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How to Apply for a Healthcare Entitlement Certificate (S1) ?


Understanding the Healthcare Entitlement Certificate - S1

The Healthcare Entitlement Certificate, commonly known as the S1 form, is a crucial document for UK nationals seeking state healthcare in certain European countries. It is especially relevant for those who are at or approaching retirement age and planning to move to an EU country. The S1 certificate demonstrates that your state healthcare costs will be covered by the UK government. This part of the article focuses on understanding the eligibility criteria and basic application procedures for acquiring an S1 form.


How to Apply for a Healthcare Entitlement Certificate (S1)

Eligibility Criteria for the S1 Form

Before delving into the application process, it’s essential to know who is eligible for an S1 form:

  1. Working Residents in EU Countries: If you’re paying UK National Insurance as a worker while residing in an EU country, Iceland, Liechtenstein, Norway, or Switzerland, you are eligible to apply for an S1 form​.

  2. Retired Individuals: The S1 form is particularly relevant for UK citizens approaching retirement age who are moving to an EU country. To be eligible, you must be a resident of the country you are moving to and not just a UK resident​.

  3. Pension Considerations: You cannot obtain an S1 form if you receive a pension from the EU country you reside in, even if you’re eligible for the UK state pension too. However, if you have been living in the EU, Switzerland, Iceland, Norway, or Liechtenstein before 1st January 2021 and receive Employment Support Allowance, you may be eligible for the S1 form​​​.

  4. Students and Posted Workers: Students studying in the EU, Iceland, Liechtenstein, Norway, or Switzerland, and workers temporarily posted by a UK company to these regions, may be eligible for healthcare cover funded by the UK​​.


Application Process for the S1 Form

Once you have determined your eligibility, the next step is to apply for the S1 form:

  1. Applying via NHS Overseas Healthcare Services: The primary way to apply for an S1 form is through the NHS Overseas Healthcare Services. You can contact them via phone or email to initiate your application. You can apply for an S1 form from the Overseas Healthcare Services: Telephone: +44 (0)191 218 1999 - Email:

  2. Form Completion and Registration: After completing the S1 form, it is necessary to register it with the relevant healthcare authority in the EU country where you now live. This is a crucial step to access healthcare services or obtain a medical card in that country.

  3. Online Application Option: You have the option to apply online using a Government Gateway user ID and password. This method allows you to save your answers and return later to complete the form​​.

  4. Postal Application: If you prefer, you can fill in the form online, print it, and post it to HMRC. Remember to gather all your information before starting, as you cannot save your progress. The address for sending the S1 form to the NHS Overseas Healthcare Services is:

Overseas Healthcare Services

NHS Business Services Authority

Bridge House

152 Pilgrim Street

Newcastle upon Tyne


United Kingdom


Essential Information and Documentation

When applying for the S1 form, certain information and documentation are required:

  • If there has been a name change, details of the previous name.

  • Nationality information, especially if you are a national of the EU, Norway, Iceland, Switzerland, or Liechtenstein.

  • Details about any family members who are nationals of these countries.

  • For agents applying on behalf of a client, an authorisation form is required.


Navigating Specific Scenarios and Local Regulations for the S1 Form

Continuing from the basic understanding of the S1 form, this part of the article delves into specific scenarios and local requirements in different European countries. Understanding these nuances is essential for a smooth transition and ensuring adequate healthcare coverage.


Country-Specific Registration for S1 Form

Each European country has its specific procedures for registering the S1 form:

  1. France: In France, expatriates with the S1 form enjoy the same healthcare rights as French nationals. Once in France, it’s essential to register with the local Caisse Primaire d’Assurances Maladie (CPAM) office to activate S1 rights.

  2. Spain: In Spain, you must register the S1 form with the Instituto Nacional de la Seguridad Social (INSS) to access healthcare services. This enables UK nationals to benefit from the Spanish healthcare system.

  3. Portugal: In Portugal, present the S1 form to the local Centre for Social Security (CDSS) upon arrival. You'll then receive a Portuguese National Health Service (NHS) number and enjoy similar healthcare privileges as Portuguese residents.

  4. Cyprus: For those moving to Cyprus, registering the S1 form with the General Health Service (GHS, known as Gesy) is necessary to activate the S1 rights.

  5. Malta: In Malta, register with the Maltese Ministry of Health Entitlement Unit and present your certificate to access healthcare services.


Special Considerations and Brexit Implications

  1. Coverage and Costs: While the S1 form entitles you to state healthcare in your country of residence, it may not cover the full cost of specific treatments. Countries like Spain cover about 75% of healthcare costs, necessitating supplementary insurance for the remaining costs​.

