Retiring Abroad This information sheet aims to answer the increasing number of enquiries we receive from people thinking about retiring abroad. Spain, in particular, is a popular destination and is currently home to more than 50,000 UK pensioners. Some people with Parkinson s disease already living abroad also ask us what is available locally to help them cope with the condition. Others contact us for advice because they are thinking of returning to the UK after many years abroad. Retiring abroad Retiring abroad can seem a very attractive option for many reasons. You may have family in a particular country and want to move to be close to them. You may prefer to live in a warmer climate or may have holidayed somewhere on a regular basis and dreamed of living there permanently. Property prices and the cost of living may be cheaper than in the UK. Many people do make successful moves to another country and never regret it. However, others sadly make expensive mistakes, often because they haven t researched thoroughly enough or haven t considered potential difficulties that may arise in the future, such as changes in health. It is extremely important to research and plan thoroughly and consider all aspects of living abroad before you make a decision. Before you go Consider the following questions: Why do you want to retire abroad? Are you considering a permanent move or do you only want to spend part of the year abroad? If you move abroad, do you want to return to the UK frequently to visit friends and relations, or for medical appointments? Can you afford to retire abroad? What are the advantages and disadvantages of a move abroad? What do your family and friends think and how will it affect them? How will you feel and cope with them living further away from you? Find out as much as you can about your destination Within the European Union (EU) countries and some countries of the European Economic Area (EEA) there are common agreements that set out the fundamental rights of EU nationals moving from one member state to another. Outside these areas, different conditions apply. No matter what country you are considering moving to, it is important to check what is available and your rights for that particular country even if it is in the EU. The British Consulate in the country or the country s embassy in the UK should be able to advise further. Many countries also have expatriate organisations which can be a good source of information and support. The British Consulate should be able to advise on these. The internet is also a good source of information. For instance The Daily Telegraph has an expatriate website (www.telegraph. co.uk/expat/) or try http://britishexpats.com These websites have forums or noticeboards where you can ask for information or advice from other expatriates. Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 1
For popular destinations for retiring abroad, like France and Spain, there are magazines like Living in France (www.livinginfrance.com), as well as many similar publications avaiable in larger newsagents. Make sure you know what the cost of living will be in the country of your choice and what amenities are available This is particularly true when it comes to accommodation. Visiting the country at different times of the year and living there on a trial basis is a good idea. This should give you an opportunity to gain a better understanding of the lifestyle without forfeiting your home in the UK or taking on binding commitments. Although property prices can be lower in some countries, buying property abroad can be difficult and may involve a lot of red tape. It is very important to seek professional legal advice from someone who knows the local practices and customs. The local British Consulate and the Law Society should be able to provide details of English-speaking lawyers who can assist you both in the UK and abroad. the social support systems are unavailable or difficult to penetrate. Find out as much as you can about health and social care provision and costs in the country you are planning to live in This is probably one of your most important considerations. What is available in terms of information, rights and entitlements depends very much on the country you are planning to retire to. Obviously, what is available and how it is organised will be different for each country. Don t assume that all the services available in the UK will be available elsewhere. For instance, an article in the UK press said that in some countries, such as Italy, Spain and Portugal, it is traditional for family members to assume responsibility for medical after care for a person in hospital including providing meals or washing bed linen. Although some alternative private professional care may be available in some countries to help those who don t have family to provide these kinds of services, this will not be so in all countries and can be costly. Remember that your circumstances and requirements may change in the future. For instance, although you may plan to rely on your car when you move abroad, it is important to check what public transport is available in case you have to stop driving later on. Access to the UK is also an important consideration, especially in order to keep in touch with family and friends and for emergencies. Consider how easy it will be for you to integrate into the local community too some countries are easier than others and a lot depends on the particular culture. Some people find that they become very lonely if Unfortunately, we are not in a position to be able to provide detailed information on the health and social care systems of other countries. If the country in question has a Parkinson s organisation, they can often advise further. Details of these groups are provided on the Parkinson s Disease Society (PDS) website at www.parkinsons.org.uk or can be obtained from the PDS Helpline on 0808 800 0303. Otherwise, we suggest you contact the British Consulate in that country or the country s embassy in the UK for further information. Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 2
