If you're moving abroad on a permanent basis, you'll no longer automatically be entitled to medical treatment in the UK under normal NHS rules. This is because the NHS is a residence-based healthcare system.
Tell your GP practice that you're moving abroad so you and your family can be removed from the NHS register.
Before leaving the UK, it's important to check what healthcare services are available to you in the country you're moving to.
Healthcare systems vary from country to country and might not include services you'd expect to get free on the NHS. You may have to pay a patient contribution towards any treatment, or you may need to take out health insurance.
The Foreign, Commonwealth and Development Office (FCDO) has useful information for British nationals living abroad on GOV.UK, including information on entry and residence requirements, health, benefits and finance.
In most countries, you will have to register with the relevant authorities. Once you're registered as a resident, to work and make social security (national insurance) contributions, you'll be entitled to state-run healthcare on the same basis as a resident of that country.
Even if you're not working, many countries expect you to make patient contributions or to join a national health insurance scheme.
Find out more about healthcare in the EU, Norway, Iceland, Liechtenstein and Switzerland on GOV.UK.
Some people living abroad are eligible for healthcare paid for by the UK under the S1 scheme.
An S1 entitles you and your dependants to state healthcare paid for by the UK, in the country where you live, on the same basis as an insured resident of that country.
If you live in the EU, Iceland, Liechtenstein, Norway or Switzerland, you and your dependants may be able to apply for an S1, if you meet the eligibility criteria.
If you have a registered S1, you'll also be entitled to:
- a UK-issued EHIC or GHIC to get state-funded necessary medical treatment during a temporary visit to other eligible countries
- planned treatment in an eligible country other than the country where you live through the S2 scheme
- treatment by the NHS when visiting the UK
To be eligible for an S1 you must be living in the EU, Iceland, Liechtenstein, Norway or Switzerland and meet one of these criteria:
- you receive an eligible exportable benefit issued by the DWP (including UK State Pension)
- you are a posted or frontier worker recognised by HMRC (for example, you have a Portable Document A1)
- you receive the unemployability supplement element of a UK war pension
You will be eligible for an S1 only if you are lawfully present as a resident in an EU country, Iceland, Liechtenstein, Norway or Switzerland. If you are going to these countries on a temporary basis, usually up to 90 days, you can use your UK GHIC or UK EHIC to get medically necessary state healthcare.
Find out more about getting healthcare cover abroad with a UK GHIC or EHIC.
If you're applying for an S1 in Switzerland, you'll need to meet some extra nationality criteria. You must be:
- a UK national
- a Swiss national
- an EU citizen
- a refugee or a stateless person
- a family member or survivor of someone who has one of these nationalities or statuses (you do not need to be a UK, Swiss or EU national yourself)
If you receive a UK State Pension
If you live in an EU country, Iceland, Liechtenstein, Norway or Switzerland and receive a UK State Pension, you and your dependants may be entitled to an S1.
If you receive both a state pension from the country you live in now and a UK State Pension, you cannot get an S1. This is because the country you live in will be responsible for your healthcare.
If you have lived and paid social security contributions in several countries covered by the UK's European reciprocal healthcare arrangements, and you are now living in a different country, the country in which you paid social security contributions for the longest period is responsible for your healthcare.
Find out more about State Pension if you retire abroad on GOV.UK.
If you need support you can contact the International Pension Centre.
If you receive exportable benefits
You and your dependants may be entitled to an S1 if you live in an EU country, Iceland, Liechtenstein, Norway or Switzerland and receive one of these UK benefits payable abroad (an exportable benefit):
- Contribution-based Employment Support Allowance
- Maternity Allowance
- Widow's Benefit or Widowed Parent's Allowance
Find out more about claiming benefits if you live, move or travel abroad on GOV.UK.
If you got an S1 before 1 January 2021 because you received one of the following benefits, you are still entitled to an S1 for as long as you receive that benefit:
- Disability Living Allowance (DLA)
- Personal Independence Payment (PIP)
- Carer's Allowance (CA)
- Attendance Allowance (AA)
From 1 January 2021, these benefits no longer entitle you to an S1 if you do not already have one.
You will be entitled to an S1 for as long as you receive an eligible benefit unless any of these apply:
- you start receiving a state pension from the country you live in – at this point you will stop being entitled to a UK issued S1 and the country you live in becomes responsible for your healthcare
- you start receiving a UK State Pension – at this point your UK State Pension will be your entitlement to an S1
- you start receiving an eligible exportable benefit – at this point your eligible exportable benefit will be your entitlement to an S1
- you start receiving any sickness benefits on the basis of your employment or self-employment in another EU country, Iceland, Liechtenstein, Norway or Switzerland
- you choose to return to the UK
The same applies to a time limited S1, and you can apply to renew it as long as you are still receiving one of the benefits listed above, unless one of the above qualifications applies to you.
If you need support you can contact the International Pension Centre.
If you are a posted worker, frontier worker or civil servant
You and your dependants may be entitled to an S1 if:
- you are a posted worker, also known as a detached worker, employed or self-employed in the UK but temporarily sent to an EU country, Iceland, Liechtenstein, Norway or Switzerland for up to 2 years
- you are a civil servant working for the UK government in an EU country, Iceland, Liechtenstein, Norway or Switzerland
- you are a frontier worker working in the UK and living in an EU country, Iceland, Liechtenstein, Norway or Switzerland
If you are eligible and for more information, contact HM Revenue and Customs (HMRC).
