HEALTH SERVICE

Sad to relate, the older you become the greater the likelihood that you will need medical treatment. It is therefore essential to investigate the health provision in the country and the area of the country where you are planning to settle, and find out if you are eligible for it. The Department of Health Overseas Branch should be able to advise you, otherwise you could enquire at the embassy or consulate of the country concerned.

In some countries you will be eligible for free treatment for most conditions; in others only very basic care is provided free, and you will need to take out private health insurance to supplement the basic treatment. In others you have no option but to take out private insurance.

Items that you may well have to pay for in part or in full include:

• dental treatment
• prescribed medicines
• ambulance travel
• optician’s charges
• home nursing.

As far as European Union countries are concerned if you are receiving a state invalidity or retirement pension or widow’s benefit from the UK you and your dependents will normally be entitled to the health services of the sickness insurance organisation of an EU country. To prove your eligibility you need to obtain Form E121 from your local social security office before you go. This is not to be confused with Form E111 (to be replaced during 2005 with the European Health Insurance Card) which is for holidays, business trips and short term stays abroad.

If you are not in receipt of any benefit or pension you may be entitled to medical treatment under the health insurance scheme of a European Union country. However, you will normally be required to produce evidence that you have contributed to the UK National Insurance scheme for a certain period. The Inland Revenue’s Centre for Non-Residents in Newcastle can provide you with the necessary certificate.

If you have not reached pensionable age, you will probably be expected to join the insurance scheme in the country of settlement or else take out private health insurance.

Private health insurance

If you find that there are gaps in the public healthcare provision of the country you are planning to retire to or that you are not eligible for all the healthcare benefits you should seriously consider taking out a private health insurance plan.

You may already subscribe to such a scheme, in which case it would be worthwhile enquiring whether it could be extended to cover residence abroad: BUPA, Exeter Friendly Society and PPP are among the insurance companies which offer international plans. Most plans specify an upper age limit for joining – typically 65 or 75 – and insurance cover for the US and Canada will work out more expensive than for the rest of the world because of the high cost of health treatment in North America.

Alternatively you may decide to take out private health insurance in your country of residence, which often works out cheaper. The reason for this is that the insurance company or brokerage sometimes has its own clinics and hospitals or can negotiate special terms for its patients.

You should check whether the following are included in the policy. If not, a supplement may be payable:

• dental care
• spectacles and contact lenses
• medical evacuation (to UK or a centre of medical excellence)
• prescribed medicines
• visits to other countries
• home nursing
• psychiatric treatment
• osteopathy, homeopathy or chiropractic treatment
• physiotherapy.

You also need to ask:

• Are there exclusions (eg if I take part in certain sports)?
• Are there any illnesses not covered?
• Do costs increase after I reach a certain age?
• Do I become eligible immediately on joining or is there a waiting period?
• Is there a ceiling on my medical cover, and what happens if my treatment exceeds this?

If you have difficulty in choosing a plan, you could contact Healthsearch, an organisation which provides impartial advice on medical insurance plans for a small fee. Healthsearch operates a postal service and can also arrange face-to-face consultations. After you have completed the Healthsearch questionnaire you are sent a search analysis report recommending the two plans which best suit your circumstances.

Eligibility for medical treatment on visits to the UK

If you are resident in another country you will be expected to make use of the medical scheme in that country. Should you decide to return to the UK expressly for medical treatment you may well find that you are not eligible for free treatment under the NHS since you are no longer a UK resident. The only exception is if the medical authorities of the country in question refer you to the UK for treatment. This sometimes happens in the case of Gibraltar, for instance. Where there is a social security agreement in place between the UK and the country where you normally reside, you may be entitled to emergency medical treatment if you fall ill during your visit. However, you should check the details of the agreement first of all, and if there is any doubt, you should take out private insurance for your trip.

Keeping healthy

To avoid spending one’s retirement hanging around doctors’ surgeries or in hospital it makes sense to keep yourself as fit as possible. While it is not possible to ward off every illness, a sensible lifestyle can do a great deal to keep you in trim.

Regular exercise

If you have opted for retirement in the sun there will be plenty of open air attractions, including golf, swimming, tennis, bowls (or the local equivalent). Strenuous exercise is best avoided: jogging, squash, football and rugby, for instance can lead to heart attacks or injuries, unless you are exceptionally fit.

Social activity

Even if you are a shy retiring type it is essential to get out and meet people. Introspection is fine in small doses, but shutting yourself off from other people may turn you into a misery and you will start to imagine you are seriously ill.

Sensible food

A well balanced diet is important with plenty of fresh fruit, vegetables and protein. Sugar and fatty foods should be avoided as much as possible: fry-ups and cream cakes should not form part of your regular diet.

Alcohol in moderation

Alcohol can be beneficial if taken in moderate quantities; it helps you to relax. However, the availability of cheap wines and spirits, particularly in southern Europe, can lead to excessive consumption, and this in turn can cause cirrhosis of the liver, degeneration of the arteries, the shakes, etc.

No smoking

Smoking is a killer. It causes lung cancer, chest infections and coronary disease – hardly the ideal accompaniment to your retirement lifestyle. If you can’t kick the habit, graduate to cigars or a pipe.

Prevention

Operate on the principle that prevention is better than cure. Take the necessary vaccinations and tablets; have your eyesight tested regularly – poor eyesight can cause accidents; occasional medical check-ups may be sensible; take precautions against sexually transmitted diseases and AIDS.