  2. Pensions from Multiple Jurisdictions: If you receive pensions from multiple EU countries, the country where you made the longest pension contributions becomes responsible for your healthcare. For instance, if you receive a state pension from both the UK and France but live in Spain, the country to which you paid contributions the longest will manage your healthcare​.

  3. Post-Brexit Changes: After Brexit, the eligibility for the S1 form based on certain exportable benefits like Disability Living Allowance and Personal Independence Payment has changed. If you moved to an EU country and applied for the S1 form before 1 January 2021, you continue to be entitled to the healthcare services it provides​.

  4. Preparation Before Departure: Before leaving the UK, notify your GP to be removed from the NHS register as you will no longer be eligible for this residence-based healthcare system. Check the health services available in your destination country, as they may differ from those provided by the NHS​.


Navigating Healthcare Abroad with an S1 Form

Understanding the local regulations and requirements for the S1 form in different European countries is key to ensuring you have the necessary healthcare coverage. This section provides insights into specific scenarios and local authority registration processes, assisting UK nationals in making informed decisions about their healthcare when moving abroad.

Administrative Procedures and Timeline for S1 Form Application

In the final part of this article, we delve into the administrative procedures and expected timeline for applying for the S1 form, providing a comprehensive guide to ensure a seamless application process.

Steps for Application

  1. Eligibility Check: Before applying, confirm your eligibility to continue paying National Insurance contributions in the UK while living in the EU, Iceland, Liechtenstein, Norway, or Switzerland​.

  2. Form Completion: Complete the form CA8454 to apply for healthcare cover from the UK for you and your dependents.

  3. Application Submission:

  • Online Application: Apply online using a Government Gateway user ID and password. This option allows you to save your progress and return later to complete the form​.

  • Postal Application: Alternatively, you can fill in the form online, print it, and post it to HMRC. It's important to gather all necessary information before starting, as you cannot save your progress in this method​.

  1. Required Information: When applying, you need to provide specific information, such as any name changes, nationality details, EU Settlement Scheme status, and details of family members who are nationals of the EU, Norway, Iceland, Switzerland, or Liechtenstein​.

  2. Agent Representation: If an agent is applying on your behalf, ensure they have the necessary authorisation form filled out to accompany the CA8454 application form​.


Specific Scenarios

  • Students: If you are a student studying in the EU, Iceland, Liechtenstein, Norway, or Switzerland, you may apply for healthcare cover abroad. It's advisable to check the specific requirements for students on the NHS website​.

  • Retirees and Non-Working Individuals: Those who have recently left the UK, are not working, or are retired, should contact the NHS Business Services Authority for application details​.


Timeline and Response

  • HMRC Response: After submitting your application, HMRC will respond with any necessary actions you need to take​.

  • Checking Application Status: You can check when to expect a reply from HMRC regarding your application. This helps in planning and ensures you are informed about the progress of your application​.


How to Complete Form S1 - A Step by Step Guide


Section 1 - Personal Information

Previous Application Reference:

  • Question: Date and Home Office reference number of any previous application or correspondence.

  • Suggested Answer: Provide specific dates and reference numbers if applicable.

Applicant's Details:

  • Question: Title (Mr, Mrs, Miss, Ms, Other).

  • Suggested Answer: Tick the appropriate title.

  • Question: Surname/Family name.

  • Suggested Answer: Enter your surname.

  • Question: All other names.

  • Suggested Answer: Include all other names used.

  • Question: Name at birth if different.

  • Suggested Answer: Provide your birth name if different.

  • Question: Date of birth.

  • Suggested Answer: Enter your date of birth in DDMMYYYY format.

  • Question: Place and country of birth.

  • Suggested Answer: Provide the place and country of birth.

  • Question: Details if name at birth is different.

  • Suggested Answer: Date of change to present name and reason for change.

  • Question: Present address and postcode.

  • Suggested Answer: Write your current address.

  • Question: Contact details (daytime, mobile, email).

  • Suggested Answer: Provide your contact information.

  • Question: Marital status.

  • Suggested Answer: Tick the appropriate box.

  • Question: Spouse’s details if married (name before marriage, date of birth, place of birth, country of birth, nationality).

  • Suggested Answer: Fill in details if applicable.

  • Question: Explanation for statelessness from birth.

  • Suggested Answer: Provide a detailed explanation.

Section 2 - Residence Requirements


Parent's Details:

  • Question: Parent's full name, date of birth, place country of birth.

  • Suggested Answer: Provide details of the parent on whom the applicant’s qualification depends.

  • Question: If parent is deceased, date of death and nationality at time of death.

  • Suggested Answer: Fill in if applicable.

  • Question: Nationality of parent before 1 January 1983.

  • Suggested Answer: Tick the appropriate box and provide additional details if needed.

