If you are visiting the United Kingdom and require treatment in our hospitals, you may have to pay for this. The NHS provides free hospital treatment to anyone who is ordinarily resident (settled and living in the UK) in the UK whatever their nationality. If you are not ordinarily resident at the time of treatment, you will have ‘overseas visitor,’ status. This means that you may be charged for the treatment you receive.
What happens if I need to attend the accident and emergency department (A&E)?
You will not be charged for treatment that you receive in the A&E department. However, if you are admitted as an inpatient then charges may apply.
For those overseas citizens in possession of a valid European Health Insurance Card (EHIC) please present your card to our A&E and Triage reception staff.
If your country of residence has a reciprocal agreement covering your emergency treatment in the UK please advise our A&E reception staff.
In these instances, we will re-coup the cost for your care from your country of residence.
We will always provide treatment that a clinician has assessed as immediately necessary or urgent. All maternity treatment is regarded as immediately necessary (Please refer to the section on Maternity). Treatment is not free however by virtue of it being immediately necessary or urgent, we would not stop this treatment, however if you are a chargeable overseas visitor, you will be charged for any admitted (inpatient) or outpatient care you receive.
For treatment assessed by a clinician as non-urgent, the full estimated cost of treatment must be paid before treatment is provided. This will include the cost of initial assessment and investigations to make a diagnosis. You will be provided with our bank details and a unique reference to be able to make payment to an account for your treatment.
Recovering charges for NHS services
NHS trusts have a legal obligation to identify patients who are not entitled to free NHS treatment and to make and recover charges for the NHS services provided. These obligations are set out in the guidance published by the Department of Health.
You may be contacted by the overseas visitors’ team and asked to confirm continual UK residence, immigration status, nationality and / or status under the EU settlement scheme, in order for the hospital to assess whether you are ordinarily resident in the UK, and not affected by the charging regulations.
You should be prepared to provide evidence if requested and this would be one item from the following list:
- Current signed passport
- Residence permit issued by UK Border Agency – Biometric Residence Permit (BRP)
- If you’re claiming asylum, an asylum registration card (ARC)
- EU or Swiss national identity card
- Valid armed forces or police identity card
We also require proof of address. These documents must include your current address and dated within the last six months.
- an original, recent utility bill (gas, electric, water, or telephone – but not a mobile phone bill)
- council tax bill (current year)
- bank, building society, or credit union statement or passbook
- an original, recent mortgage statement from a recognised lender
- current council, or housing association rent book or tenancy agreement
- notification letter from Department for Work and Pensions confirming your right to benefit or state pension
EU and EEA (European Economic Area) visitors
If you are an EU national and do not have status under the EU settlement scheme (excludes EU nationals from the Republic of Ireland), (even if you usually live in the UK) you will not be ordinarily resident and may be required to pay for certain types of NHS hospital treatment. For more information visit – Apply to the EU Settlement Scheme (settled and pre-settled status)
Visitors to the UK from an EU country who fall ill or have a medical emergency during a temporary stay in England can use a valid European Health Insurance Card (EHIC) issued by their home country to access healthcare. Planned treatment is not covered by the EHIC. Visitors from the EU will need to arrange an S2 form from the relevant organisation in their home country before travelling to England. The S2 only covers state-provided treatment in a hospital and will not include travel or hotel costs.
Visitors may have to pay for treatment if:
- an EHIC cannot be provided
- a PRC cannot be obtained from the relevant EU member state
- an S2 form has not been issued
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 Norwegian 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.
Non EEA patients
If you are a Non EEA national you may be asked to confirm you have Indefinite Leave to Remain as your residence permit to live in the UK, or have another kind of settled visa (more than 6 months in length), and have paid the Health Surcharge to the Home Office.
If you are in the UK with a visit visa, whilst lawfully here, you will not be considered a settled UK resident and will be required to pay.
Resident in a Non EEA country that has a Bilateral Health Agreement with the UK
If you are usually resident in: Anguilla; Australia; Bosnia and Herzegovina; British Virgin Islands; Falkland Islands; Gibraltar; Isle of Man; Jersey; Kosovo; Macedonia; Montenegro; Montserrat; New Zealand; Serbia; St Helena; Turks and Caicos Islands; then you may not have to pay for all of your care.
We will ask you to confirm residence in the overseas country, or that you are a national of the country – The Overseas Visitor Manager will advise what evidence you need to provide and what care you are eligible for.
UK nationals who no longer live in the UK
Because the NHS is a residency-based system, under NHS rules UK nationals who move abroad on a permanent basis lose their entitlement to free NHS healthcare.
