CSI cover was a requirement under EU rules to count periods of studies or self-sufficiency, as lawful residence, and towards PR status.

You need to provide one of the following documents which was valid for the relevant period of study or self-sufficiency:
  • schedule or other document from a private medical insurance provider outlining the level of cover, this must have covered you/your sponsor/your family member(s) for the majority of risks while in the UK
  • European Health Insurance Card (EHIC) (formerly form E111) issued by an EEA Member State (not the UK)
  • form S1 (formerly E106, E109, E121)
  • form S2 (formerly E112)
  • form S3
The following do not count as CSI:
  • cash back health schemes, such as:
    • dental
    • optical
    • prescription charges
  • travel insurance policies
  • access to the UK’s NHS
  • a UK issued EHIC card

Proving past healthcare coverage by another Member State’s social security system

Past coverage under your home country’s social security system can be proved in a number of different ways that differ according to national practices:
  • Italian citizens who came to the UK to study and did not register with AIRE (Anagrafe Italiani residenti all’estero): they can prove this by obtaining a letter confirming their former healthcare coverage from their local healthcare institution (azienda sanitaria locale), if possible with a print-out confirming the dates when they held an Italian Healthcare Insurance Card (Tessera Europea di Assicurazione Malattia).
  • Bulgarian and Romanian citizens may be issued Structure Electronic Document S041 by their social security institution back home which confirms that their citizens remained covered by their home country’s social security system for a specified period of time and therefore were entitled to receive healthcare in the UK at the expense of their home country during that period of time – if you have been issued SED S041, you should download our practice note on SED S041 and include a copy in support of your application for permanent residence.
  • Dutch citizens may also be issued with the old Form E104 , which is a certificate showing periods of previous coverage by their home country’s social security system for a specified period of time and therefore were entitled to receive healthcare in the UK at the expense of their home country during that period of time – if you have been issued Form E104, you should download our practice note on Form E 104 and include a copy in support of your application for permanent residence. [link to document]
Separately, some EEA citizens may be able to invoke the existence of reciprocal arrangements concluded by the UK with individual Member States. The basis for this claim is the ruling by the Court of Appeal in Ahmad v Secretary of State for the Home Department [2014] EWCA Civ 988 in which Arden LJ held “[53] … It is common ground that if there were reciprocal arrangements with the EEA national’s own state that would be sufficient to constitute comprehensive insurance cover.” Please refer to the article linked above.