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What is Comprehensive Sickness Insurance?

If you’re an EU/EEA national in the UK, there are certain cases where you may require comprehensive sickness insurance, or have had it in the past.

For more information about comprehensive sickness insurance and your rights as an EU/EEA national in the UK, reach out to our legal experts for advice on 0333 305 9375, or contact us online today.

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Comprehensive Sickness Insurance Overview

Comprehensive sickness insurance cover (CSI) is a form of insurance that fully covers, or mostly covers, costs of medical treatment.

It is something that was required for certain EU citizens under the old permanent residency scheme in order to hold permanent resident status.

Under the new EU Settlement Scheme, it is no longer a requirement for EEA/EU citizens to have CSI when applying for pre-settled status or settled status.

However, many EEA nations with settled status in the UK may find obstacles to applying for British citizenship because of a requirement to have had comprehensive sickness insurance in the past.

What Counts as Comprehensive Sickness Insurance?

The Home Office defines comprehensive sickness insurance as ‘any form of insurance that will cover the costs of the majority of medical treatment’ in the UK.

The following are not included in the definition of CSI:

  • Cash back health schemes, such as:
    • Dental
    • Optical
    • Prescription charges
  • Travel insurance policies

Because of this, CSI will often simply refer to private health insurance purchased from a private company. It may in some cases also refer to the protections granted by a reciprocal agreement with an individual’s home country, or possession of a European Health Insurance Card.

However, because the official definition refers to the need for insurance to cover a ‘majority’ of medical treatment, there are uncertainties as to what might count as a ‘comprehensive’ insurance policy.

The Home Office goes on to state that caseworkers must take a ‘proportionate approach’ when deciding if an insurance policy is comprehensive or not. They also state that a policy ‘may contain certain exemptions but if the policy covers the applicant for medical treatment in the majority of circumstances [they] can accept it.’

The Home Office doesn’t make it clear what type of exemptions might be allowed or disallowed on an insurance policy.

Because of this, it means that caseworkers will judge on a case-by-case basis as to whether or not policies fit the criteria of being ‘comprehensive’, potentially leading to inconsistency in how cases are handled.

If you’re uncertain if your health insurance would be considered to be comprehensive, don’t leave it up to chance. Get in touch with our legal experts on 0333 305 9375, or contact us online for help and advice regarding your situation.

Who Needs Comprehensive Sickness Insurance?

Comprehensive sickness insurance was formerly a requirement for certain EU nationals in the UK under the old permanent residency scheme.

Under this scheme, EU citizens with permanent residence status were required to exercise their ‘treaty rights’ by either being employed or self-employed while in the UK.

Those who weren’t employed or self-employed, such as students or self-sufficient individuals, were required to prove that they had CSI. Families of these individuals who were issued with a family permit or residence card were also required to have CSI.

The permanent residency scheme expired on 31 December 2020 has since been replaced with the EU Settlement Scheme. Under the new scheme, EEA nationals are not required to have CSI in order to be granted pre-settled or settled status.

However, this does not mean that CSI is no longer relevant, or important, for EEA citizens, especially for those who wish to apply to become a British citizen.

Contact us today if you require assistance with your British citizenship application.

What Are the Rules for British Citizenship Applicants?

Overview of Citizenship Application Rules

There are two rules in particular that are important when considering the role of comprehensive sickness insurance in British citizenship applications.

The first is the rule stating that EU citizens need to have been ‘lawfully resident’ in the UK for 5 years, under EU law.

The second relates to the ‘good character’ requirement, which assesses whether or not a person has complied with immigration requirements in the past 10 years prior to them submitting their application.

The Lawful Residence Rule

In order to be eligible for citizenship, all applicants must have legal residence in the UK for at least 5 years before the date of their application.

However, if an EEA applicant did not have CSI in the UK when they were required to, such as if they were unemployed, a student, or a self-sufficient person, then this would be considered a breach of regulations and would not count towards the lawful residence requirement.

It may be the case that some applicants will simply wait until they meet the 5 year criteria before applying, particularly if they’ve successfully gained settled status under the EU Settlement Scheme.

However, the second rule may well prove to be an additional barrier to obtaining citizenship.

