Overseas patients

Who is eligible for free NHS treatment?

The NHS provides free hospital treatment to anyone who is ordinarily resident in the UK whatever your nationality. If you are not ordinarily resident (settled and living in the UK) at the time of treatment, you will have ‘overseas visitor,’ status. This means that you may be charged for the treatment you receive.

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.

How can I prove that I am entitled to free hospital treatment?

To receive free hospital treatment, you will need to provide evidence that you are legally living within the UK.

You will be asked where you have lived in the last 6 months and to provide ID along with evidence to support your ordinarily resident status.

The following documents can be used as proof of identity:

  • current signed passport
  • residence permit issued by UK Border Agency
  • 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.

You can use the following as proof of address:

  • 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 who enterd the UK before 31st December 2020

Austria, Belgium, Bulgaria, Croatia, Cyprus (Southern), Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, UK, plus Iceland, Liechtenstein and Norway. Switzerland by special arrangement.

  • People visiting the UK from these countries will need to supply a valid European Health Insurance Card or replacement certificate for all necessary NHS hospital care to be free of charges to them. An S2 would be required for planned care in the UK
  • A UK State Pensioner living in any of these countries with a registered S1 document for residence overseas will be entitled to all types of NHS hospital treatment without charge
  •  EEA people coming to the UK with the intention to stay may still be insured in their home country and hold a valid European Health Insurance Card – if we obtain it we can reclaim healthcare costs from the EEA country.

EU Settlement Scheme Post 1st January 2021

After 31st December 2020 you will need to apply to the EU Settlement Scheme to continue living in the UK after 30 June 2021. You need to apply if:

The EEA includes the EU countries and also Iceland, Liechtenstein and Norway.

This means you need to apply even if you:

The deadline for applications is 30 June 2021. More information can be found on https://www.gov.uk/settled-status-eu-citizens-families

If you have already received pre-settled or settled status in the UK then provide the details to the Overseas Team to avoid charges.

Non EEA patients

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.

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, this does not include emergency treatment given in any other department in the hospital which will include; 

  • If you are operated upon
  • If you are admitted to an inpatient ward
  • If you are allocated an outpatient appointment.  
  • For those overseas citizens in possession of a valid European Health Insurance Card (EHIC) please present your card to our A&E 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 of your care from your country of residence.

If I am not eligible for free treatment, what will I have to pay for?

You will be charged for any treatment given to you, by any member of staff in any of our services, both in the hospital or in the community. National guidance states that 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.

We will always provide treatment that a clinician has assessed as immediately necessary or urgent.  

Maternity

All maternity treatment is regarded as immediately necessary.  Treatment is not free however by virtue of it being immediately necessary or urgent and you will still be charged.

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.

I am just visiting the UK. Do I have to pay for treatment if I become unwell?

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 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.

Contact us

Please contact the Overseas Visitors Department for further guidance and support or to find details on how to send your documents to the team.

Due to the pandemic we are working remotely and therefore not making in person appointments. Please see details below on how to get in touch during office hours:

Bwc.overseasvisitors@nhs.net

Tel: 07464 495475