Access to the NHS is universal, but depending on your immigration status within the UK, you may be charged for accessing certain services. However, there are certain services that are free to everyone:
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Treatment given in an accident and emergency (A&E) department – this does not include any further treatment following an admission to hospital; and
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Treatment for certain infectious diseases (but for HIV/AIDS, only the first diagnosis and counselling that follows it are free); and
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Compulsory psychiatric treatment; and
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Family planning services – this does not include termination of pregnancy or infertility treatments.
Who will not be charged for accessing the NHS?
You will not be charged for any NHS treatment if you are ‘ordinarily resident’ in the UK, or if an exemption to charging applies.
‘Ordinarily Resident’
The full definition of ordinarily resident for the purposes of accessing NHS services can be found here and is summarized as follows:
“A person will be “ordinarily resident…” in the UK when that residence is lawful, adopted, voluntary, and for settled purposes as part of the regular order of their life for the time being, whether of short or long duration.”
In practice, you are normally ‘ordinarily resident’ in the UK if you are living and working in the UK and are:
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A British citizen
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Naturalised within the UK
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Settled within the UK (commonly referred to as holding Indefinite Leave to Remain)
British citizens/EEA/Swiss nationals who are visiting the UK may be charged for NHS services they receive at the point of accessing care. The final decision to charge will rest with the healthcare provider.
EU nationals
A valid European Health Insurance Card gives EEA nationals the right to access state-provided healthcare during a temporary stay in another European Economic Area (EEA) country or Switzerland:
- Anyone insured for healthcare in another EEA member state or Switzerland and who, for medically necessary treatment, presents either a European Health Insurance Card (EHIC) from that member state or a Provisional Replacement Certificate (PRC) for that card, or, for elective treatment, presents an S2 document for that treatment.
- The spouse/civil partner and children under 18 of the above are also exempt when lawfully visiting the UK with them.
Non-EEA nationals and the NHS Surcharge
Any non-EEA national, subject to immigration control, is exempt from charge for accessing any NHS services if one of the following applies to them while their leave to enter/remain is still valid:
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They have paid the NHS surcharge when making their visa application; or
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They would have been covered under one of the above, but for the fact that they applied for leave to enter or remain in the UK before the NHS surcharge was implemented (6 April 2015).
Note: A child born in the UK to an exempt person is also exempt from charge provided they are under 3 months old.
Who will be charged for accessing the NHS?
Non-EEA nationals who are visiting the UK and have not paid the NHS surcharge (commonly those entering on a visitor visa/sought entry at the UK border), including those who hold long-term multiple entry visas, will be charged for accessing NHS services (except the free services noted above).
British citizens/EEA/Swiss nationals who are visiting the UK may be charged for NHS services they receive at the point of accessing care. The final decision to charge will rest with the healthcare provider.
If your circumstances are as above, it is recommended that you are covered for healthcare through private medical insurance for the duration of your visit, even if you are a former UK resident. Should you need NHS treatment and you have not arranged insurance, you will be charged at 150% of the standard NHS rate.
What happens if I cannot pay?
Once the hospital has established that you must pay for treatment, you will usually be asked to pay the full cost in advance, unless emergency treatment is required immediately.
All treatment will be given, regardless of the ability to be able to pay, except if the treatment is non-urgent and can wait until you have left the UK. In non-urgent cases, treatment will only be given once the full cost has been received.
Note: Failure to pay for accessing NHS services may affect your ability to apply for a UK visa in the future.