  • Question: Previous addresses for the last 3 years.

  • Suggested Answer: List all addresses, including dates of residence.


Section 3 - Referees and Identity

Referee Details:

  • Question: Referee qualifications, relationship with the applicant, and confirmation of photo likeness.

  • Suggested Answer: Each referee should fill in their details, how they know the applicant, and sign the declaration.

  • Question: Address, contact details, and passport number of referees.

  • Suggested Answer: Referees to provide their personal information.


Section 4 - Biometric Enrolment

Biometric Information:

  • Question: Previous BRP details, if issued.

  • Suggested Answer: Provide BRP number, issue and expiry dates, place of issue, and nationality. Confirm if BRP is enclosed or provide reasons if not.

  • Question: Details of previous UK immigration applications.

  • Suggested Answer: Provide dates, locations, and any relevant British diplomatic post involved.

  • Question: Medical or physical conditions affecting biometric recording.

  • Suggested Answer: If applicable, provide a doctor's letter detailing the condition and any special arrangements needed.


Section 5 - Declaration

Applicant's Declaration:

  • Question: Confirmation of information accuracy, understanding of information use, and authorisation for HM Revenue & Customs.

  • Suggested Answer: Read carefully and sign if you agree.

Special Circumstances:

  • Question: Explanation of any special circumstances and which requirements are not met.

  • Suggested Answer: Provide detailed reasons and continue on a separate sheet if necessary.


Section 6 - Additional Information

Employment and Income Details:

  • Question: Current employment status, employer's details, income, and period of employment.

  • Suggested Answer: Provide accurate employment details and income information.

Past Employment History:

  • Question: Previous employers’ details and periods of employment.

  • Suggested Answer: List all relevant past employers and the duration of each employment.


Section 7 - Documents Provided

Documentation Checklist:

  • Question: Types of documents provided (e.g., birth certificate, marriage certificate, proof of address).

  • Suggested Answer: Tick appropriate boxes and ensure all relevant documents are attached.


Section 8 - Consent and Agreement

Consent for Data Usage:

  • Question: Consent for the use of provided information.

  • Suggested Answer: Read the terms and provide consent by signing.

Agreement to Terms and Conditions:

  • Question: Agreement to the terms and conditions of the application.

  • Suggested Answer: Sign to indicate agreement after thoroughly reading the terms.


Section 9 - Final Review and Submission

Final Checklist:

  • Question: Confirmation that all sections are completed and documents attached.

  • Suggested Answer: Review the entire form, check all boxes, and ensure no section or required document is missed.

Submission Instructions:

  • Question: Understanding of where and how to submit the form.

  • Suggested Answer: Follow the submission guidelines provided in the form.


Section 10 - Additional Notes

Additional Comments:

  • Question: Space for any additional comments or information relevant to the application.

  • Suggested Answer: Use this section for any extra information that might support your application.

Applying for a Healthcare Entitlement Certificate (S1) in the UK is a straightforward process, provided you follow the outlined steps carefully. It’s important to check your eligibility, complete the necessary forms accurately, and submit them through the appropriate channels. Be mindful of the specific requirements for your situation, whether you’re a student, a retiree, or a non-working individual. By adhering to these guidelines, UK nationals can ensure they have the necessary healthcare coverage when relocating to EU countries, Iceland, Liechtenstein, Norway, or Switzerland.


How a Personal Tax Accountant Can Help You with Filling Up S1 Form and Getting the Healthcare Entitlement Certificate

How a Personal Tax Accountant Can Help You with Filling Up S1 Form and Getting the Healthcare Entitlement Certificate?

Navigating the complexities of obtaining a Healthcare Entitlement Certificate (S1) in the UK can be challenging, especially when it intersects with tax matters. A Personal Tax Accountant can play a vital role in this process, offering expert guidance and support. Here's how they can assist:

Understanding Tax Status and Eligibility

  1. Assessing Tax Status: A Personal Tax Accountant can assess your tax status to determine your eligibility for the S1 form. This is crucial because eligibility often hinges on your UK National Insurance contributions, which are inextricably linked to tax status.

  2. Clarifying National Insurance Contributions: They can explain how your National Insurance contributions in the UK affect your eligibility for healthcare cover in EU countries. This understanding is essential in determining whether you qualify for the S1 certificate.

Completing the S1 Form

  1. Accurate Form Filling: Tax accountants possess the meticulous attention to detail required for accurately completing forms like the S1. They can ensure that all financial information is correctly reported and that the form complies with HMRC requirements.

  2. Providing Financial Documentation: They can assist in gathering and organizing the necessary financial documents that might be needed for the S1 application, such as proof of income or tax payments.