Paying for treatment Paying for treatment and the cost of care are also key issues. While the UK has mutual healthcare agreements with many countries, these don t cover all the expenses you can incur. They may not entitle you to free treatment but only to reduced-cost treatment. Pre-existing conditions may be excluded. You could be visiting a country with a reciprocal healthcare agreement with the UK, but in an emergency you could be sent across the border for treatment in a country where no such arrangement exists. The costs of relatives flying out to stay with you or bring you back to the UK in an emergency would not be covered. Your entitlement as a visitor may be quite different to your entitlement as a resident. Make sure you get expert advice about this before you go and make sure you understand clearly what your situation is. Having comprehensive health insurance to cover private medical and dental treatment, plus medical repatriation to the UK if necessary, is vital. Make sure it covers everything you need and covers pre-existing conditions such as Parkinson s. The UK Foreign and Commonwealth Office (FCO) website has a section on Medical and Health Insurance and the UK Department of Health website has information on getting treatment in countries both within and outside the EEA that have reciprocal agreements with the UK. Parkinson s and the health and social care system It is particularly important to find out the level of care available to treat Parkinson s. You might ask the following questions: What level of specialist care is available? What treatments do they use for Parkinson s? What is available? Will the medication you are currently taking be available in the country you will be living in? Some treatments won t be available in some countries, even if their health service is modern and efficient. Sometimes even if a drug is available, it may be only in a generic form or as a different brand and not as the particular brand that you have been prescribed in the UK. Although medication can sometimes be shipped abroad, this can be costly and complicated. Are services like physiotherapy, speech and language therapy, and occupational therapy widely available? What social services are available? Even if you don t need these now, it is important to know what is available in case you need them later. Although good services are available in many countries,they are poor or non-existent in others. Some people think that the way around this is to make regular visits to the UK for treatment. Although this is a possible solution, it is important to note that most UK nationals who are resident in another country are not entitled to free UK health service treatment. If they choose to visit the UK for the purpose of obtaining NHS treatment, they would normally be charged for such treatment. Anyone, regardless of whether they are a UK resident, is able to access the following NHS services: Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 3
Outpatient emergency treatment Compulsory psychiatric treatment Family planning services Treatment for certain communicable diseases However, there are some categories of patients who are exempt from paying for NHS services that do not fall into these categories. To find out more, contact the Department of Health Customer Services Centre on 020 7210 4850 or visit www.dh.gov.uk/en/ Healthcare/ EntitlementsandCharges/OverseasVisitors/ Index.htm Learn the language Although in some countries the expatriate community is so large that it is possible to manage without speaking the local language, most people find that not speaking the local language causes problems when dealing with officials, healthcare and shops. Although medical staff in some countries may speak some English, it would be unwise to assume that you can rely on this. Unless you speak their language, trying to explain your symptoms or health issues could be very difficult. Consider your financial circumstances carefully It goes without saying that this is a crucial consideration. You need to be clear what your financial situation will be when you retire remember to allow for exchange rate fluctuations and inflation. You need to know the value of your pension, your tax liability, and your welfare rights/benefits entitlement. The FCO publication Going to Live Abroad details ways in which you can do this. For benefits information see the FCO publication Going to Live Abroad. If you are on benefits, you need to check whether you would still be entitled to these if you moved abroad. The Department for Work and Pensions (DWP) website (www.dwp.gov.uk) provides some information in the Disabled people and carers section or check with your local DWP office. The number should be in the local phone book. NB: Although a pension can be paid in any country outside the EU/EEA, you will only receive increases if you live in certain countries. In other countries, your pension will be paid at the level you received when you moved from the UK. In some countries, British Expatriate Alliances are campaigning to get this changed see the Canadian one which also provides information on alliances in other countries: www.britishpensions.com State retirement ages vary from country to country. Certain entitlements, such as medical treatment, will vary according to whether you are retired and/or in receipt of a state pension. Once you are in the country Find yourself a good doctor if possible, one who speaks English, and register with the local health/social authorities, as this will give you access to the local welfare services after a short period of time. Register with the British Consulate. This helps the Consul to keep in touch with you if you get into difficulties, or in the case of an emergency. In countries with large expatriate communities the Consulate may also have an information sheet to help retired UK expatriates settle in. They may also have information about British associations, clubs, publications and charitable organisations. Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 4
Make sure your passport is valid and renewed when necessary. Make sure family and friends in the UK are fully informed of your contact address at all times and keep in touch with them regularly. This may seem obvious, but it can be easy to lose touch with people when you are living in a different country. Make a will. If you die without one abroad, this can cause great difficulties for your heirs. If you have assets in the UK and abroad you may need separate wills for each country. If you decide to return to the UK Sometimes people decide to return to the UK. This needs to be considered very carefully. The financial considerations are obviously very important. If you have worked abroad for many years, there may be tax and pension implications that can be very costly. Also, you may not have an automatic entitlement to certain benefits in the UK. See the DWP website for more information. In terms of healthcare, if a British passport holder returns to the UK and resumes residency, they will be eligible for NHS services. However, note the comments above on eligibility if you spend a considerable portion of the year abroad. If you have lived overseas for many years, you may find that life in the UK is quite different from how you remember it. Friends and family can have lives of their own and you can end up feeling lonely and isolated. The PDS sometimes receives enquiries from people who have read about treatment for Parkinson s that they think is only available, or