Comprehensive Sickness Insurance (CSI) is required by law for EEA and Swiss students, self-sufficient individuals, and their family members staying in the UK with them.
Do I need comprehensive sickness insurance if I work?
To be eligible for their own right of residence, family members of self-sufficient individuals and students must also have Comprehensive Sickness Insurance. See the section below for more information.
There are a LOT of self-sufficient EEA nationals living in the UK right now. They may, for example, be married to a British citizen but not now employed or self-employed. They will need to show they have Comprehensive Sickness Insurance to show they have a current right of residence in the UK unless they have already earned permanent residency through five years of continuous work or self-employment (and be able to give proof).
What is comprehensive sickness insurance British citizenship?
So, what exactly is Comprehensive Sickness Insurance? In a nutshell, CSI is a sort of health insurance that EU nationals who were not economically engaged such as students or self-sufficient individuals were required to get while residing in the United Kingdom.
Do EU citizens need health insurance in UK?
If you’re coming to the UK from the EU, Norway, Iceland, Liechtenstein, or Switzerland, you should take the following precautions:
- If you are qualified to use your European Health Insurance Card (EHIC) in the UK, bring it with you.
What is comprehensive health insurance UK?
Comprehensive Health Insurance covers the cost of private healthcare, allowing you to avoid the NHS’s lengthy waiting lists. The finest type of health insurance is a comprehensive policy. It fully covers both inpatient (when you require a hospital bed, such as after surgery) and outpatient (where you don’t, such as consultations, diagnostic tests, and scans) care.
What Makes Health Insurance Comprehensive?
The greatest and most comprehensive medical insurance policies will include coverage that is only available as an optional extra in cheaper plans, such as alternative therapies or psychiatric coverage, as a basic feature rather than an add-on.
You can acquire coverage for both inpatient and outpatient care with comprehensive insurance. When compared to a basic coverage, which does not cover outpatient therapy at all, this is a significant difference.
Who needs comprehensive insurance?
While governments and insurance companies do not compel drivers to obtain comprehensive coverage, if you finance or lease your vehicle, you may be required to purchase it under the terms of your contract. If you own your automobile outright, you should consider a comprehensive policy, according to WalletHub, if:
- You don’t have a substantial emergency reserve to replace or repair your car if it breaks down.
Modern cars last longer and cost more to fix than older cars, which were required to lose comprehensive coverage after six years or 100,000 miles. Most experts now advise having comprehensive insurance on your automobile if the cost of the premium is greater than 10% of the car’s market value minus the deductible.
This method from Insuramatch explains how to figure out if you should keep comprehensive coverage for your car:
- To check the six-month premium cost of your comprehensive policy, look at your monthly statement, the insurance company’s web portal, or your policy declaration page.
- Subtract the deductible amount from the value of your automobile; if you’re not sure, use a site like Kelley Blue Book to receive an estimate of its value based on the make, model, miles, condition, and special features.
- Subtract the amount of your six-month comprehensive coverage premium from the answer in step 2.
If you get a negative number, it’s more cost-effective to cancel your comprehensive insurance. Keep the comprehensive coverage if the result is a significant positive number. If your positive number is low, you can choose to keep this sort of policy or save the money and replace or repair your car yourself if necessary.
Do children need comprehensive sickness insurance?
Comprehensive Sickness Insurance (CSI) is required by law for EEA and Swiss students, self-sufficient individuals, and their family members staying in the UK with them.
Does Ehic count as CSI?
If your stay in the UK is is temporary, the European health insurance card (EHIC) obtained from your home country is acceptable proof of CSI. You will need to purchase separate insurance if your stay is to be prolonged or if you are unable to obtain an EHIC card from your country of residence.
Do I need CSI if I have permanent residence?
As the reality of Brexit sets in, many EU citizens and their non-EU family members are considering naturalization as British citizens. However, a succession of Home Office guideline documents produced this year, ostensibly ‘clarifying’ how caseworkers at the department should handle naturalization petitions, has sparked significant concern. Many naive persons are likely to be caught out by this, believing that being awarded established status meant they had a “clean immigration record,” when in fact, immigration history is evaluated under different criteria for naturalization petitions, frequently with devastating results.