If you work as flight crew or on a vessel at sea you can also check your entitlement by contacting HMRC.
If you receive a qualifying element of a UK war pension
If you receive the unemployability supplement element of a UK war pension you may be eligible for an S1.
For more information, contact the overseas account team in Veterans UK at dbsvets-treatment-oat@mod.gov.uk.
UK State Pension or eligible exportable benefit
If you receive a UK State Pension or eligible exportable benefit, you can apply for an S1 from the Overseas Healthcare Services from Monday to Friday, 8am to 6pm.
- Telephone: +44 (0)191 218 1999
- Email: s1applications@nhsbsa.nhs.uk
You can apply for an S1 up to 90 days before moving to live in an EU country, Iceland, Liechtenstein, Norway or Switzerland to help with your visa application or 90 days before you start to receive your UK State Pension.
You need to provide an address in the country you are moving to. This can be a temporary address, but you must contact the NHS Business Services Authority (NHSBSA) and the relevant authority in the country you are moving to, to let them know your new address if it changes. This is so that important confidential information is not sent to the wrong address.
Posted workers, frontier workers and civil servants
If you are a posted worker, a frontier worker, or a UK civil servant you can apply for an S1 from HMRC.
HMRC has a helpline for National Insurance enquiries from non-UK residents. They can answer questions about posted worker status and explain which documents you will need to get healthcare while posted.
Your S1 will be issued by email if you have provided an email address. The email will contain a link to an online portal where you can download your S1. If you do not have an email address, your S1 will be sent to you by post.
Once issued, you must promptly register the S1 with the relevant authority in your country of residence. Often you need to do this before you can register for healthcare or get a medical card.
To check the registration process for the country where you live, see GOV.UK information on healthcare in the EU, Norway, Iceland, Liechtenstein or Switzerland.
It's your responsibility to make sure you have appropriate healthcare cover while waiting for your S1 to be registered. If you do not have healthcare insurance while the S1 is being registered, you may be charged for any healthcare treatment you receive.
When you apply for an S1, you can add anybody you consider to be a dependant. However, if your dependant is eligible to apply for their own S1, they must apply separately.
The definition of a dependant can vary between EU countries, Iceland, Liechtenstein, Norway or Switzerland. Your dependant's registration will only be accepted if they meet the country's definition of a dependant.
They may not be considered for a dependant S1 if they are insured by their country of residence or another EEA country. For example, your dependant might not be eligible if they are working in the country of residence or receiving a state pension or benefit from another country.
Contact the relevant health authority in your country of residence for more information.
If you're entitled to an S1 as a dependant of a UK state pensioner, your health cover as a dependant will be cancelled once you apply for an S1 as a state pensioner. You will be sent a new S1 to your registered address from NHSBSA Overseas Healthcare Services. You must register this form to make sure you continue to have healthcare cover.
If you have a UK State Pension and you also start receiving a state pension from the country you live in or another EU country, Iceland, Liechtenstein, Norway or Switzerland, then you may not be entitled to a UK S1 anymore. The country you live in or paid contributions towards your state pension for the longest period becomes responsible for your healthcare.
For more information contact the NHSBSA Overseas Healthcare Services.
If you're moving abroad permanently, you'll no longer be automatically entitled to medical treatment in the UK under normal NHS rules. This is because the NHS is a residence-based healthcare system.
However, if you have a registered UK-issued S1 and live in an EU country, Iceland, Liechtenstein, Norway or Switzerland, from 1 January 2024 you can access the NHS on the same basis as a UK resident when visiting England on a temporary basis, so you will not have to pay for NHS treatment.
If you want to access NHS treatment while visiting Scotland, Wales or Northern Ireland, you must check the charging regulations with the relevant NHS authority.
For more information see the NHSBSA website: can S1 certificate holders access healthcare whilst visiting the UK?
You must inform NHSBSA Overseas Healthcare Services if you change your address or your circumstances change. If you do not, the UK could overpay for your healthcare in the country where you live.
If you cannot be contacted you might also miss important information about your entitlements, and this may result in your S1 being cancelled.
You must contact the NHSBSA at s1applications@nhsbsa.nhs.uk or call +44 191 218 1999 if you have any change to your contact details or circumstances.
Iceland, Liechtenstein and Norway
You may be entitled to state-provided healthcare paid for by the UK if you moved to Iceland, Liechtenstein or Norway:
- before 1 January 2021
- on or after 1 January 2024
If you moved between 1 January 2021 and 31 December 2023, your entitlement will start from 1 January 2024 at the earliest unless you were covered by the EEA EFTA Separation Agreement.
Switzerland
If you moved to Switzerland between 1 January 2021 and 31 October 2021, your entitlement will start from 1 November 2021 at the earliest unless you were covered by the Swiss Citizens' Rights Agreement.
If you moved before 1 January 2021, you may be entitled to state-provided healthcare paid for by the UK regardless of your nationality.
Page last reviewed: 2 May 2023
Next review due: 2 May 2026