The NHS in England is a residence-based system. This means that not everyone is entitled to free NHS hospital treatment. An overseas visitor is any person who is not 'ordinarily resident' in the UK.
If you think that you are exempt from charges, our Overseas Visitors Manager will ask you to provide evidence to confirm that you are eligible to have free NHS treatment – we are required by law to do this.
From 23 October 2017 the law in the UK placed a requirement on all providers of NHS-funded secondary care to make and recover charges from overseas visitors where relevant services have been provided to them and no exemption applies.
This means that patients may be asked to provide documentation to prove their residency in the UK before treatments are given.
If any overseas patients assessed are not entitled, the treating clinician will be asked to make the decision on the severity of the patient's needs. All treatment for 'immediately necessary' and 'urgent' care will not be refused but will remain chargeable. However if a patient is not entitled to free NHS treatments they will be asked to pay in advance of their treatment or have their non-urgent treatments refused.
The baseline questions you will be asked are:
Have you lived in the UK for the past six months? (Y/N)
Do you have an EHIC (European Health Insurance Card) or other documents to show that you are entitled to free NHS care? (Y/N)
Visitors from the European Economic Area (EEA)
If you fall ill or have a medical emergency during your temporary stay in England, then you'll need a valid European Health Insurance Card (EHIC) issued by your home country. If you can't show a valid EHIC, you may be charged for your treatment.
If your EHIC has been lost or stolen during your visit in England and you need a replacement, then you'll have to contact the relevant organisation in your home country to request a Provisional Replacement Certificate (PRC).
If you do not have an EHIC and cannot obtain a PRC, you will be charged at 150% of the national NHS rate.
Visitors to the UK from Norway, Iceland, Liechtenstein and Switzerland
Visitors to the UK from Norway will be able to access medically necessary care in the UK by presenting a valid Norweigen passport.
Visitors from Iceland, Liechtenstein and Switzerland who fall ill or have a medical emergency during a temporary stay in England may have to pay for NHS healthcare. Any treatment that has to be paid for will be charged at 150% of the national NHS rate.
Visitors from a non-EEA country
You need to ensure you are covered for healthcare through personal medical or travel insurance for the duration of your visit even if you are a former UK resident. If you need NHS treatment and you have not arranged insurance, you will be charged unless an exemption category applies to either you or the treatment.
Further up-to-date information on categories of people who are exempt from charges is available on the NHS website (please see 'Related Links' on the left).
If we decide that you are not entitled to free NHS treatment (in accordance with current overseas visitors hospital charging regulations), you will have to pay for your treatment and the full cost of any prescribed medication and asked to sign an ‘Undertaking to Pay’ form.
We prefer you to pay by bank transfer, credit /debit cards, although we do accept banker’s draft, or cash.
If you have travel insurance you will have to pay for your treatment first and then reclaim it back from your insurance company afterwards. If for any reason, you require further treatment, additional charges will be made.
To discuss your circumstances please contact our Overseas Visitors Manger.
Tel: 01493 453084 or email: firstname.lastname@example.org
EEA Residents Living and Working in the UK before 1st January 2021
If you are a citizen of EU countries, Norway, Iceland, Liechtenstein or Switzerland and were lawfully resident in the UK on or before 31 December 2020, you will continue to receive access to NHS-funded healthcare as long as you meet the ordinary residence test. You must also apply to the EU Settlement Scheme and will have until the 30th June to do so.
Once granted either pre-settled or settled status, or while an application is pending, you will then not be charged for healthcare, as long as you continue to be ordinarily resident in the UK. Patients will be asked for evidence of pre-settled or settled status and proof of ordinary residence.
For further information regarding the EU Settlement Scheme please follow this link: https://www.gov.uk/settled-status-eu-citizens-families.
EEA Nationals Living and Working in the UK after 1st January 2021
If you are a National of an EU country, Norway, Iceland, Liechtenstein or Switzerland and were not resident in the UK before the 1st January 2021, you will be subject to immigration control.
Those who are subject to immigration control (except Irish nationals) must pay the immigration health surcharge when applying for a visa to enter and remain in the UK for more than six months (exemptions to this currently applies for healthcare workers).
You cannot be considered as ordinarily resident in the UK until you have been granted indefinite leave to remain.
For further information please follow this link:
Frequently asked questions
Free NHS Hospital treatment is a residency based system. People who do not normally live in this country are not automatically entitled to use the NHS secondary care free of charge – regardless of their nationality or whether they hold a British passport or have lived and paid national insurance contributions in this country in the past. This includes British Citizens who are no longer resident in the UK.
Yes, those with valid European Health Insurance Cards (EHICs) or Provisional Replacement certificates (PRCs) are covered for all maternity care, including antenatal and postnatal care, providing the reason for their visit was not specifically to give birth or receive maternity treatment.
A person can be ordinarily resident in more than one country at once. As long as they are properly settled here, despite spending more time in their other place of residence, they will meet the ordinary residence test. There is no requirement that the time be equally split between the UK and another country in order to maintain ordinary residence in the UK. Where a person has lived in more than one country for several years, consideration needs to be given to whether there is a pattern of regular trips to the UK over the years that demonstrates a sufficient degree of continuity to establish ordinary residence in the UK. The length and number of trips to the UK, family and other relationships with people in the UK, financial, property and other connections to the UK will all be relevant factors in determining if the person is ordinarily resident in the UK despite spending time living in another country. If you live only in Spain, and are only here as a visitor, not as a resident, then they will not meet the ordinary residence test.
Visitors who are residents in the EEA and hold a valid European Health Insurance Card (EHIC) or Provisional Replacement Certificate (PRC) are entitled to receive all immediately necessary treatment free of charge or that the need of which arises whilst visiting the UK. If EEA visitors do not have a valid EHIC or PRC and no other exemption applies, then they will be personally liable for any treatment other than A&E that they access. Your European Health Insurance Card will not cover you for elective treatment.
Emergency healthcare is free to everyone ONLY in the Accident & Emergency Department.