Overseas visitors

If you are visiting the United Kingdom and require treatment in our hospitals, you may have to pay.

The UK’s healthcare system is a residence-based one, which means entitlement to
receive relevant services without charge is based on living lawfully in the UK.

This contrasts with many other countries which have insurance-based healthcare
systems.

This page gives you more details about treatment for overseas visitors.

NHS hospitals have a legal obligation to establish whether a person is an overseas visitor and whether charges apply, or if any exemptions are in place or whether the individual’s home country has a reciprocal agreement with the UK.

Where there is no exemption or reciprocal agreement in place we must charge the person liable and recover the costs from them.

The test of residence that the UK uses to determine entitlement to free relevant services is known as ‘ordinary residence’. An overseas visitor is defined in the Charging Regulations as anyone who is not ordinarily resident in the UK.

If you come to us for treatment, you may be asked to complete a form and provide documents to prove that you are ordinarily resident in the UK.

If you can’t provide the documents you may have to pay a deposit equal to the estimated cost of your treatment before you have an appointment or treatment.

Maternity services, or other treatment which the doctor or nurse thinks is immediately necessary or urgent, will not be withheld. However, charges will still apply and you will receive an invoice after your treatment.

A person does not become ordinarily resident in the UK simply by:

• having British nationality
• holding a British passport
• being registered with a GP
• having an NHS number
• owning property in the UK
• having paid (or are currently paying) National Insurance contributions and taxes in this country.

Whether a person is ordinarily resident is a question of fact, for which a number of factors are taken into account.

Failure to pay

If you fail to pay for NHS treatment for which charges are appropriate, your future application to enter, or remain in the UK may be denied.

Necessary (non-medical) personal information may be passed via the Department of Health and Social Care to the Home Office for this purpose.

Patient data can be used for overseas debt recovery purposes.

Free treatment

Some NHS services are free to everyone. This includes family-planning services and treatment of certain infectious diseases. Treatment in our emergency department (ED) is free only up to the point an overseas visitor is admitted as an inpatient, seen by separate specialist doctor within ED following triage, or given an outpatient appointment.

This means that emergency treatment elsewhere in the hospital, such as coronary care and further emergency or urgent treatment after admission, is chargeable.

Fertility treatment/assisted conception services

Access to assisted conception services is restricted by the Department of Health and Social Care. To be entitled to these services you must meet both the ordinary residence criteria and certain leave requirements in the UK (usually indefinite leave to remain or British citizenship).

Long stay visitors who are visa holders where the immigration health surcharge has been paid are not entitled to access this service free of charge.

Patients living in European Union (EU) countries

If you access our services because the need arose during a visit to the UK, you will need to show us your European Health Insurance Card (EHIC) or a provisional replacement card.

If you do not have these documents with you, you will be required to pay for your treatment and recover the costs when you return home.