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What are the rules on accessing the UK health service if you live in Austria?

If you're British and live in Austria you will previously have been registered with the National Health Service, but once you move abroad things change - here's what this means for accessing UK healthcare both on a regular basis and if you have an accident or fall sick while on a visit back to the UK.

Published: 19 October 2022 17:00 CEST
Updated: 20 October 2022 13:19 CEST

What are the rules on accessing the UK health service if you live in Austria?

The NHS is described by the British government as a “residence-based health service” which means that if you don’t live in the UK you’re not automatically entitled to NHS care, even if you are a British citizen and even if you still pay tax in the UK.

However funding, access and care rules can vary depending on your circumstances.

Moving to Austria

When moving to Austria, you need to register with the Austrian public health system.

Enrolment is generally automatic and linked to employment. A vast majority of workers are insured by ÖGK through their employer. Still, many, such as self-employed people, will have their insurance with SVS or BVAEB, in the case of public servants.

Insurance is also guaranteed to co-insured persons, such as spouses and dependents, pensioners, students, disabled people, and those receiving unemployment benefits.

Healthcare in Austria is a state system, and similarly to the NHS it’s free at the point of delivery, though there may be some differences depending on the company you need to sign up for.

Pensioners

If you are a pensioner, student or posted worker, it’s likely that the UK will continue to pay for your healthcare through the S1 system.

However, being covered by S1 doesn’t mean that you remain registered with the NHS – S1 only affects who pays for your care.

So, in Austria, you register for a health card (e-card) in the same way as everyone else, and when the doctor swipes the health card the UK government will cover those costs. For everyone else in Austria, that would be the public insurer.

Full details HERE on how to request an S1.

Can I stay registered with my UK GP?

No, you need to have a local address to be registered with an NHS GP. In practice, many people don’t get around to telling their GP that they have moved and so stay registered for months or even years, but technically you should notify your GP so that you can be removed from the NHS register.

Even if you do remain registered with a UK GP, they won’t be able to issue prescriptions for you in Austria as most UK GPs are not licensed to practice outside the UK – therefore are not covered by insurance.

If you are on regular medication it may be possible for your GP to issue you with an advance stock of medication to cover you while you get settled in Austria, but many prescriptions are limited to a maximum of three months.

What about travelling outside Austria?

Once you’re registered in the Austrian system you will be able to get a your e-card, which has the EHIC on its back side and covers medical care while on trips in Europe.

If your e-card doesn’t show any information on the back, you need to contact your insurer to have it updated. More on this here.

If travelling outside of Europe – ie a holiday in the US – you need to ensure that you have travel insurance with full medical cover in case of any mishaps while abroad.

What about trips back to the UK?

Although your day-to-day healthcare will be covered by the Austrian system, there’s still the possibility or falling sick or having an accident while on a trip back to the UK.

If you are an S1 holder you can show this to provide proof that you are entitled to NHS treatment, and if you are covered by the Brexit Withdrawal Agreement you can show your UK-issued EHIC or GHIC to provide proof of your entitlement to NHS care.

However if you don’t have either of these, the CEAM covers all trips in the EU and European Economic Area, as well as Switzerland and the UK, so if you are charged for medical care while in the UK – because you do not have a UK address – then you will be able to claim the costs back once your return in Austria.

This also means that any Austrian nationals who are with you on your trip – such as an Austrian spouse or partner – have their care costs covered too through CEAM.

In practice, most UK nationals who need to use the NHS while on trips back to the UK report that no-one ever thinks to ask whether they are UK residents.

It’s true that some Brits living in Austria keep their registration with a UK GP and make regular trips back to get prescriptions, while this can happen in practice it does involve lying or at least being economical with the truth about where you live.

Overall it’s better to get registered with an Austrian GP so that they can get to know you and have a full overview of your care as well as any ongoing medical conditions and prescriptions. Most Brits are pretty happy with Austrian healthcare, which consistently ranks among the best in the world.