UK nationals who moved to the EU on or after 1 January 2021 should not expect to use NHS services for free when visiting the UK unless they have an EHIC, PRC or S2 to show that their healthcare costs are funded by the EU country where they reside, or another exemption applies.
The UK government always advises visitors to the UK to take out travel or health insurance that has the necessary healthcare coverage for their needs. This is particularly important for those with pre-existing health conditions. Appropriate insurance means visitors may be able to recoup any treatment costs from their insurer.
Some women may be asked to pay for their maternity care. All maternity services, such as scans, are so important to the mothers’ health and that of her unborn baby that they will not be denied or delayed even if the mother does not have the funds to pay for treatment immediately. Charges will still be invoiced and expected to be paid at a later date. If this applies to you, you can contact the overseas team for more details.
All maternity treatment is regarded as immediately necessary. Treatment is not free however by virtue of it being immediately necessary or urgent, treatment would not be denied or delayed and you will still be charged. Patients still need to be ‘ordinarily resident’ in order to have free NHS care however we will not stop treatment if someone cannot afford to access their care.
Maternity services include all antenatal, intrapartum and postnatal services provided to a pregnant person, a person who has recently given birth or a baby. No one must ever be denied, or have delayed, maternity services due to charging issues.
No  woman must ever be denied, or have delayed, maternity services due to charging issues. Due to the severe health risks associated with conditions such as eclampsia and pre-eclampsia, and in order to protect the lives of both mother and unborn baby, all maternity services, including routine antenatal treatment, must be treated as being immediately necessary.
 Pregnant women includes any women who are pregnant as well as transgender or non-binary people who are pregnant.
IVF Funded services are for permanent ordinary resident patients only who are living in the UK lawfully (ie British Citizens living here and Non British Citizens who hold Indefinite Leave to Remain status). Patients who have paid the Immigration Health Surcharge and therefore usually can have full access to the NHS services will be fully chargeable for IVF services. Even if one partner is a IHS payee and the other is a permanent resident, the IHS payee will be chargeable and the partner exempt from charges.
Along with ICB Funding criteria all fertility referrals are screened by the OVM team to check they are ordinarily residents or if they have indefinite leave to remain. If they are on any other type of visa they will have the option to pay privately for their care.
How will I know if I have to pay?
The overseas visitors team can provide you with more detailed information if you are unsure whether you are entitled to free hospital treatment. You will be asked to provide evidence of entitlement – the overseas visitors team can advise you of what documents are acceptable. If you are deemed to be chargeable then an invoice will be raised for your treatment.
You will have the opportunity to pay:
- from an overseas bank account
- by debit / credit card
- by cash with our cashiers department
With all payment methods you should quote the account number on your invoice. All routine and planned care must be paid for in advance of care being received.
Overseas Visitors who may qualify for free healthcare
- If you live in a country that has a Reciprocal healthcare agreement with the UK, you may be entitled to free healthcare. Our overseas office can advise you.
- If you are a European national with a valid European Health Insurance Card (EHIC) you will be entitled to free emergency treatment, but not planned care. If you are unable to show a valid EHIC, you will need to pay for your treatment.
- If you are a refugee or asylum seeker whose formal application is being considered by the UK Border Agency, you will need to provide the overseas officer with documentary evidence of your asylum claim before treatment commences. If this is confirmed then you will be entitled to receive free treatment.
- Visitors from countries with no Reciprocal agreement and people who have no legal rights to be in the UK, including failed asylum seekers and illegal immigrants, are not entitled to free hospital treatment.
Overseas visitors who may not qualify for healthcare
- An individual without legal status at point of treatment including failed asylum seekers and illegal immigrants if not supported by Home Office or Local Authority
- Ex-pats who now ordinarily reside overseas.
- An individual with a Biometric Residency Permit (BRP) whose card is marked to confirm their “visitor” or “temporary stay” status in the UK. This may include academic visitors and private medical visitors.
Overseas visitors with private health insurance
If you have private health insurance you must provide a letter of guarantee from your insurer to cover the full cost of your treatment. If you are unable to provide a letter of guarantee you will need to cover the costs of your treatment and seek reimbursement from your insurer.
We may use your information to
- Establish your identity and your entitlement to free NHS treatment
- Notify the Department of Health and Social Care of an NHS debtor
- Determine your immigration status using Home Office services (you will be informed if this happens)
Please contact the Overseas Visitors Department for further guidance and support or to find details on how to send your documents to the team.
Please see details below on how to get in touch during office hours:
Tel: 07464 495475