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Fertility treatment for EAA Family Permit spouse not covered by NHS?

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Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Thu Sep 23, 2021 5:49 pm

Hi all,

We have just been told by the hospital that the fertility treatment (IVF) we require is not free on the NHS, even though I am a British Citizen (plus citizenship from an EU country), because my wife is only has a Leave to Remain until 2024 card (via EAA Family Permit). This means we have to wait 3 more years until we can receive this treatment.
Do you know if this is correct?

Regards,

Mario

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by CR001 » Thu Sep 23, 2021 6:08 pm

That is correct yes. It is not free.

general-uk-immigration-forum/ivf-treatm ... l#p1868388
secret.simon wrote:
Thu Jan 16, 2020 11:01 pm
Me007 wrote:
Thu Jan 16, 2020 5:09 pm
does the new regulations apply to people that came before then as well ?
Yes.

Regulation 13 of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 of 21st August 2017 specifically excluded "chargeable assisted conception services" from the purview of Regulation 11 of the original NHS Charging Regulations 2015, which exempted people whose latest immigration applications were decided before charging for overseas patients was brought into force.

Also see the Explanatory Memorandum for the 2017 Amendment Regulations, from Paragraph 7.36.

Also see this Mumsnet forum thread, which looks at alternatives, such as relocating to other countries for the purpose of IVF.
immigration-for-family-members/new-rule ... l#p1589475
vinny wrote:
Fri Jan 26, 2018 2:18 pm
Guidance on overseas visitors hospital charging regulations wrote:Assisted conception services
5.15. Since 21 August 2017, those exempt from charge under Regulation 10 (health surcharge arrangements) or 11 (transitional arrangements) are not exempt from charge in relation to assisted conception services.
Char (CR001 not Casa)
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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Thu Sep 23, 2021 10:10 pm

Thank you. Isn't it kind of unfair if a British person wants kids but isn't allowed to get this on the NHS because the wife isn't a citizen/IRL person? Feels a bit discriminating to me, given that one parent would be a citizen.

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by secret.simon » Fri Sep 24, 2021 3:24 am

Fairness, like beauty, is in the eyes of the beholder.

On these forums, we try to assist others through navigating the thicket of immigration rules as they *are*, not how we think they ought to be.

If you are so inclined, you can take the government through the courts to get the law re-interpreted or write to your MP to get the law changed. Or as a dual citizen, you could explore options for getting the treatment in the countries of your spouse's or your other nationalities. And of course, you can choose to go private.
I am not a lawyer or immigration advisor. My statements/comments do not constitute legal advice. E&OE. Please do not PM me for advice.

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Fri Sep 24, 2021 8:19 am

Thank you for your response.

Do you happen to know if any other treatments, once my wife is pregnant, are also not covered because she only is an EEA Family Permit holder? E.g. ultrasounds, giving birth at the hospital, follow-up check-ups on the baby, etc. Are these costs then free on the NHS?

Regards,

Mario

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by JB007 » Fri Sep 24, 2021 8:21 am

SettledStCitizenUK wrote:
Thu Sep 23, 2021 10:10 pm
Isn't it kind of unfair if a British person wants kids but isn't allowed to get this on the NHS because the wife isn't a citizen/IRL person? Feels a bit discriminating to me, given that one parent would be a citizen.
Even those born British citizens can be billed at 150% of NHS costs for treatments. Some of these would have paid all their working taxes to the UK (40+ years) and have contributed for the hospitals to be built/equipment needed by the NHS. If anybody has grounds for complaint, it is these pensioners.

Brits find that paying for IVF can be cheaper in other countries, rather than paying privately in the UK. Some couples who can have free IVF on the NHS, pay for IVF in another country anyway, rather than watch time tick by while they wait for a turn on the NHS waiting list. You have been given some links of which country these people go to. Have you looked to see if you will get a cost reduction for IVF in your own EU country? Or whether they will fund all the treatment? The same with the country of your wife?

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Fri Sep 24, 2021 2:36 pm

Thank you. Yes, we will get it done abroad. It is true what you say (although I have also paid taxes and NI for two decades in the UK, but yes, you are right).

Do you happen to know if any other treatments, once my wife is pregnant, are also not covered because she only is an EEA Family Permit holder? E.g. ultrasounds, giving birth at the hospital, follow-up check-ups on the baby, etc. Are these costs then free on the NHS? Or are these deemed essential (ultrasounds, giving birth at the hospital, follow-up check-ups on the baby, etc.)?

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Fri Sep 24, 2021 2:40 pm

Just to add that I was born British Citizen but my parents moved to Italy when I was 3 years old. I've been living in London since university.

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by JB007 » Fri Sep 24, 2021 3:33 pm

SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:40 pm
Just to add that I was born British Citizen but my parents moved to Italy when I was 3 years old. I've been living in London since university.
SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:36 pm
...I have also paid taxes and NI for two decades in the UK, ...
Your wife
SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:36 pm
only is an EEA Family Permit holder?
As you were born a British citzen and have been living in the UK for the last 20 years, how is your wife on a EEA Family permit? As that expires in 2024, does that mean she only came to the UK/became your wife in 2019?

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Fri Sep 24, 2021 7:54 pm

Thanks for being so kind to answer my question ;)

"Your wife" It is me writing here and raising the issue, correct? How do you reply to people interested in becoming a single parent?

