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How do I show I have Comprehensive Sickness Insurance (CSI)?

21 October 2020 Iain Halliday Blog


Following two changes to nationality policy, the first in May 2020 and the second in September 2020, EEA nationals who want to become British citizens now need to answer the questions: how do I show I have Comprehensive Sickness Insurance (CSI)?

When deciding citizenship applications, the Home Office will now look at the last 10 years and, if you were in the UK during that period, they will assess whether CSI was required. If it was required, and you did not have it, your citizenship application can be refused.

CSI is not required for settled status or pre-settled status. Nothing in this post applies to those types of application. The change in policy relates to the good character requirement for citizenship applications. If you did not have CSI when this was required, this is considered to be a breach of UK immigration law. Those who have breached UK immigration law within the last 10 years are generally unable to meet the good character requirement.


Do I even need CSI?

CSI is only required for EEA nationals who have not worked continuously for 5 years. If you have always worked and paid National Insurance contributions, then you do not need to read any further.

If you have lengthy gaps in employment, have never worked, or have studied in the UK within the last 10 years, then you will need to consider whether you need to show CSI before applying for citizenship.

If you can show that you acquired permanent residence at some point in the past, then you do not need to show you had CSI.

Example 1


Marcin is an EEA national came to the UK with his parents in 2012, when he was 15 years old. He is now 22. His father has worked continuously since the family’s entry to the UK. Marcin attended school until the age of 18 and is currently at University. He has never worked in the UK. He was granted settled status in 2019 and wants to apply for citizenship.


As a student, Marcin may think he needs CSI. However, he can, instead, show that he acquired permanent residence in 2017 as he has lived in the UK as the family member of an EEA national (his father) who has worked for 5 years. Although he is no longer a family member (as he is over 21), once you have acquired permanent residence CSI is no longer required. Permanent residence is acquired automatically so it does not matter that he has never had a document certifying permanent residence.


Example 2


Javier came to the UK in 2010 and worked continuously until 2016, when he stopped working in order to take care of his children. He has been a ‘stay at home dad’ since. His wife is a British citizen; her earnings are sufficient to provide for the family. Again, Javier may think he needs CSI as he is not currently working and is not the family member of an EEA national who is working (as British citizens are not included within the definition of “EEA national”). However as he acquired permanent residence in 2015, he does not require CSI.

In both of these examples, the applicants would need to provide evidence to establish that they have acquired permanent residence at some point in the past by providing, for example, P60 certificates.

Alternatively, if you can show that you were engaged in genuine and effective work during your studies, you can be treated as a worker, rather than as a student, meaning that no CSI is required. Part time work can, in some circumstances, constitute genuine and effective work.

If you are unable to rely on a historic period of residence or part time work, then you need to meet the CSI requirement.

How to show the CSI requirement is met?


There are three ways to show that the CSI requirement has been met.

The most obvious is that you had private health insurance cover. However, most people were completely unaware of the requirement, so would not have purchased this.  

Alternatively, if you had an EHIC card issued by your country of nationality, this will meet the requirement. An EHIC issued by the UK is not sufficient.

Finally, if you are (or were) entitled to healthcare in your country of nationality and they would have reimbursed the UK if you had fallen ill, this will meet the requirement. It is sometimes possible to get a letter from your national Government confirming cover.  

Example 3


Olivia is a Swedish national who came to the UK in 2014 and completed her Master’s degree. She studied for the 2014-15 academic year and has worked continuously since September 2015. She did not have private health insurance or an EHIC during her studies. However, Sweden has a publicly funded healthcare system and, had she fallen ill whilst studying in the UK, the cost of her treatment would have been covered by the Swedish Government. She can request a letter from the Swedish Social Insurance Agency confirming the dates she was covered and use this to meet the CSI requirement for her period of studying.    


If you are considering applying for British citizenship, and are concerned that the CSI requirement may be a problem, then please get in touch.


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