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 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 for the treatment received.
Eligibility for free treatment
- The NHS provides free treatment to anyone who is a living lawfully in the UK, voluntarily and for settled purposes as part of the regular order of their life for the time being (‘ordinarily resident’)
- There are some NHS services, which are free to everyone. These include: Accident and Emergency (A&E) services provided prior to admission as an inpatient or outpatient, family planning services (except termination of pregnancy) diagnosis and treatment of sexually transmitted infections, and diagnosis and treatment of certain infectious diseases, such as malaria, tuberculosis and measles. A full list of conditions are available on pages 33 to 34 of the Department of Health’s guidance on implementing the overseas visitor charging regulations
- Treatment required for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence, except where you have travelled to the UK for the purpose of seeking that treatment
When you qualify for free healthcare
- If you normally live in a country that has a reciprocal healthcare agreement with the UK. This covers urgent 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 will entitle you to relevant services that are medically necessary during your visit; it does not cover planned treatment. You will need to bring your EHIC card with you to access treatment. 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.
- 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.
- If you have private health insurance you will be required to pay for 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 via email to: firstname.lastname@example.org
When you do not 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.
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 cannot prove that you have lived legally in the UK for the last twelve months, you will need to pay for your treatment, Please note that the onus is on the individual patient receiving treatment to provide appropriate documentary evidence supporting any claim to free NHS Services.
If you are a parent and your child requires treatment, you must bring documents to show your child is legally resident in the UK.
Documents that can be used as proof of identity include:
- Current, signed passport
- Residence permit used by the UK Border Agency
- Student visa
- Biometric residence permit
- Asylum Registration Card
These documents can be used as proof of address provided they show your current address:
- Bank, building society statement or passbook dated within the last three months
- Utility bill dated within the last three months (not mobile telephone bill)
- Original, not photocopied, mortgage statement from any UK lender
- Council tax bill for the current year
- Current council or housing association rent book or tenancy agreement dated within the last twelve months
- Notification letter from the Department for Work and Pensions confirming your right to benefits or state pension, dated within the last three months
- UK driving license
- P60, P45 or payslip dated within the last three months
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. 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.
How to pay
You can pay for your treatment by debit card, credit card or cheque.
You can contact our overseas office by telephone or email.
Monday to Friday, 08.00 to 16.00
0300 555 1201 ext 57337