CAN SOMEONE HELP?: free NHS treatment and NICs

A client has ILR under Windrush since 1987. They are a Belgian citizen, and have never worked in the UK, nor anywhere else for that matter. However, they have paid national contributions to Belgium who now pays their pension.

The client has received a letter by the NHS stating that they can use NHS services but it would be Belgium who has to pay for it.

Now the client is slightly worried as apparently in Belgium the client would be required to pay certain amounts out of their own pocket.

What I don’t understand is, firstly, if someone lives in the UK (even on ILR) but never worked, never claimed any benefits….they would be eligible for free NHS treatment. Secondly, would the client be treated as if they are a patient in Belgium meaning that they would be required to pay it partially themselves?

Does anyone have experience with this? If so, I suppose this is the correct procedure, but is it? Also, how does this reimbursement work practically for the client?

Many, many thanks!

This may be helpful, if you haven’t seen it: https://www.citizensadvice.org.uk/scotland/health/help-with-health-costs/nhs-charges-for-people-from-abroad/#h-getting-healthcare-if-you-re-from-the-eu-eea-or-switzerland

If this is under the S1 or S2 funding routes, then there should be no copayment for treatment in the UK, and reimbursement is resolved between the respective government departments.

It would be the inverse situation, where the UK was the competent state for someone getting treatment in Belgium, where they may have to pay an up-front copayment in line with other residents in that country.