Emergency care

There are certain types of NHS care that are not charged for, such as A&E treatment or treatment from paramedics, but if you need to be admitted to hospital you may have to pay.

NHS hospitals won’t turn you away if you cannot prove residency, but they may present you with a bill when you leave if you cannot prove either residency or health cover in a European country.

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Brexit: What Brits in Austria need to know if they intend to move back to the UK

Moving countries is a time-consuming process – but if you’re British and living in Austria you might think that moving back to the UK would be simpler.

Well, there won’t be a language barrier and as a UK citizen you won’t need any immigration paperwork (although if you’re bringing an Austrian or other foreign partner with, then that gets complicated) – but you will still face administrative hurdles around pensions, healthcare, driving and taxes.

Some of these issues existed before Brexit, while others are a direct result of the UK leaving the EU. Here are the most common questions from Brits thinking of moving back to the UK:

Do I still qualify for NHS treatment?

You are entitled to NHS treatment if you are ‘ordinarily resident’ in the UK – there is no minimum time limit so as soon as you are back in the UK on a permanent basis, you can use the NHS.

Getting back on the NHS might be one of the easier parts of moving back to the UK. Photo: Pixabay

You will need to register for a GP in your local area in order to access non-emergency treatment and to get an NHS number if you do not already have one.

You may need to provide proof of a UK address in order to use NHS services – although in reality UK citizens are rarely asked for this, apart from when registering with a GP.

If you have been an S1 holder while living in the EU you should cancel that, just so there is no confusion over where you are getting your healthcare.

If you go back to Austria or elsewhere in Europe for a visit, remember that you are now a tourist and will need a GHIC card to get European healthcare, while travel insurance is also advised in case of an accident or illness while visiting an EU country.

Can I drive on my EU licence in UK?

If you have been living in the EU you may have had to change your UK licence for a French or Spanish one for example.

Once you’re back living in the UK you can continue to drive on you EU licence until the age 70 or if you move to the UK when you are 67 or over you can drive for three years. After this time you’ll need to change your licence.

If your licence or photocard has an expiry date – once it’s time to renew, you should swap it for a UK licence. You’ll need a valid photocard licence to drive in the UK.

You can find details on the swap process for UK licences here, and if you’re in Northern Ireland here.

UK residents with an EU licence can if they want exchange their licence for a UK one, if they wish to do so, without the need for a re-test.

Can I bring my Austrian partner with me?

If you’re returning alone you won’t need to do any kind of immigration paperwork, your UK passport is enough. However, if you are bringing with you a partner who is not a UK citizen, it becomes complicated.

After the end of the Brexit transition process, there was an ‘amnesty’ period in which Brits with EU partners could move back to the UK under the old immigration rules. This is now ended and EU partners face the same immigration process as all other foreign spouses.

Essentially either your partner will need to have already secured a relatively high-paying job in the UK, or you will need to prove that you have a large amount of money to support them.

They will need to go through the process of getting a UK visa (which is expensive – between £1,000 and £1,500 just for the visa fee) and there is no guarantee that their application will be successful simply because they are married/in a civil partnership with a Brit. They will also need to take an English-language exam.

Full details here.

What about my pension contributions from the EU?

If you have been working in Austria, you will probably have been contributing to the Austrian pension system. Pre-Brexit, UK and EU pension contributions could be blended into a single pension – but this is no longer the case.

Brits still living in the EU who are covered by the Withdrawal Agreement are theoretically covered by blended pensions if they had made pension contributions in the UK before moving to the EU, but the same does not apply if you move back to the UK.

The good news is that EU countries still practice this – so if for example, you have worked in France, Italy and Austria, your contributions will be totted up and paid out as a single pension – you apply in the last country you worked in.

Brexit ended the easy movement of pensions between the EU and UK – something you’ll need to keep in mind if you move back. (Photo by Centre for Better Ageing / Pexels)

Keep in mind, however, that different countries have different pension ages. So if for example, you worked in Austria (pension age 65) and Greece (pension age 67) – you will start to get the Austrian portion of your pension from the age of 65, but you won’t get the Greek part until you turn 67.

