The National Health Service (NHS) is a residency-based healthcare system that works on the concept of ordinary residence. An overseas visitor is anyone who is not ordinarily resident in the United Kingdom (UK), and as such may be subject to charge for healthcare received during the course of a visit to the UK.
If you are visiting the UK or have been living outside the UK for more than six months, you may have to pay for NHS hospital treatment. We are obliged by law to find out if people using our services are eligible for free care, or whether we need to charge you for the treatment you receive.
If you are an overseas visitor and need access to urgent care or maternity services, we will not stop you from accessing treatment, but you may be charged for it.
Eligibility for free hospital treatment
- The NHS provides free hospital treatment to anyone who is a legal resident in the UK on a permanent basis (‘ordinarily resident’)
- If you need urgent treatment at an accident and emergency department (A&E) or a minor injuries unit you will not be charged.
- If you are not a legal resident of the UK, you will be charged for any emergency treatment you received as an inpatient of the hospital, and any follow up outpatient appointments.
- There are some NHS services which are free to everyone. These include: family planning (except termination of pregnancy) diagnosis and treatment of sexually transmitted diseases, and diagnosis and treatment of certain infectious diseases, such as malaria, tuberculosis and measles. A full list of conditions is available on pages 33 to 34 of the Department of Health’s guidance on implementing the overseas visitor charging regulations.
When you qualify for free healthcare:
- If you normally live in a country that has a bilateral healthcare agreement with the UK. This covers emergency treatment only and does not cover planned treatment, or treatment that could be carried out in your country of origin.
- If you normally live in a country covered by European Union regulations and hold a valid European Health Insurance Card (EHIC). This card covers emergency treatment only and does not cover planned treatment. You will need to bring your EHIC card with you to hospital. It must be in your name and within the expiry date to be valid.
- If you are a refugee or asylum seeker whose formal application is being considered by the UK Border Agency, you will need to provide evidence in document form to be eligible for free treatment. You will need to pay for any medication prescribed to you.
- If you are a student or have come to work in the UK, and have paid an NHS surcharge which entitles you to full use of the NHS, you will be asked for evidence of your payment in document form to be eligible for free treatment. This does not cover planned treatment for assisted conception, which will need to be paid for.
- If you have private health insurance and are able to provide a letter of guarantee from your insurer confirming they will cover the costs of your treatment. If you are unable to provide a letter of guarantee, you will need to cover the cost of your treatment and seek to have it reimbursed by your insurer.
- If you normally live in a country covered by European Union regulations and intend to have any pre-planned treatment, you will need to present a valid S2/E112 document. This document is a guarantee of payment issued by the EEA member state which is necessary to allow the UK to recover costs of treating EEA residents.
Should you have an S2 document, you must make advance arrangements and you will be given the same clinical priority as NHS patients, including NHS waiting times. You will need to send this document in advance to being admitted to the overseas visitors team for processing via email: firstname.lastname@example.org
When you don’t qualify for free healthcare:
- If you are not a legal resident of the UK on a permanent basis (i.e. not ‘ordinarily resident’). This includes failed asylum seekers and illegal immigrants.
- If you are unable to provide the documentation needed to prove you are eligible for free healthcare.
When you come to hospital you will be asked how long you have lived in the UK to determine if you are eligible for free healthcare. You will be asked to show documentary evidence that you are living legally in the UK, including proof of identity and proof of address.
If you are an overseas visitor, you will be asked to show evidence that you are entitled to free healthcare during your visit.
If you are a parent bringing your child to hospital, you must bring documents to show your child is legally resident in the UK. These documents can be used as proof of identity:
- Current, signed passport
- Residence permit used by the UK Border Agency
- Valid UK photo card driving license
- Valid armed forces or police photographic identity card
- Photographic disabled blue badge
- Citizen card
- Application Registration Card for patients who are claiming asylum
These documents can be used as proof of address provided they show your current address and date for the last six months:
- Original, not photocopied, utility bill such as gas, electric, water or telephone. Mobile phone bills cannot be accepted
- Bank, building society or credit union statement or passbook
- Original, not photocopied, mortgage statement from any UK lender including banks and building societies
- Council tax bill for the current year
- Current council or housing association rent book or tenancy agreement
- Notification letter from the Department for Work and Pensions confirming your right to benefits or state pension
If you cannot prove that you have lived legally in the UK for the last six months, you will be interviewed by a member of our overseas visitors team either on the ward or in an outpatient clinic.
At the interview, we will ask you questions and confirm if you need to pay for your treatment, and explain how you can pay. Should you believe you should not pay, you will need to evidence that you are eligible for free NHS care. If you are liable to pay, the cost of your treatment will be explained and we will ask you to pay before you receive treatment (if the care is non-urgent). You will be provided with a leaflet containing further information on overseas visitor charging.
If charges apply, you will be asked to sign an undertaking to pay form, which confirms your details, home address and a copy of the Trust’s overseas visitors terms and conditions.
If your interview happens after your first visit to hospital, or care is emergency or urgent, we will charge you retrospectively for your treatment.
Please note the onus is on the individual patient receiving treatment to provide appropriate documentary evidence supporting any claim to free NHS services.
Cost of treatment
As of 23 October 2017 it is a legal requirement that all patients not eligible for free NHS treatment pay the estimated full cost of their care upfront and in full before any treatment begins. Our overseas office will advise you of the estimated cost of the treatment you are going to receive.
We will not withhold any emergency treatment from you if you are unable to pay, however non-urgent care may be withheld until we receive your full payment. If you have made an initial payment towards the cost of your treatment we will confirm how much you have left to pay and provide you with a final invoice once all your hospital care has been fully updated and coded.
How to pay
You can pay for your treatment by debit or credit card via an overseas visitors officer, or in cash, at the cashiers office (level 7).
You can contact our overseas office by telephone or email. We can arrange to come and visit you on the ward or in the outpatients’ department.
Monday to Friday, 09.00 to 17.00
01752 437 055