Navigating Complex Scenarios

  1. Handling Complex Cases: If your case involves complicated scenarios like multiple pensions from different jurisdictions, a Personal Tax Accountant can provide clarity. They can advise on how these factors impact your healthcare entitlement in the country you’re moving to.

  2. Advice on Tax Implications: Moving abroad and applying for an S1 form can have tax implications. A Personal Tax Accountant can advise on potential tax liabilities or benefits, ensuring that you make informed decisions.

Liaising with Authorities

  1. HMRC Liaison: They can act as a liaison between you and HM Revenue & Customs (HMRC), facilitating smoother communication and quicker resolution of queries related to your S1 application.

  2. Responding to HMRC Inquiries: If HMRC has follow-up questions or requires additional documentation, a Personal Tax Accountant can respond promptly and effectively, reducing the likelihood of delays in your application.

After Submission Support

  1. Monitoring Application Progress: After submitting the S1 form, they can help monitor the progress of your application, keeping you updated on any developments or additional requirements.

  2. Addressing Post-Submission Queries: Should there be any queries or issues after submission, a Personal Tax Accountant can offer advice and support in resolving them, ensuring that the process moves forward smoothly.

Added Value

  1. Holistic Financial Advice: Beyond the S1 form, tax accountants can provide broader financial advice, helping you to plan for your healthcare and financial needs in the new country.

  2. Peace of Mind: Having a professional manage the intricacies of the S1 application can offer peace of mind, allowing you to focus on other aspects of moving abroad.

In conclusion, a tax accountant’s expertise can be invaluable in navigating the intricacies of obtaining a Healthcare Entitlement Certificate in the UK. From understanding eligibility criteria to liaising with tax authorities and providing comprehensive financial guidance, their role is instrumental in ensuring a smooth and successful application process.


20 Important FAQs about Healthcare Entitlement Certificate and S1 Form

Q1: Is the S1 form renewable, and how often?

A: The S1 form may need renewal based on your circumstances, such as changes in employment status or residency.


Q2: Can family members be included under one S1 form?

A: Yes, dependents can often be included under the primary applicant's S1 form.


Q3: What happens to my S1 eligibility if I switch jobs within the EU?

A: Changing jobs may affect your S1 eligibility, particularly if your new job doesn't involve paying UK National Insurance.


Q4: Does receiving an S1 form impact my UK tax status?

A: Obtaining an S1 form itself doesn't impact your UK tax status, but your residency status related to S1 eligibility might.


Q5: Can I use the S1 form for private healthcare?

A: The S1 form is intended for state healthcare systems in participating countries, not for private healthcare.


Q6: What if I lose my S1 form?

A: If you lose your S1 form, contact the NHS Overseas Healthcare Services for a replacement.


Q7: Are there any age restrictions for applying for an S1 form?

A: There are no specific age restrictions, but eligibility criteria related to employment, retirement, or benefits apply.


Q8: How does Brexit affect new S1 applications?

A: Post-Brexit, some changes have been made to eligibility criteria, particularly for certain exportable benefits.


Q9: Can I use the S1 form immediately after moving to an EU country?

A: Generally, yes, but it must first be registered with the relevant healthcare authority in your new country.


Q10: Are there any income requirements for obtaining an S1 form?

A: Income isn't a direct criterion for eligibility, but your employment and benefit status, which may be income-related, are considered.


Q11: Can I apply for an S1 form if I'm self-employed?

A: Yes, if you're a self-employed person paying UK National Insurance, you can apply.


Q12: How long does it take to receive an S1 form after applying?

A: Processing times can vary, so it's advisable to check with the NHS Overseas Healthcare Services for current timeframes.


Q13: Does the S1 cover dental and eye care?

A: Coverage for dental and eye care depends on the healthcare system of the country you reside in.


Q14: Can I have healthcare cover in two countries with an S1 form?

A: The S1 form typically covers healthcare in your country of residence within the EU/EEA/Switzerland.


Q15: What should I do if my circumstances change after receiving an S1 form?

A: Notify the relevant authorities, as changes in circumstances can affect your entitlement.


Q16: Is there a fee for applying for an S1 form?

A: There's usually no fee for applying for an S1 form.


Q17: Can I apply for an S1 form while living outside the EU?

A: The S1 form is for UK nationals residing in the EU, EEA, or Switzerland.


Q18: How does divorce or separation affect my S1 coverage?

A: Changes in marital status may affect your eligibility, especially if your entitlement was through a spouse.


Q19: Can students apply for an S1 form?

A: Students can apply if they meet specific criteria, such as being covered by UK National Insurance.


Q20: Is temporary employment in the EU eligible for S1 coverage?

A: Temporary workers may be eligible, provided they continue paying UK National Insurance.

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