Overseas patients

To be entitled to free NHS-funded care, you need to be “ordinarily resident” in the United Kingdom. To establish your eligibility, you may be asked questions about your residential status.

The National Health Service Act 2006 and the National Health Service (Charges to Overseas Visitors) Regulations 2015 (as amended) set out which visitors are required to pay for NHS treatment.

Being ordinarily resident in the UK means that you are living in the UK on a lawful, voluntary and properly settled basis as part of the regular order of your life for the time being. If you are a non-EEA national subject to immigration control you are also required to have indefinite leave to remain in the UK

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)

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.

Accordion

  • National ID card
  • Passport and Visa (both if applicable to you)

(The proof you use must be less than three months old. Your name and address needs to be on the letter):

  • Bank or building society statement
  • Rent Agreement or Mortgage details
  • Telephone bill
  • Water, gas, electric or Council Tax bill
  • A letter from your college confirming you are attending a full-time or part-time course of study (including course duration and number of hours per week of attendance) 0 Copy of any birth/marriage certificates
  • An IND and ARC (for patients claiming asylum)
  • Any Home Office issued documents which are relevant to your application
  • European Health Insurance Card (EHIC) 0 Provisional Replacement Certificate (PRC)
  • Evidence of sickness insurance
  • Letter or statement from HMRC or DWP
  • National Insurance or benefits letter
  • Wage slip or a P60

All evidence requests can be responded to in writing by sending copies in the post to

Overseas Visitors Team (Finance
St Anne’s House
729 The Ridge
St Leonards-on-Sea
East Sussex, TN37 7PT

Legal obligation to identify patients who are not entitled to free NHS treatment

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.

We may use your information to

  • Establish your identity and your entitlement to free NHS treatment
  • Record NHS debtors to the Department of Health and Social Care
  • Determine your immigration status using Home Office services (you will be informed if this happens)

Overseas visitors who may qualify for free healthcare

  • A Non-European student studying full time in the UK or an individual who has come to work in the UK on a relevant visa and has paid the health surcharge
  • A refugee or an asylum seeker whose formal application to the UK Border Agency is being considered. You will need to provide documentary evidence such as your Application Registration Card (ARC) and we will need to confirm that your application is still being considered. Please note that you will still need to pay for any medication prescribed to you.
  • Under the UK-EU Trade and Co-operation Agreement, a citizen who normally lives in a country that is a member of the European Union (EU) and has a valid European Health Insurance Card (EHIC) in their name, or can obtain a valid Provisional Replacement Certificate (PRC) from the member state for the dates of treatment. The valid EHIC card / PRC covers immediately necessary treatment only, to prevent you from cutting short your visit to the UK.Residents of Switzerland who are visiting the UK are eligible to receive needs-arising treating without charge if they present their EHIC or PRC under the UK-Switzerland SSC Convention.This card / PRC can be obtained by all insured individuals (including children in their own right) and you must bring it with you to hospital or email it to esht.overseasteam@nhs.net. You can also ask our staff to take a copy the card / PRC as it will be forwarded to the overseas visitors’ team.

The countries this relates to are:

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 and Switzerland.

  • A citizen who normally lives in a country that has a reciprocal healthcare agreement with the UK. There are a number of variations in the level of free treatment afforded to visitors travelling to the UK from these countries. Generally, only immediate medical treatment is to be provided free of charge.  They do not usually apply when the person has travelled to the UK for the purpose of obtaining healthcare. Further details can be provided on request from the overseas team.

Please note that if the agreement is withdrawn during your treatment you will become immediately responsible for the cost of the remainder of your course of treatment.

The countries are currently

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

  • You fall within a group of individuals who are entitled to receive healthcare on the same or similar basis as an ordinarily resident person.
  • If you are a visitor from Iceland or Lichtenstein that has rights under the Brexit Withdrawal Agreement (WA) because you are an EU national who was exercising EU treaty rights in the UK before 31 December 2020 as a worker, self-employed person, student, self-sufficient person or jobseeker; Please note that you would be chargeable for NHS hospital care at 150% of NHS National Tariff if you have no rights under the WA.
  • The UK and Norway have reciprocal healthcare arrangements under Medical Treatment Protocol to the 1990 UK-Norway Social Security Reciprocal Agreement which provide that Norwegian and UK nationals residing in Norway or insured in Norway will be able to access necessary healthcare while travelling in or posted to the UK, by presenting a valid passport and proof of residency.

Who may not qualify for free 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.

Provision of treatment to overseas visitors in an Emergency Department

Treatment received in our Emergency Departments (A&E) is free. However, if you are admitted to hospital as an inpatient or receive any outpatient appointments charges will apply.

If your country of residence has a reciprocal agreement covering your emergency treatment in the UK, please advise our Emergency Department reception staff.

In these instances we will re-coup the cost of your care from your country of residence.

Urgent treatment

We will always provide treatment that a clinician has assessed as immediately necessary or urgent. All maternity treatment is regarded as immediately necessary. Treatment is not free however by virtue of it being immediately necessary or urgent and if you are a chargeable overseas visitor, you will be charged for any admitted or outpatient care you receive.

Non-urgent treatment

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.

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 be required to pay for your healthcare yourself.

Overseas visitors required to pay for NHS hospital healthcare

You will have the opportunity to pay:

  • from an overseas bank account
  • by debit / credit card
  • by setting up a standing order to pay the Trust, or
  • 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.

More information

Please contact the overseas visitors’ team to discuss your individual circumstances as this may vary on a case by case basis or for further guidance and support: