National Insurance: application for healthcare cover in the European Economic Area (CA8454)
Use the online service or postal form to apply for a healthcare certificate E106 or E109 in the European Economic Area.
Ref: CA8454 https://public-online.hmrc.gov.uk/lc/content/xfaforms/profiles/forms.html?contentRoot=repository:///Applications/NICs_iForms/1.0/CA8454&template=CA8454.xdp
To apply for a healthcare certificate E106 or E109 in the European Economic Area, you can:
- use the online service (sign-in or set up a Government Gateway account)
- fill in form on-screen, print and post to HM Revenue and Customs (HMRC)
You may need to include attachments if you’re currently working for a UK employer. You must send us a copy of your latest payslip when you return this form.
The address is:
HM Revenue and Customs
If you’re a mariner, fill in the mariners’ questionnaire and include this, a copy of your mariners’ discharge book and latest payslip with your application for health care cover to:
Marine Group S0970
PO Box 3900
Fill in and submit this form online and send any extra information to HMRC by post (for example, a completed mariners’ questionnaire and payslip). You’ll get a unique reference number when you submit the form. Include this number on the information you send by post. You can track the progress of the form online using the same reference number.
Apply by post
Instead, you can download this form, fill it in and send it to HMRC along with the extra information. If you submit the form this way, you can’t track its progress online.
You’ll need to fill in the postal form fully before you can print and post it. You can’t save a partly completed form so you should gather all your information together before you start to fill it in.
Before you start
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