This controversy centered on EU citizens’ lack of comprehensive sickness insurance (CSI), a little-known regulatory need that few non-immigration lawyers were aware of. After all, why would anyone get CSI when they could utilize the NHS for free? Here, we analyse the issue and consider potential solutions.
Why is this such a problem?
If seeking to establish lawful residency on a self-sufficient or student basis, UKVI guidance now makes it clear(er) that EU nationals (and occasionally their family members) should have had private health insurance.
Many people who have been given settled status were under the impression that being granted settled status meant the Home Office was pleased with their legal residency for the previous five years (or three years if married to a Brit). In terms of immigration history, established status was seen as a “clean bill of health” by many. As a result, many people have applied to naturalize as British citizens, often with misplaced confidence. If they are depending on a time of residence as a’self-sufficient’ or’student,’ their naturalization applications may be denied unless they have CSI.
Furthermore, in addition to having lived in the United States for five (or three) years, there is a further criterion to be of ‘good character.’ UKVI caseworkers are given specific policy guidance on how to interpret this ostensibly subjective and ill-defined phrase. Immigration-related difficulties, such as a failure to ‘comply with the EEA Regulations’ within the past 10 years, are one component of good character.
So, confusingly, you have one rule saying you must have resided here lawfully for five years, but then, lo and behold, you have another requirement buried deep inside UKVI advice! It’s a prerequisite that you’ve lived here legally for ten years.
Why does the Home Office expect EU nationals to have CSI?
The necessity for EU nationals to have CSI is stated in regulation 4 of the EEA Regulations, which states that you must have CSI to be classified as a “self-sufficient person” or “student.”
Prior to the EU Settlement Scheme, most EEA nationals asking for naturalization had to apply for a permanent residency card, and if they relied on being self-sufficient or a student for part of their qualifying time, they would have had to deal with the CSI issue. For most EEA nationals, obtaining a permanent residency certificate was a prerequisite to filing for naturalization.
However, because the permanent residency application only cost £65, being denied was not the end of the world, and if you were successful, you could be confident in your naturalization application, at least for the five (or three) year qualifying period.
How can I meet the residence requirements for settled status, yet fail the residence requirements for naturalisation?
The EU Settlement Scheme the mandatory registration system that received over 4 million applications up until August 2020 has its own set of rules. All the Home Office requires to qualify for indefinite leave to remain under the EU Settlement Scheme is that you have lived in the UK for five years in a row. If you have, you will be granted established status, which is a powerful kind of indefinite leave to remain if you have not committed any serious crimes (ILR).
As a result, the eligibility requirements for settled status are far more lenient than those for permanent residence and a permanent resident card. In general, this is a good thing.
The situation becomes more complicated for those who have been given established status but have never considered applying for a permanent residency card. These individuals frequently desire to take the next logical step in securing their status by applying to naturalize as British citizens (most become eligible after holding settled status for one year, although if married to a British citizen, you can apply as soon as you are granted ILR).
To be eligible for naturalization, you must establish that you have not broken any immigration laws in the five years prior to your application (or within a three-year period if married to a British citizen). The instructions state unequivocally that:
‘…as this is not a requirement of the EU Settlement Scheme, this grant of settled status (also known as indefinite leave to come or remain) will not indicate that they were here lawfully under the EEA Regulations during that time, as defined by the British Nationality Act 1981.’
As a result, even if you met the residency requirements for established status, you may not meet the residency requirements for naturalization – even though the qualifying period is the same. The residency requirements for settled status and naturalization range significantly.
However, the CSI-problem does not necessarily end there. Even if you met the five-year residency requirement, you may have had a period in which you were self-sufficient or a student without CSI throughout the larger 10-year period used to assess good character. This might now be a reason for refusal, according to the guidelines.
What qualifies as CSI?
