Parents / Tourist Visa/ Hefty NHS Bill

[wpongal]

dear friends

we recently had parents visit us from asia, they had to access accident&emergency facility due to a relapse of existing condition. on discharge, they were advised to travel to India. they have now returned to india ..only to find a heavy NHS bill.

has anyone in the past undergone this kind of an experience, what are the options available in such circumstances?

many thanks
wpongal

[Casa]

This happens frequently following the tightening up on 'health tourism' when visitors have used the NHS without being entitled.

Unless your parents settle the bill in full they will be denied all future visitor visa applications. See below:

You should be aware that under paragraphs 320(22) and 322(12), and 3.14 of
Appendix V, of the Immigration Rules a person with outstanding debts of over £500
for NHS treatment that is not paid within two months of invoicing, may be denied a
further immigration application to enter or remain in the UK.
In the absence of prompt full settlement or a reasonable repayment schedule, nonclinical
information relating to this debt is provided routinely to the Home Office and
may be used by the Home Office to apply the above Immigration Rules. The
information will remain active for the purpose of the above rules until the debt is
settled and a record of the settled debt will also be retained, both subject to normal
limitation periods.
In the event that you may seek entry to the UK or make an advance immigration
application after settling an NHS debt in the previous two months, you are advised
to retain and carry evidence of payment for potential examination by Home Office
officials.

The NHS will have notified the Home Office of the outstanding debt. See the information in the link below:

https://www.gov.uk/government/uploads/s ... s_2016.pdf

[rmukherjee]

we recently had parents visit us from asia, they had to access accident&emergency facility due to a relapse of existing condition. on discharge, they were advised to travel to India. they have now returned to india ..only to find a heavy NHS bill.

has anyone in the past undergone this kind of an experience, what are the options available in such circumstances?

I have a friend whose father had to go to an NHS hospital after chest pains. It was not a pre-existing condition and his insurer (Tata AIG) paid for a procedure (doctors advised against travel before the procedure was done). The "excess" was about £100 -- this was 3 years ago.

Strong piece of advice for other readers of this: when coming to the UK, come with the best medical insurance possible and understand clearly what is and isn't covered.

From the 2015 government advice (page 12):

A charge cannot be made or recovered from any overseas visitor for...

...accident and emergency (A&E) services, this includes all A&E services provided at an
NHS hospital, e.g. those provided at an accident & emergency department, walk-in centre
or urgent healthcare centre. This does not include those emergency services provided
after the overseas visitor has been accepted as an inpatient, or at a follow-up outpatient
appointment, for which charges must be levied unless the overseas visitor is exempt from
charge in their own right...

As a layperson, my read of this is -- normally genuine medical emergencies are treated free, that is any A&E (Accident and Emergency wing) outpatient care is free. In-patient & follow-up care has to be paid for and you should have medical insurance for this.

Do your parents have medical insurance (usually as part of their Travel Insurance)? I'd advise talking to the insurer if they can covert part at least (although they insist on being informed ahead of time). I'd also say the hospital admin should have informed you in advance of applying charges, so that you had a chance to contact your insurer. My friend was told that a procedure was needed and that they needed insurance details or some assurances about payment. The admin also had experience with AIG and was able to do most of the paperwork themselves.

[wpongal]

Thank you friends,

We are currently battling out with the Insurance team who have not made any decision whatsoever.

In the event the insurance team don't cover the full amount (£2000), can we request the hospital for any discount/waivers (if applicable)?

Our intention is to clear the invoice only once insurance clears their part.

Any suggestion would help.
Wpongal

[Casa]

You can request a payment plan. IMHO your only hope of a discount or waiver would be if the hospital failed to follow the correct procedure in issuing the invoice.

When was the invoice issued? Note the following regarding NHS notification of the outstanding debt to the HO. This is what you want to avoid.

a) in respect of relevant NHS services provided from 1 November 2011 up to,
and including 5 April 2016, relevant NHS bodies must notify the Home Office
of outstanding debts of £1000 or more that have been outstanding for 3
months or more*; and
b) In respect of relevant NHS services provided on, or after, 6 April 2016,
relevant NHS bodies must notify the Home Office of outstanding debts of
£500 or more that have been outstanding for 2 months or more*.
* Note: the time period starts from when the patient is formally charged,
usually with an invoice, rather than from the date of treatment, which might be
an earlier date.

[wpongal]

Thank you!

The treatment was carried out between 5th - 10th of September 2016. £500 deposit was paid while the patient was in hospital. However, the invoice was only raised and sent on 21st September to the Indian address ( i am not sure how they procured them?).

Insurance company has also received the invoice around 29th Septmeber and yet to make any comments.

Sounds like we are well within the 2 month limit but eager to sort the case.

How does this case link to our ability to invite friends from India?

Thanks
wpongal

[Casa]

I believe the issue may only be with your parents future visa applications.

I suspect that the information was shared with the Home Office regarding your parents home address in India.