cheaper, in the UK. This may not necessarily be the case and you should check this out thoroughly in the country you are living in before making any decisions. See the Age Concern information sheet Moving Back to the UK for more details. Acknowledgements/further information Much of the information in this article has been taken from the Age Concern and the FCO information sheets listed throughout this publication. Age Concern Information for older people planning to leave the UK (Planning to Live Abroad) or moving back to the UK (Moving Back to the UK) is available from the Age Concern website at www.ageconcern.org.uk or via their Information Line on 0800 009966 (seven days a week from 8am to 7pm). Department for Work and Pensions (DWP) Website: www.dwp.gov.uk email: ion-pass@xerox.com Fit for Travel Travel health information for people travelling abroad from the UK. Website: www.fitfortravel.nhs.uk Hospital for Tropical Diseases, London Adviceline: 020 7950 7799 International Pension Centre Website: www.thepensionservice.gov.uk Tel: 0191 218 7777 National Travel Health Network Centre (NaTHNaC) Website: www.nathnac.org/travel/ or email: nathnac@uclh.nhs.uk Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 5
The Foreign and Commonwealth Office See the information sheet Retiring Overseas, which contains many useful tips. Available from their website: www.fco.gov.uk or from 0845 8502829. HM Revenue and Customs (HRMC) See their website www.hmrc.gov.uk or contact your local HRMC Enquiry Centre the number should be in the local phone book. Survival Books This is a small UK publisher of books that provide practical information for anyone planning to live, work, retire or buy a home abroad. Books include a Retiring Abroad in France (ISBN 1-901130-61-8) and in Spain (ISBN 1-901130-73-7) and a Living and Working series of guides to different countries, including Spain. See the website www.survivalbooks.net or phone 01935 700060. Parkinson s Association in Spain Asociación Parkinson Internet (Apanet) is a Spanish-speaking organisation, though it is possible that some of their members/staff may speak some English. Asociación Parkinson Internet Calle Collado de Marichiva 3, 3ºA 28035 Madrid Tel: (+34) 913 763 114 Email: parkinson@apanet.org.es Website: www.apanet.org.es We don t know of any expatriate Parkinson s groups in Spain. However, Age Concern has an office in Spain. Age Concern España works to support the significant number of older people living in Spain for whom English is their first or second language. Age Concern España is in a unique position to provide support to these people through its large network of Englishspeaking volunteers. They are also committed to integration in Spain and are developing stronger links with Spanish organisations. Their website has some information on moving to Spain and there are a number of local organisations within Spain. They have a useful information sheet Retiring to Spain which you can download from their website. Age Concern España (The Federation) Apartado 7 07180 Santa Ponsa Mallorca Spain Tel: (+34) 971 71 87 94 Email: info@ageconcern-espana.org Website: www.acespana.org Some information about the DWP and the International Pension Centre DWP s international business is dealt with by the International Pension Centre (IPC). The IPC also deals with (some) working-age benefits and healthcare, the latter for people within the European Economic Area (EEA). Its role is to ensure that all customers receive their full entitlements when they travel abroad, both in accordance with UK law and also the UK s various agreements with other countries including, of course, the EEA. The E121 is a vital document for UK pensioners moving to live in the EEA. It entitles the pensioner (and their dependants) to health care in their new country of residence, but only state-funded medical treatment is covered. This means a UK pensioner in, say, Spain gets the same cover as a Spaniard would under the Spanish Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 6
scheme. The EEA system of health cover does have limitations. For example, a UK pensioner in Spain should get free of charge whatever treatment a Spaniard gets free but, equally, they must pay whatever a Spaniard pays. Treatment obtained privately is not covered, so charges for such treatment are nonrefundable. So too is repatriation to the UK either alive or otherwise. These rules apply in all countries across the EEA and not just Spain. The European Health Insurance Card cannot be used if you move to the EEA permanently. It is imperative that people find out about the healthcare scheme of the country concerned well before they actually decide whether to move. In France, for example, there is a 70/30% system in place. The individual has to pay all costs up front and can claim 70% back from the French scheme. However, the remaining 30% is the individual s responsibility and many people living in France (including French people themselves) take out supplementary private insurance. Another point is that people may be reasonably fit and healthy when they first move abroad but they do need to consider what they will do and how their partner will cope if, say, either of them require constant care in the future. The UK has a social security agreement with various countries in the EEA. For further information about paying national insurance, what benefits are payable in the EEA, and information about healthcare visit the following link to the DWP website www.dwp.gov.uk/ international/ssa.asp. Pensioners who are moving to live abroad should contact the IPC to tell them about their move and any revised banking arrangements. If you are going to an EEA country, the IPC will also automatically issue form E121 if it is appropriate. Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 7
Parkinson s Disease Society 215 Vauxhall Bridge Road, London SW1V 1EJ, UK Tel: 020 7931 8080 Fax: 020 7233 9908 Helpline: 0808 800 0303 (The Helpline is a confidential service. Calls are free from UK landlines and some mobile networks) Email: enquiries@parkinsons.org.uk Website: www.parkinsons.org.uk Parkinson s Disease Society of the United Kingdom (2008) Charity registered in England and Wales No. 258197 and in Scotland No. SC037554. A company limited by guarantee. Registered No. 948776 (London) Registered office: 215 Vauxhall Bridge Road, London SW1V 1EJ Revised February 2009 To obtain any PDS resource, please go online to www.parkinsons.org.uk or contact Sharward Services Ltd, the appointed PDS Distribution House, at Westerfield Business Centre, Main Road, Westerfield, Ipswich, Suffolk IP6 9AB, tel: 01473 212115, fax: 01473 212114, email: pds@sharward.co.uk Contact the Parkinson s Disease Society freephone helpline for advice and information on 0808 800 0303 8 Code FS82