We understand that your visit to our hospital may be very stressful for you and we would like to make it as easy as possible when it comes to your understanding of the information that may be required by our staff to establish entitlement to NHS services.
The National Health Service Act 2006 and the National Health Service (Charges to Overseas Visitors) Regulations 2015, as amended in 2017 and 2020 sets which visitors are required to pay for NHS treatment, and which treatments are chargeable.
Hospital treatment is free to people classed as ordinarily resident in the UK which means that “you must be living lawfully and voluntarily in the UK for settled purposes as part of the regular order of your life, for the time being”. In addition all patients subject to immigration control must have “indefinite leave to remain”. Ordinary residence is not dependent on Nationality (including UK citizens), European Union Settlement Scheme (EU SS) status, payment of UK taxes, National Insurance contributions, registered with a GP, having an NHS Number, or owning property in the UK.
The Department of Health Overseas Charging Regulations place the responsibility on individuals to prove entitlement to free NHS treatment. We would ask for your co-operation in providing the evidence requested, to avoid your liability for the cost of any treatment provided to you now or in the future.
Visitors from the European Free Trade Association (EFTA) which comprise of Norway, Iceland, Liechtenstein and Switzerland
If you are visiting from Iceland, Liechtenstein or Switzerland and began a temporary visit to the UK on or before 31 December 2020, you will be able to access medically necessary treatment while your current visit lasts, even if it extends into 2021.
If your visit began on or after 1 January 2021, you may have to pay for treatment. Any treatment you have to pay for will be charged at 150% of the NHS national tariff of the national NHS rate in line with National Health Service (Charges to Overseas Visitors) Regulations.
Visitors from the European Union (EU) and Norway
If you are visiting the UK from an EU country and you fall ill or have a medical emergency during your temporary stay in England, you can use a valid European Health Insurance Card (EHIC) / Provisional Replacement Certificate (PRC) issued by your home country to access healthcare.
If you don’t have a EHIC card you can apply for one from the country where you normally live through www.ehic.europa.eu and selecting your national flag.
It’s also possible to get a PRC if you don’t have your EHIC, this is an emergency document and will provide the same level of cover as the EHIC and is normally dated for the period of your visit to the country. Please contact your national healthcare provider to request this document.
If you do not have an EHIC and cannot obtain a PRC, you may have to pay for treatment. You will be charged at 150% of the NHS national tariff of the national NHS rate in line with National Health Service (Charges to Overseas Visitors) Regulations.
UK pensioners living in EU / EFTA
UK nationals who moved to the EU on or before 31 December 2020 whose healthcare costs in their EU/EFTA country of residence is funded by the UK because of a registered UK-issued S1 form should not be charged for healthcare in secondary healthcare settings in England.
UK nationals who move to the EU/EFTA after 1 January 2021 and hold, or become eligible for, a UK S1 will not be entitled to relevant services in England without charge, as the UK has not opted for this under the SSC Protocol and they are not covered by Regulation 13 of the Charging Regulations.
If you’re visiting England from a EU / EFTA country, even if you are a former UK resident, you will be charged for NHS secondary care at 150% of the NHS national tariff of the national NHS rate in line with National Health Service (Charges to Overseas Visitors) Regulations unless an exemption from the charge category applies to either you or the treatment.
Visitors from the Rest of the World
If you are visiting England from a Non EU / EFTA country, you need to ensure you are covered for healthcare through personal medical insurance for the duration of your visit, even if you are a former UK resident. This is a requirement of your entry conditions to the country.
If you are coming for more than six months, you may need to pay the Immigration Health Surcharge as part of your visa application. This means you will be able to receive treatment on the same basis as an ordinary resident of the country.
All students are required to provide a copy of their passport, Biometric Residents Permit (BRP) and proof of Immigration Health Surcharge (IHS) or a valid travel insurance, to cover their entire stay in the UK. In addition you may have to provide a letter from the school, college or university where you are studying, confirming that you are attending a course and whether it is full / part-time, the duration and confirmation of your attendance rate. EU students (excluding students from Iceland, Lichtenstein, Norway or Switzerland), studying on courses less than 6 months, are required to have a European Health Insurance Card (EHIC) or valid travel insurance. Students who come from the EU or EFTA countries to the UK to study (for courses lasting more than six months) whose student visas start on or after 1 January 2021 will pay the IHS as part of their student visa application.
If the NHS Access form and documents are insufficient to confirm entitlement to free NHS services or you are a chargeable patient; you will be asked to make a payment for your treatment costs. Payment will be based on your initial clinical diagnosis and is an estimate of the overall treatment costs. This will be taken as a deposit against the final invoice. All patients are charged at 150% of the NHS national tariff in line with National Health Service (Charges to Overseas Visitors) Regulations.
Immediately necessary or urgent services, including maternity services – Clinically assessed immediate, urgent and maternity care will not be withheld on the basis of ability to pay even though you remain liable for the treatment cost. If you’re insured please see below.
Non-urgent or elective treatment – We are required by law to withhold treatment from chargeable overseas visitors until the estimated full cost of the service has been paid. This decision will be based on clinical opinion.
Insured Patients – Should your medical expenses be covered by travel or health insurance you may not need to pay at the time of your treatment but we will need to assess this based on the information available to us at the time of your attendance and after consultation with your insurance company.
Whilst we will provide you with an estimation of your treatment costs, we will assess the actual cost once you are discharged from our care and issue a final invoice as soon as possible afterwards. Please note that this may differ from the estimate provided as this will depend on your diagnosis and your treatment pathway. Any overpayment will be refunded once the final invoice has been issued.
We would ask that you settle your invoice as soon as possible after receiving it. If you have any financial difficulties please let us know so we can work with you to explore payment options; Unpaid invoices outstanding for 2 months may be referred to debt collection and in some circumstances also reported to UK Border Agency; this may affect future applications to enter or remain in the UK.
Reciprocal Healthcare Agreements
Reciprocal agreements on a tiered basis have been agreed with some countries.
Within the reciprocal agreements there are variations in the level of free treatment provided to visitors travelling to the UK. Generally, only immediate medical treatment* is to be provided free of charge, to allow the overseas visitor to return home for other needs i.e. follow up treatment or outpatient appointments.
Please ensure you check with the Overseas Visitors Team to ensure your financial responsibilities are clear and DO NOT ASSUME all your treatment will be covered. You may be liable to pay for Outpatient and follow-up appointments that are not clinically or immediately necessary, where you could have received the treatment / appointment by returning to your home country.
If you’re being treated under a reciprocal agreement and it is terminated during the course of your treatment then you will become liable for all further costs.
Immediate treatment is defined as to save the patient’s life / prevent a condition from becoming immediately life-threatening or needed promptly to prevent permanent serious damage occurring. Treatment considered immediately necessary or urgent (including all maternity treatment will never be withheld pending payment).
For more information on this please visit http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.aspx
If you have any questions please contact our Overseas Visitors Team, Monday to Friday 9.00am to 4.00pm who will be happy to help. You can also email the team at firstname.lastname@example.org
Overseas Visitors Team
The Downlands Suite
West Sussex BN11 2DH
Tel: 01903 286731
Overseas Visitors Team
The Chichester Suite
St Richard’s Hospital
West Sussex PO19 6SE
Tel: 01243 788122 ext 35426
* The National Health Service Act 2006 and the National Health Service (Charges to Overseas Visitors) Regulations 2017 set which visitors are required to pay for NHS treatment.
For more information on this please visit http://www.nhs.uk/NHSEngland/AboutNHSservices/uk-visitors/Pages/accessing-nhs-services.asp