overseas Guides Company
http://www.Emigrationguide.com

How to successfully adjust to your new home overseas! (excerpt taken from Emigration Guide)

It is only natural to feel strange and a little alienated initially. If you have children you will have a distinct advantage: you can volunteer to help at school, offer lifts to your child’s classmates, take children to activities and get into conversation with other parents at the school gates. If you are able to find work, even if it’s just part-time, you’ll find adjusting to your new environment and making friends far easier.

Joining a club – tennis, golf, bird-watching or whatever takes your fancy – is a wonderful option and you’re likely to meet like-minded people if you follow your hobbies and interests.

Here’s an example of the kind of activities on offer to help you settle into your new home, courtesy of one of our readers in Cyprus, although it could apply to expats in any destination:

“If you like dancing, there’s ballroom and Latin, rock ’n’ roll, line dancing and country to name but a few – and of course, karate, judo, tap dancing, jazzercise … the list goes on. Football is the country’s favourite sport and rugby is available too. You can also learn to sing by joining one of several choirs, or maybe even learn how to build a traditional stone wall. If you don’t want to join a club, then it’s worth putting your time to use as a volunteer - anything from helping in a charity shop to assisting with building a new playground for children at the general hospital, or taking disabled people shopping.”

I love the enthusiasm shown by this reader – I can only believe that she has made a whole group of new friends with an attitude like that.

Sources of information and support

Check out the Embassy, Consulate or official website of your new country before leaving the UK.

Make contact with the UK Embassy when you arrive in your new country. They sometimes plan get-togethers for expats at various times, such as to celebrate the Queen’s birthday.

Try to meet other expats from the UK who will be able to give you the low-down on the local area and help you avoid the pitfalls they ran into when they first moved.

A few more ideas to help you settle in

Access to a telephone is a must. Just to hear a friend or family member’s voice from back in the UK makes such a difference. Mobiles are all very well for local calls, but become expensive when making calls abroad, so do check when you rent or buy that there is an existing land line. This is also essential for internet access.

You should also try to create a comfortable home as soon as possible, with all your familiar bits and pieces around you, plus familiar possessions for your children, if you have them.

If you’re not moving to an English-speaking country, learning the language and familiarising yourself with the culture can go a long way to making you feel at home. Indeed, taking language lessons is a great way to meet new people. It’s best to make a conscious effort to be laid back and tolerant of people’s differences. You may find when you move that things are done differently, so remember that you are the visitor.

It’s worth paying a courtesy call to your new neighbours – they will appreciate it and it is essential to be on friendly terms with them if you want to be part of the community. You also never know when you may need their help. Don’t hesitate to ask them for guidance. People are usually only too pleased to help and thrilled to be asked. But remember small rural communities can be slow to welcome “outsiders”.

Try to have fun and keep busy. Find activities such as sports clubs, dance classes, Rotary, volunteering, music clubs or bands. Alternatively, take an online degree, write a novel, take up photography, paint, find an amateur dramatics society or join a gym.

And finally, if you can, take some time off when you first arrive in your new country before starting a new job. Spending a few days unpacking and discovering your local shops and amenities with the whole family is more fun than going straight into work or leaving one partner to do it all alone.

With any luck, before you know it, you will look round and realise you feel completely at home!

Kim Brown
The Overseas Guides Company
Have you been to the main website yet? http://www.Emigrationguide.com

Beating the tax man when moving overseas

I think you will agree with me when I say that, on planning to move abroad, keeping the taxman happy can be very important. Recently a good friend of mine left South Africa without actually going through the emigration process - and therefore the final tax process too. His wife has a British passport so there was no problem when it came to moving to Britain, but the problem has arisen now that his mother has died and he wants to transfer the balance of his inheritance to the UK.

If he had officially emigrated this process would have been comparatively easy and much more tax-friendly but, since he did not do so, it has become a highly complex process. Plus of course, there is the added problem of trying to get things done from a distance. It took me a full month of visits and endless phone calls to tax and government offices in America before I finally had all the papers I needed to formally emigrate – I don’t want to think of the frustration and the cost of trying to do this from abroad. Quite apart from anything else, it was a personal relationship that I forged with one of the people in the tax office that finally ‘cracked the case’!

You obviously need to make sure in your own mind that you intend to remain abroad, but once you are absolutely sure of this – as I was – you need to go into all the tax implications of your move in order so that you get the most possible value from your savings.

You may be surprised to hear that many Brits end up actually paying more tax than they need to when they emigrate. It’s all down to exactly when you leave the country. I was surprised to learn that you may even be owed a refund: it has something to do with unused allowances and varies by the month, peaking for lower income earners in July and higher earners if they leave in August. You need the input of a good IFA (independent financial advisor) to make sure that you time your move correctly.

