Moving to Canada

[chloenelson1993]

Hi all,

I should probably start by giving a brief outline . So I'm type 1, have been for 17 years, always struggled and finally got a kick up the bum to sort it out in 2015. HbA1c down from 108 to 80 ( maybe less I have a check up soon , fingers crossed). I am also the girlfriend of someone in the Army, who has just been told he is being posted to Canada!

I've always assumed I could never be a traveller or imagined moving to another country because of my diabetes as I'm not sure how the care would work and monitoring ( which currently is every 3 months because I'm trying to reduce my hba1c). However I have noticed from various social media following and forums that actually there are a few people who do this and do so fine and well.

I'm just wondering if there was anyone on here who had also moved abroad or travelled for a long length of time and any tips and how it all works really with prescriptions and care. Do you get seen there ? Do you come home for appointments ? Do you get meds from a doctor there or here?

 

[azure]

Sounds very exciting @chloenelson1993

Do you know how long you'd be in Canada and which province you'd be in?

 

[chloenelson1993]

I'll be honest it's a thought, currently there are no final decisions.

It would be 2 years however, coming back to the UK 3 times per year hopefully and it's a place called Alberta ?

 

[azure]

I'll be honest it's a thought, currently there are no final decisions.

It would be 2 years however, coming back to the UK 3 times per year hopefully and it's a place called Alberta ?

Ok, so if it was me I'd be asking if I got any special medical cover from your partner being in the army,firstly.

Then I'd Google healthcare in Alberta to try to get an idea of what's available. If you'll be working, then you could look into how that would affect your medical care/cover.

 

[azure]

Google is your friend for basic info:

https://www.gov.uk/guidance/living-in-canada

http://www.telegraph.co.uk/news/health/expat-health/7949665/Expat-guide-to-Canada-health-care.html



.

 

[bulkbiker]

Might be worth changing your title to Moving to Canada?
There are a few Canadians on the forum who maybe able to help with how healthcare there works..
@NoCrbs4Me is in Canada and there are more whose names I can't recall at the moment.
I would second Azures advice to see if the army will give you any cover although when I lived overseas it was only to married couples (but that was in the 1990's)

 

[DCUKMod]

@chloenelson1993 - It would be worthwhile asking your boyfriend to enquire about health cover for you when you are there, if you are officially going as his partner/dependant.

Maaany moons ago, I worked overseas, attached to military establishments and was included in their excellent health care arrangements, including free medical (including prescriptions) and detail treatment. In this days, long, long ago, for partners to be included in these arrangements, they had to be married, but I have a feeling things may have moved on from then. I don't know though.

If you were to be included in your boyfriend's healthcare arrangements (they differed slightly, but just slightly for serving (or contracted) people and their dependants, I would probably also want to check what any necessary Endo arrangements would be, due to T1s being unable to serve.

I must admit, I had 6 years overseas in military environments, and often the only young, single (in my 20s) Brit woman around. I, erm,...... had a great, lively social life.

Have you had a look here? http://www.army.mod.uk/welfare-support/23237.aspx

 

[NoCrbs4Me]

I'll be honest it's a thought, currently there are no final decisions.

It would be 2 years however, coming back to the UK 3 times per year hopefully and it's a place called Alberta ?

Sounds like your boyfriend is going to BATUS at CFB Suffield, which is the British Army's largest armoured training facility (https://en.wikipedia.org/wiki/British_Army_Training_Unit_Suffield). That's not too far from where I live in Calgary. Suffield is a lovely place - it can get down to -40 C in the winter.

We have a modern western medical system here that is free for residents. If you move to Alberta from outside of Canada your coverage begins on your date of arrival in Alberta, once all registration validation requirements are met. (http://www.health.alberta.ca/AHCIP/register-for-AHCIP.html)

Insulin is only covered here up to CDN$600 per year (http://www.health.alberta.ca/services/diabetic-supplies.html). However, if you were a dependent of someone in the British army posted to Canada, I'm guessing the British government has some mechanism for health care for people posted here. I think your boyfriend should ask about how it would work for your health care coverage with his superiors in his unit. If you're not considered a dependent, you might need to get married to get health care coverage through the army or even live with him on base.

One important thing to address: I doubt you can just move to Alberta with your boyfriend without going through the paperwork/bureaucracy of becoming a landed immigrant (http://www.cic.gc.ca/english/immigrate/index.asp). I would think it would not be an issue if you're married to someone posted to Canada with the army.

Hope this helps.

 

[beckysalvage]

Hi @chloenelson1993

I moved to Costa Rica last year for a 2 year job so I know what you are going through! Its scary but alot of things can be sorted out before you leave and (luckily!) you are going somewhere where the language is English!

Definitely follow the advice of @NoCrbs4Me and @DCUKMod and check out what you can get through your boyfriend as a dependent, as you might be totally covered, who knows!