"As you were born a British citzen and have been living in the UK for the last 20 years, how is your wife on a EEA Family permit?" I was born British (see previous comment)

"As that expires in 2024, does that mean she only came to the UK/became your wife in 2019?" correct

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by secret.simon » Sat Sep 25, 2021 4:22 am

I think the crux of @JB007's question/remarks was surprise that your wife was issued an EUSS Family Permit at all.

Normally, at least under EU law before Brexit, there is a sharp divide between family members of dual British-EU citizens who were naturalised in the UK after having acquired PR under EU law and those of purely British citizens (such as those born in the UK), who have to meet much more onerous requirements (and considerably higher fees, in the '000s) for immigration to the UK.

Did you disclose that you acquired your British citizenship by birth in the UK, rather than by naturalisation, when applying for your wife's Family Permit? I think that that may have resulted in a different immigration decision to start with.

To @JB007, assuming that the OP disclosed his dual citizenship, the OP's application may have been considered under the Surinder Singh route, as Lounes is plainly not applicable (to the OP, Lounes is the case law that applies to dual British-EU citizens who naturalised in the UK; Surinder Singh is the case law that applies to British citizens that exercised treaty rights in the rest of the EU while simultaneously living with non-British family members).

Anyway, returning back to the topic, your options have been listed in posts above. As it stands, your wife and you will need to pay for fertility treatments on the NHS and you may well want to look at treatment abroad.

Be aware that as the NHS is under pressure for funding, one of the ways that the government is funding it is by pressuring the NHS to bill anybody using NHS services who is not legally entitled to it. See this thread, where a British citizen and their non-British spouse were billed for the fertility treatment years after the treatment and after they had paid the Immigration Health Surcharge that is payable (@£625 per year of the granted visa) by non-British spouses of purely British citizens. Likewise, visitors to the UK get billed @150% of the NHS cost for any non-emergency care in the UK. See this thread for a discussion on that theme.

As an aside, a purely British citizen would be paying about £3000 for a 2.5 year spousal visa (~£1000 for the application + ~£1800 for the Immigration Health Surcharge), which they'd have to pay twice, for the five year spousal visa route and then about £2500 for ILR at the end of the five years.
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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by JB007 » Sat Sep 25, 2021 6:17 am

secret.simon wrote:
Sat Sep 25, 2021 4:22 am
To @JB007, assuming that the OP disclosed his dual citizenship, the OP's application may have been considered under the Surinder Singh route, as Lounes is plainly not applicable (to the OP, Lounes is the case law that applies to dual British-EU citizens who naturalised in the UK; Surinder Singh is the case law that applies to British citizens that exercised treaty rights in the rest of the EU while simultaneously living with non-British family members).
@secret.simon I did think about the British born citizen using Surinder Singh for an EU Family Permit for his wife in 2019, but couldn't work that out either as he had said he had been living back in the UK since university and had paid two decades of taxes and NI to the UK.
JB007 wrote:
Fri Sep 24, 2021 3:33 pm
SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:40 pm
Just to add that I was born British Citizen but my parents moved to Italy when I was 3 years old. I've been living in London since university.
SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:36 pm
...I have also paid taxes and NI for two decades in the UK, ...
SettledStCitizenUK wrote:
Fri Sep 24, 2021 7:54 pm
"As that expires in 2024, does that mean she only came to the UK/became your wife in 2019?" correct

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by secret.simon » Sun Sep 26, 2021 2:09 am

JB007 wrote:
Sat Sep 25, 2021 6:17 am
@secret.simon I did think about the British born citizen using Surinder Singh for an EU Family Permit for his wife in 2019, but couldn't work that out either as he had said he had been living back in the UK since university and had paid two decades of taxes and NI to the UK.
Indeed, in this case, I am inclined to agree that the OP may not have made the correct application for his spouse (not that making the correct application would give them access to free fertility treatment either).

The OP's username suggests that they have (or had) Settled Status in the UK. But if they were born a British citizen, they can never have held Settled Status. A British citizen can't hold an immigration status in the UK (which is why Lounes and Surinder Singh applications are treated differently to normal Settled Status applications).

But anyway, we have strayed far from the OP's original question and we need to draw this thread to a close.
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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by JB007 » Sun Sep 26, 2021 9:41 am

SettledStCitizenUK wrote:
Fri Sep 24, 2021 2:36 pm
Do you happen to know if any other treatments, once my wife is pregnant, are also not covered because she only is an EEA Family Permit holder? E.g. ultrasounds, giving birth at the hospital, follow-up check-ups on the baby, etc. Are these costs then free on the NHS? Or are these deemed essential (ultrasounds, giving birth at the hospital, follow-up check-ups on the baby, etc.)?
As secret.simon has explained, unless they qualified for the EU Surinder Singh route, a British born citizen sponsored their non-EEA partner to the UK on a spouse visa. The partner pays the Immigration Health Surcharge with their visa application.

You can start using the National Health Service (NHS) when both:

you’ve paid the healthcare surcharge (or are exempt from paying it)
your visa or immigration application is granted

You’ll still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and assisted conception.

https://www.gov.uk/healthcare-immigration-application


For your baby -as you were born a British citizen and born in the UK, your baby will be born a Brtish citizen. As a British citizen who lives in the UK, they can use the NHS.

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Re: Fertility treatment for EAA Family Permit spouse not covered by NHS?

Post by SettledStCitizenUK » Tue Sep 28, 2021 11:23 am

Apologies for the confusion, the username was merely chosen because we initially thought my wife has Settled Status but it turned out it's just Leave to remain until 2024.

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