CSI is defined as “any form of insurance that will cover the expense of the bulk of medical treatment they may get in the United Kingdom,” according to Home Office guidance. An EHIC card is allowed, but only if it was issued by a member state of the European Union other than the United Kingdom.
I did not have CSI. What can I do?
I’ll get to the topic of ‘discretion’ in a moment, but before you walk down that path, double-check that you can’t establish that you’ve been a legitimate resident here all along. Finding an alternative base is very dependent on your individual circumstances. However, here are some current ways in which we have assisted our clients in overcoming the problem.
You may have obtained a right of permanent residence in the UK if you had been a resident in the UK for some time previous to the problematic period. You do not ‘apply’ for permanent residence under EU law; nevertheless, you may apply (or may have applied) for a permanent residency card. That card, however, did not ‘grant’ you the right to permanent residence; it only proved that you already had it.
To be clear, even if you did not apply for a permanent residency card, you may have already obtained a permanent resident right.
If you were a qualified person for five years before to the problematic period (for example, by working and/or being self-employed), you will have obtained a right of permanent residence. You are no longer required to obtain CSI after you have a right of permanent residency.
Case study: Raoul
Raoul, a Frenchman, arrived in the United Kingdom in July 2009. For more than five years, he worked as a greeter. From 2015 until 2017, Raoul was unemployed. Raoul never applied for a green card or a permanent residency permit. In March of this year, he was granted established status. He just applied to naturalize, but the Home Office is now inquiring about Raoul’s position between 2015 and 2017, as well as whether he had CSI at that time.
Raoul would have obtained permanent residence after working for five years in this scenario, thus by July 2014. Raoul has not been absent for more than two years since then, and hence has not lost his permanent residence. It makes no difference that he did not apply for a permanent residency card; he must now establish that he obtained permanent residence and that he has not lost it afterwards. The ‘CSI dilemma’ therefore vanishes, because a person with a permanent address does not require CSI.
It’s possible that you have (or had) a family member on whom you can rely to secure your right to stay during the difficult moment.
For example, you may have a family member who was a ‘qualified person’ throughout the time period in issue and obtained lawful residency as a result of their relationship with you. Perhaps a member of your family had already obtained a permanent residency permit (regardless of whether they applied for a permanent residence document).
If you fall into the category of what is frequently referred to as a ‘close family member,’ you are more likely to benefit. This includes spouses, children under the age of 21, and parents who are financially reliant on them.
If you were a ‘extended family member,’ you would need to have been’recognised’ as such at an early date by being supplied the necessary papers in order to profit in this way.
Case study: Ana-Maria
Ana-Maria, a Romanian national, and her Romanian mother arrived in the UK in October 2014, when she was 17 years old. Despite the fact that Ana-Maria and her mother arrived in the UK at the same time, Ana-Maria resided with friends in separate accommodations. Ana-Maria didn’t get a job until January of 2017. Since Ana-arrival, Maria’s her mother has worked nonstop.
Ana-Maria is now worried that the time between October 2014 and January 2017 may be used against her if she files for naturalization.
Despite the fact that Ana-Maria did not have CSI throughout this time, she can show that she was legally present in the country thanks to her mother. Ana-Maria is considered a ‘close family member’ of her mother (who is also an EU citizen) and does not need to prove that she was ‘dependent’ on her mother because she was under 21 at the time.
As a result, the fact that she did not possess CSI throughout this time is irrelevant. She will, however, need to prove her relationship with her mother as well as the fact that her mother worked during the time period in question.
An EU national or a member of their family is eligible to stay in the UK for up to three months under Regulation 13 of the EEA Regulations. There is no requirement that the person be a ‘qualified person’ for the first three months, thus you should not need to have held CSI during that time.
What if you left the UK for a vacation or a brief stay in your native country, then returned to the UK during the troublesome period’? Is a new three-month right to reside triggered as a result of this? It appears to be the case by law. Getting that three-month ‘grace period’ re-triggered could make all the difference, depending on your circumstances.