The Good Character Rule

The ‘good character’ requirement of British citizenship applications assesses the applicant’s adherence to immigration rules and regulations. It is a mandatory requirement of the British Nationality Act when considering the eligibility and viability of an individual’s application for citizenship.

For EEA nationals and their family members, the guidance now states that their immigration history will be assessed over a 10 year period prior to their date of application.

The guidance also refers to the mandatory requirement to have had CSI under EEA regulations during relevant periods of time to become a ‘qualified person’.

This means that Home Officer caseworkers will have to assess whether or not the applicant complied with CSI requirements in the past 10 years from the date of application in order to fully establish the applicant’s adherence to the good character requirement.

If the applicant did not have CSI while in the UK when they should have, it may lead to their application for citizenship being refused unless the caseworker decides to exercise discretion in the applicant’s favour.

As a result, EEA nationals who were granted leave under old EEA regulations as students or self-sufficient persons may find it difficult or impossible to apply for British citizenship if they did not have CSI during the relevant period.

Why Might Discretion Be Exercised?

The fact that the guidance states that discretion may be exercised in comprehensive sickness insurance cases reflects some of the confusion around the requirements under EEA regulations at the time.

Previous lack of publicity and clear guidance on the matter has been an issue for many EEA nationals in the UK.

For example, many EEA nationals with permanent residence status were not aware of the requirement to have CSI in the UK under certain circumstances, particularly those who switched from being employed or self-employed to being students or self-sufficient during their period of leave.

In addition, some of the definitions and boundaries of these statuses were not made clear. For example, no specific guidance was given if a student also works part-time, if a student ceased to be in employment for any reason, or how many hours of work were required to consider an individual a worker under the guidelines.

Ultimately, it will be up to the applicant to provide evidence, information and reasons as to why they didn’t have CSI during their period of leave in the UK, despite it being a mandatory requirement at the time.

There are currently little to no guidelines on when the Home Office may exercise discretion for EEA nationals applying for citizenship who did not meet the CSI requirements. Individual cases are being assessed on a case-by-case basis, and it’s unclear how strict or lenient the Home Office might be in these instances.

If you’re concerned about not fulfilling the requirements for British citizenship because of a comprehensive sickness issue or any other factor at play, speak to one of our legal experts for advice. Call us on 0333 305 9375, or contact us online today.

Does Access to the NHS or a European Health Insurance Card (EHIC) Count as Having Comprehensive Sickness Insurance?

It may have been the case that possession of an EHIC card would have successfully met the CSI requirement in a period of leave, as long as the individual made a declaration that they did not intend to stay in the UK permanently.

However, the specific guidelines around the legality of this are unclear, including if the intent behind the declaration or the declaration itself has any weight when influencing the validity of the EHIC card as a replacement for CSI.

In addition to this, the Home Office’s stance has long been that access to the NHS is not comparable to having CSI, and EEA nationals will have to seek alternative forms of CSI in order to meet the requirement, even if they’re able to access NHS services.

However, a court ruling in March 2022 found that access to the NHS does, in fact, constitute a form of comprehensive sickness insurance, which may signal changes in the future as to how applications are processed.

If you’re in need of assistance with your CSI issue, whether it relates to eligibility criteria for citizenship or another issue, IAS are here to help. Get in touch with us on 0333 305 9375, or contact us online today.

How Can IAS Help?

Comprehensive sickness insurance is a complex issue with significant ramifications for certain people wishing to apply to become a naturalised British citizen.

If you’re in the process of applying for citizenship, or if you’re planning to at some point in the future, and you’re in need of additional assistance, IAS are here to help.

We are experienced legal professionals who specialise in immigration law. We can help assess your eligibility for citizenship, guide you through the steps to apply, and provide close support throughout the whole process.

We can also help if you fall short of one of the requirements and need additional advice on what to do, such as if you don’t happen to meet the criteria to have held comprehensive sickness insurance to be eligible for citizenship. Our lawyers will work closely with you one-to-one to ensure that you get the help and support you need for your immigration case.

For more information about the services we offer, and how we can help you, get in touch with us today on 0333 305 9375, or contact us online.

We’re here to help with your comprehensive sickness insurance immigration issue.

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