The country that is paying your pension may require you to have an EU bank account to pay into – and you should check with the country paying your pension whether there are any other conditions to observe.

When it comes to a pension from the UK, it depends on how long you worked there – the basic rule is that you need 10 years of National Insurance contributions in order to get a state pension.

However, the UK government states that periods of work done in the EU or EEA ‘may’ count towards your qualifying period. Even if they do, however, they don’t count towards the total pension amount – so for example, if you worked for seven years in the UK and the remaining 35 years of your career in the EU, you can qualify for a UK state pension, but it will only be based on the seven years of work in the UK (in other words, the payment per month will be tiny).

Further details on UK pension entitlement.

Do I need to hand back my residency card, health card etc. before I leave the EU?

Most countries require that you hand back residency cards before you leave, but this is not always enforced. If you’re in Austria, however, this is a good idea so you don’t face any further issues. It can also help prove to the Austrian tax authorities that you’re no longer living and working there.

In general too, Austria will require you to de-register with your local authority upon leaving the country. This may work out a bit differently if you continue to own a second home in Austria, but even then, you may need to declare your Austrian home as such with the local authority.

If you do end up keeping residency or healthcare cards – don’t use them on trips back to the EU. Tempting as it might be to avoid border queues, you will create a confusing official record if you are claiming to be a resident of two countries at once.

If you have taken up Austrian citizenship, that is a different matter of course.

Do I still have to pay Austrian taxes?

It’s highly likely that you were paying taxes in the country you lived in. Generally, tax declarations concern the previous year, so you will have to do at least one tax declaration and payment after moving back to the UK.

In Austria, the annual tax declaration takes place between April for paper filing and June for electronic filing, and concerns the previous calendar year. So if for example, you move back to the UK in September 2023, you will have to electronically complete an Austrian tax declaration before the end of June 2024, covering your 9 months of residency in Austria in 2023.

Someone doing their taxes.

Moving back to the UK won’t get you out of doing one last Austrian tax return. Photo: Pixabay.

If you still own property in Austria you will pay non-resident property taxes there.

When you left the UK, you will likely have informed HMRC that you were leaving the country, so you will now have to tell them that you’re back. Whether you have to fill out a UK self-assessment form depends on whether you are a salaried employee or self-employed/retired.

Can I keep my Austrian bank account? Do I need a new UK account?

This one depends on the policy of your bank, but some banks in Austria may require you to have an Austrian address.

It’s likely that your UK bank may have closed your account if it was not operational while you were living outside the UK, in which case you will need to open a new one.

A practical option while you are moving and still have interests in both countries is to open an internet bank account with a company like Wise or Revolut – these offer accounts in both pounds and euros and give you a European IBAN and a UK Sort code, so you can use it in both countries.

Will my EU qualifications be recognised?

If you were studying or gaining professional qualifications while living in the EU, don’t assume that these will be recognised in the UK. Brexit ended the mutual recognition of qualifications – check with the professional or academic body that issued them whether these are recognised in the UK, you may need to acquire a certificate of recognition.

It’s a good idea to check this point before you start job-hunting in the UK.

Be prepared for hassle

The advantage of moving back to the UK is that you’re not starting from scratch and at least you know how things like council tax, electricity billing and healthcare work.

However, don’t assume that it will all be plain sailing – your lack of a recent UK address will make you an anomaly in many companies’ systems and you’re likely to be forced to have several long and annoying conversations with call centres while you explain that while you are a UK citizen, you have not recently been living in the UK.

There are likely to be other niggles too – many UK car insurance companies won’t recognise a no-claims bonus built up abroad, so you’ll be back to paying full premiums on your car insurance, while banks might request extra money laundering checks due to your foreign associations.

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A lot of people in the UK also seem to be confused about the difference between citizenship and residency, so be prepared to have the following conversation a lot: “I’ve recently been living in Spain. No, I’m not Spanish, I’m British, I was just living in Spain. Yes, I am a UK citizen.”

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