I am not a tax expert and you need to take good professional advice, but did you know that there is a completely legal way to save on Capital Gains Tax (CGT) when you come to sell your property/properties? If you have rental or holiday properties as well as the home you live in, the real saving comes if at some stage you have used the property as your Principal Private Residence or PPR. Principle Private Residence relief means you don't pay CGT on gains you make when selling your main home - and you can also make use of it for other properties you own too.

You can still benefit from PPR by using your rental or holiday properties as your main home at some point before you sell it. This will give you the last three years worth of growth free from CGT as well as the period in which you live there. HM Revenue and Customs does not specify how long you need to have lived there, but may ask for proof such as phone and utility bills, electoral address etc.

If you let the property out at some stage you will be entitled to up to £40,000 letting relief against your capital gain and this is available for each owner - so if it is in joint names, this doubles to a maximum £80,000. However, letting relief is only applicable to properties which have at some point been your main home.

Legal fees and stamp duty count as part of the cost of buying a property, as do selling costs such as estate agent fees - and these can be offset against any gains. In other words, any costs incurred in the buying of the property (lawyer’s fees, surveys etc.) plus in the selling of the property such as agent’s fees are taken off your capital gain before taking any CGT allowances into account. This can be further lowered by calculating the costs of any capital improvements.

If any significant alterations have been made to the property while you have owned it, the cost of these can also be taken off the gain. Minor things like painting and fixing a broken window do not count though. Again, expert advice would be welcome here: the rule of thumb is keeping every receipt!

Also, remember that if you have let your property as a corporate rental to a trading company or business, you may qualify for the much more generous business asset taper relief, giving you a 75% discount on your capital gain after only two years.

I know that much of this may be ‘slamming the stable door after the horse has bolted’, but if you are taking a long term view of moving abroad you may still be able to use this info. Once again, it’s all down to planning and homework. Not a minute of the planning I did was time wasted and, in the end, it allowed me to move seamlessly and with the minimum of trouble.

Before moving overseas it’s important to prepare! Start the emigration process off on a solid footing – get your Emigration Guide today at: http://www.emigrationguide.com/guide.htm. The Overseas Guides Company, is dedicated to helping people make educated and safe decisions when buying overseas property and moving abroad.

Kim Brown
The Overseas Guides Company
Visit my website at: http://www.emigrationguide.com/

Moving abroad with or without your children

One of the most important aspects of a move abroad is your children and their happiness, so you need to plan well in advance. If you want your child to be able to return to the UK eventually to finish their schooling, you will need to make sure they keep up to the required educational standard.

Children often settle into a new place better than most adults. Generally they make friends and pick up new languages much more quickly than their parents. They, however, do need to hear about the move from you early on in the decision-making process and to be included in conversations and decisions about the move. You will need to be confident and upbeat about the exciting journey ahead of you. If you have misgivings, keep them to yourself, or your children will pick up on them.

If your child is staying in the UK, make sure you:

• Arrange boarding school places well before you move - most have very long waiting lists.
• Appoint a legal guardian that the school can contact locally in emergency.
• Give your child a mobile phone with numbers inserted of locally resident family and friends.
• Give someone locally a cash fund for emergencies.
• Inform the school of the names of any adults permitted to take the child off school grounds for days/weekends away.
• Arrange an account at a stationery and/or bookshop for any schooling requirements.
• If your child is moving with you, you will need to:
• Sort out school registration in your new country well in advance. You will need to take this into consideration. If you are in contact with an estate agent or developer they may be able to advise you of good schools or put you in touch with clients who have previously moved to the country you’re moving to. Otherwise the local UK Embassy of your chosen country may be able to help, or the British Embassy in your new country. Expat websites are good points of contact and people are happy to help, since they probably experienced the same problems themselves when they first moved. There are international schools in a number of countries and some countries have English language schools, usually near big towns. Bear in mind that these can be expensive and you will need to consider where you will be living in relation to the school’s location.
• Find out if your child is up to the required standard in your new country – and get extra lessons if not. Ideally you should enrol the child in language lessons before setting off and if you all did it as a family this could be viewed as an adventure.
• Take along school reports from the past year if you still have them and give them to the child’s new school, as this will give them an idea of your child’s capabilities.
  

Before moving overseas it’s important to prepare! Start the emigration process off on a solid footing – get your Emigration Guide today at: http://www.EmigrationGuide.com/Guide.htm

Kim
The Overseas Guides Company
Visit my main website at: http://www.emigrationguide.com/