Talk to your care team at home about moving. I started to stockpile insulin (about 6 months worth) before I left as your GP can only prescribe 3 months in one go. You might be able to get the same insulin over there, but you might not and it is worth having a supply to keep you going until your insurance etc gets sorted. Costa Rica is a little different as they do not provide the insulin I am on (Glargine and Humalog) on their version of the NHS. You can however buy it over the counter (no questions asked, which I find very strange) but it is expensive. I currently return to the UK every 6 months or so and stock up on all my insulin/test strips etc and fly back with it all which is a pain, but I have no diabetes specialist team out here.

Canada (I think!) is likely to be more developed in their diabetes care than Costa Rica. It is worth using google to search for diabetes specialists in the area you will be going to and contacting them if possible to ask about the general diabetes care there.

Let us know how you get on, and PM me if you want to chat more about moving to another country. It might be a pain, but it is totally worth it! Last week I went to the Pacific ocean and sat on the veranda of an airbnb house with a sloth in the tree above me and a troop of spider monkeys playing on the roof! It could be worse!

Becky xxx

 

[ringi]

I am beginning to think that the NHS should check if you are tax resident in the UK before giving you any prescriptions or treatments....

 

[azure]

I am beginning to think that the NHS should check if you are tax resident in the UK before giving you any prescriptions or treatments....

It's not to do with paying taxes. It's if a person is "ordinarily resident" and a person can be working abroad and still count as "ordinarily resident" for the purposes of NHS treatmemt.

 

[cott97]

They must be resident for a minimum of 3 months to qualify as ordinarily resident or be able to prove that you intend to be.

 

[ringi]

It's not to do with paying taxes. It's if a person is "ordinarily resident" and a person can be working abroad and still count as "ordinarily resident" for the purposes of NHS treatmemt.

"ordinarily resident" is the concept behind the rules on someone having to pay tax in the UK, but for some reason, people think it is OK to tell the HMRC they don't live in the UK, but yet come back to use the NHS when needed.

 

[DCUKMod]

They must be resident for a minimum of 3 months to qualify as ordinarily resident or be able to prove that you intend to be.

GPs have quite a bit of discretion on that (very accurate) description. Both myself and more so my OH have had reason to discuss it with out GP, at one time or another. His response was that the rules are really there to avoid people living overseas (he did name a country, but no point upsetting folks who live there) from jumping on an EasyJet flight to attend their NHS hospital appointments, then heading back for the next flight out.

He set a lot of (personal) stall by the fact that we maintain a property here at all times and don't let it out when neither of us are here. That particular GP has retired, but we have both continued to be totally honest about our lifestyle and the replacement GP is happy to continue with the existing arrangements, and in fact always asks when we're next away.

Lots of people in the sailing community are affected by this and their experiences are very mixed.

 

[ringi]

He set a lot of (personal) stall by the fact that we maintain a property here at all times and don't let it out when neither of us are here. That particular GP has retired, but we have both continued to be totally honest about our lifestyle and the replacement GP is happy to continue with the existing arrangements, and in fact always asks when we're next away.

Lots of people in the sailing community are affected by this and their experiences are very mixed.

The HMRC have won court cases based on someone keeping a property for their usage in the UK (along with golf club membership etc) showing they are still resident in the UK even when they are out of the UK for most of the year.

Cypus is the real con (unless it has changed) as someone can retire there and only pay 5% tax on their pension, but as soon as the health insurance becomes too much claim it is only a holiday home.

 

[azure]

"ordinarily resident" is the concept behind the rules on someone having to pay tax in the UK, but for some reason, people think it is OK to tell the HMRC they don't live in the UK, but yet come back to use the NHS when needed.

If you believe someone is committing a fraud then you should repirt them, but it's possible to be "ordinarily resident" in more than one country and it's also possible for someone to be working abroad and still qualify for NHS treatment.

@cott97 Im not sure where you got the three months from?

 

[cott97]

NHS rules. I've applied them for someone in one of those warm countries relatively recently. As another poster says GPs use their common sense - you won't be delisted generally for a 6 month cruise but if it was known you were living abroad then you would be. It's not necessarily the primary care that's the issue but the use of secondary care.

 

[DCUKMod]

I would add that the forces medical system is effectively the NHS, although in my time of being covered by the forces system, it was significantly better than the "usual" NHS, in almost every regard. That was a few years ago now, so I wouldn't like to make any comparative judgements for these days.

 

[ringi]

@cott97 Im not sure where you got the three months from?

I think it comes from a very old tax test case when the judge had to define what resident means.

This mess could mostly be all sorted out if the NHS and HMRC used the same database of people who are resistant in the UK with all the rules being the same.

it's possible to be "ordinarily resident" in more than one country

Then the tax is paid in both countries with the tax paid in the lower tax county offset against the high tax country. Normally the person has access to healthcare in both countries.

possible for someone to be working abroad and still qualify for NHS treatment.

In nearly all cases of this, the person still has to pay tax in the UK if they tell everyone the full truth. (With complex rules to stop double tax.)

 

[cott97]

There are strict rules regarding NHS services which though rarely fully applied are enshrined in legislation. Regardless of where they originated they are the rules we can apply and if you are living abroad for more than 3 months you lose your entitlement to free NHS care. Anyone is entitled to immediate and necessary treatment from their GP and quite what that covers is an interesting debate.