Planning to live in the EU or EEA? The S1 form could be your gateway to affordable healthcare – but only if you understand how it works.
Healthcare might not be the most exciting part of your move abroad, but it’s one of the most important. Imagine settling into your new home, only to face a sudden illness and a health system you barely understand – along with bills you didn’t expect. The good news is, if you’re eligible, the UK’s S1 form can help you access state healthcare in your new country, often saving you thousands. For retirees, cross-border workers and certain other applicants, it’s a lifeline – but only if you apply early, know the rules and prepare for the costs that aren’t covered.
Contents
- What is the S1 form?
- Who can apply for an S1?
- How to apply for an S1
- Do you still need health insurance while living abroad?
- Common mistakes to avoid
- What if you split your time between countries?
- Changes in circumstances
- Why healthcare planning brings peace of mind
- FAQs
What is the S1 form?
The S1 is a certificate issued by the UK that allows certain people to register for state healthcare in another EU or EEA country (and Switzerland), with the UK covering the costs. It’s most commonly used by retirees receiving a UK state pension, but also applies to some workers who live in one EU/EEA country and work in another.
Rather than paying twice – once in the UK and again in your new country – the S1 ensures your healthcare funding follows you. Once registered locally, you’ll access healthcare just like residents, though each country’s system works differently from the NHS.
Who can apply for an S1?
You may be eligible for an S1 if you:
- Receive a UK state pension
- Receive other UK benefits while on maternity, paternity or adoption leave in another country
- Are a cross-border worker (live in one EU/EEA country and work in another)
- Are a posted worker sent abroad temporarily by a UK employer
Your dependents may also qualify for the S1. You’ll need to apply for this via form CA8454.
If you’re not yet drawing your state pension or if you’re on certain visas such as golden visas or digital nomad visas, you’ll usually need private health insurance instead.
How to apply for an S1
You apply through the Overseas Healthcare Services at the NHS Business Services Authority, either by phone (0191 218 1999) or email ([email protected]).
Once you’ve received the form, take it to your local authority in your new country to register. This step is essential – until you’re in the local system, your healthcare isn’t covered.
Do you still need health insurance while living abroad?
It’s wise to have private health insurance while you’re waiting for S1 coverage to come through
That depends on what visa you are moving abroad on. For example, for Spain’s non-lucrative visa and Italy’s elective residence visa, retirees need to show that they have health insurance when they apply for the visa.
Even if your visa doesn’t require you to have health insurance, in most cases, it’s best to have it anyway. “For a retirement visa in France, British people don’t need health insurance if they use an S1 form,” explains Marianne Lehmann from Fab French Insurance. “But while it’s not mandatory, most people prefer to have some kind of private health insurance, as it can take some time for the S1 to be registered once in France. So they might opt for shorter terms such as six-month plans, for example.”
Speak to Fab about their policies
So, even if you plan to use the S1 later, you will need to have health insurance first and for the first year or so. You can then register for the state healthcare via the S1 form, and your medical expenses will be paid by the UK. In Spain you just register at your local medical centre to get your Spanish ‘SIP’ card, which is a card to access the public healthcare system.
However, it’s important to note that the S1 does NOT make you an NHS patient overseas. It gives you healthcare on the same basis as local people. So if they pay €20 to €30 for a GP appointment, so will you. Not everything may be free at the point of delivery, as in the UK. In France the state will normally only pay around 70% to 80% of your expenses and you will have to pay the rest yourself. You can also pay for top-up insurance, such as the mutuelle in France.
If you are living overseas on a different visa, such as a golden visa or a digital nomad visa, again you will need private insurance for the application. The S1 only applies if you are receiving a UK state pension, but you can be receiving this while still working remotely for UK companies in semi-retirement.
There may be grey areas where one partner is working and the other is not, or one is over retirement age and the other is not, in which case it is always recommended to pay for the insurance.
If working on a normal working visa overseas you will be paying into the local state tax system and so should be covered for health.
Common mistakes to avoid
- Leaving your S1 application until after you move – processing can take weeks or months, leaving you without state healthcare during that time and potentially relying on costly private cover in the meantime.
- Assuming all healthcare is free – most EU/EEA countries have co-payments for certain treatments, prescriptions or specialist visits, even when you have an S1, so factor these into your budget.
- Not budgeting for top-up insurance – in countries like France, the state may only cover 70-80% of costs; a mutuelle or other supplementary plan can significantly reduce your out-of-pocket expenses.
- Forgetting to re-register if you move regions – in many countries, your S1 registration is tied to your local health authority, so moving house can mean re-registering to maintain your entitlement.
What if you split your time between countries?
You must register your S1 in your country of permanent residence. Short stays elsewhere in the EU may be covered by your UK-issued EHIC or GHIC.
Changes in circumstances
If you start work locally or stop receiving a UK pension, your S1 entitlement may change. Be sure to keep the Overseas Healthcare Services updated.
Why healthcare planning brings peace of mind
The S1 isn’t just a form – it’s your assurance that you’ll have access to affordable, reliable healthcare abroad. For retirees, that means enjoying your new lifestyle without fear of unexpected bills. But like any part of moving abroad, it works best when you know the rules, act early and prepare for the gaps.
Spanish lawyer, Raquel Perez from Perez Legal Group advises UK citizens to ensure they stay up to date with official government information. “It’s always best to make sure you have the most up-to-date information from a reputable source before making any decisions about your healthcare provision,” she says.
FAQs
Can I apply for an S1 if I’m not yet retired?
Yes, if you’re a cross-border or posted worker or you receive other UK benefits while on maternity, paternity or adoption leave in another country.
Does the S1 cover dental care?
Dental cover varies by country. In France, for example, some dental work is partially reimbursed; in Spain, much is private.
Will the S1 give me faster treatment?
No – you’ll join the local healthcare system and wait like any other resident.
Do I need a GHIC if I have an S1?
Yes – your GHIC covers temporary stays in other EU countries, but your S1 covers you in your country of residence.
What happens if I move to another EU country?
You’ll need to reapply and register your S1 in your new country of residence.
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