A word of caution, however. We previously raised this issue, and the Home Office sent the matter to their ‘policy team.’ They don’t appear to like this technique, since our application has been’sitting’ for quite some time. We were eventually permitted, but because we had bolstered our case with a ‘discretion’ argument (see below), we don’t know which argument won (unfortunately, they don’t tell you what your winning argument was!). I would probably advise against using this argument unless it is as a backup.
CSI and discretion
If all else fails, you can try to persuade the Home Office to overlook your lack of CSI by using judgment. If you say you don’t have CSI on your naturalization application, you must explain why.
The guidance makes it clear that the caseworker must examine whether he or she should ‘use discretion’ and overlook any lack of CSI. Regrettably, the advice fails to include the good aspects that could work in your favor.
If you were previously denied a permanent residence card due to a lack of CSI and did not receive CSI afterward, you would require ‘compelling grounds to exercise discretion,’ according to the guidance.
While there is a risk of over-analyzing terms that are perhaps inadequately articulated, the following is what I would extract from this section of the guidance:
- If you were previously denied CSI at the permanent residence card stage and then failed to obtain CSI after this denial, you are likely to be in trouble because you will need to provide ‘compelling grounds.’ It’s unclear what would qualify as compelling grounds, but you’d need a very excellent (perhaps extraordinary) cause to refuse CSI in these circumstances.
- If you were previously denied CSI at the permanent residence card stage and then gained CSI as a result of this, you are clearly in a better position and would not require compelling grounds.
Unfortunately, the guidance does not provide enough clarity for what I believe to be the largest group of people concerned about this issue EU nationals and family members who never applied for a permanent residence document but were recently granted settled status and were completely unaware of the CSI requirement. It’s unclear how these people’s applications will be handled.
By establishing a ‘compelling grounds’ criteria for this small group of people who were denied CSI after being denied a permanent residency certificate, a lower bar must be set for those who were simply unaware of the CSI requirement.
Based on my understanding of the guidance and some anecdotal data, the following summarizes my own thoughts on how to approach the subject of discretion:
- A CSI offense in the five (or maybe three) years leading up to the application date is more serious than one in the remaining ten years.
- If you were previously denied a permanent residence card because of a CSI issue and did not receive CSI afterward, you would need some significant mitigation (and evidence) to overcome this.
- Make a good argument for discretion if you’re going to dispute it. If you were just unaware of the CSI rule, it may be beneficial to explain any personal reasons for your inability to comprehend the rule. You may also want to submit further proof to demonstrate that you are a ‘nice person’ in general? Can you, for example, show that you have made a “good contribution” to UK society? Remember that your application will land on the desk of a UKVI caseworker who is working under similar conditions. Because there appears to be a lot of discretion, persuade the caseworker to grant your request!
Final thoughts
- Have you looked to see if you had a right of residence through some other means throughout the difficult period, such as being a ‘family member’?
- If it fails, how long must you wait until the ‘difficult time’ is no longer inside the relevant computation period? The shorter the wait, the stronger the case for waiting and applying later.
- Is your issue period within the five (or three) year time frame, or later in the ten-year time frame? If it occurs at a later time, it appears to be less of an issue.
As always, the legal analysis above is my own perspective on the CSI issue, based on a lack of clarity in Home Office instructions and anecdotal evidence. Others may hold a different point of view.
If you believe you may want assistance in this area, we provide a number of immigration legal services to assist you. This includes comprehensive guidance, document review, and complete representation, in which we handle the whole application process on your behalf. Please get in touch with us as soon as possible.
Do I need CSI after settled status?
No, both settled and pre-settled status are legal leave given under immigration regulations, therefore your stay will be legal as long as you continue to follow the restrictions and do not lose your status due to excessive absences.
CSI is not required if you obtain pre-settled or established status, even if you are a student or self-sufficient individual.
If you want to apply for citizenship, it is only required for the periods when you were a student or self-sufficient person before you were granted pre-settled or settled status, and if those periods occurred within the last 10 years prior to your citizenship application.