Form

Apply 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 (EEA).

Documents

Apply online (sign in using Government Gateway)

Apply by post

Details

To apply for a healthcare certificate E106 or E109 in the EEA, you can:

  • use the online service
  • fill in the form on-screen, print and post to HMRC

Applying online

To apply online, you need a Government Gateway user ID and password. If you do not have a user ID, you can create one when you apply.

Applying by post

Fill in the form on screen, print it and post it to HMRC.

You’ll need to fill in the form fully before you can print it. You cannot save a partly completed form, so we suggest you gather all your information together before you begin to fill it in.

You must send us a copy of your latest payslip when you return this form.

Send your completed form to:


National Insurance Contributions and Employers Office
HM Revenue and Customs
BX9 1AN
United Kingdom

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:


HMRC
Local Compliance
Marine Group S0970
PO Box 3900
Glasgow
G70 6AA

Email HMRC to ask for this form in Welsh (Cymraeg).

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Published 4 April 2014
Last updated 24 December 2019 + show all updates
  1. The address for the Department for Work and Pensions has been updated in the guide.

  2. An online service is now available.

  3. First published.