OVERSEAS VISITORS
Patients Guide


 

National Health Service Hospital Charges to Overseas Visitors

1. This Guide summarises the circumstances in which overseas visitors are not liable to pay for National Health Service (NHS) hospital treatment.

2. Under Regulations which first came into effect on 1 October 1982, visitors to the United Kingdom (UK) are liable to be charged for NHS hospital treatment. A visitor is someone not ordinarily resident in the UK. Since 1 April 1989 the amount to be charged has been determined by health authorities, and from 1 April 1991 also by NHS trusts.

3. The charges do not apply to the following people:-

a. anyone who at the time of receiving treatment has been in the UK for the previous 12 months.

b. anyone who has come to the UK to take up permanent residence.

c. anyone who has come to the UK for employment (whether as an employed or self-employed person); this includes students and trainees whose course requires them to spend not less than 12 weeks in employment during their first year and unpaid workers with voluntary organisations providing certain services similar to those of Health Authorities and local authority social services departments.

d. members of HM Forces and other Crown servants and British Council or Commonwealth War Graves Commission staff serving overseas, and others working overseas under arrangements sponsored by HM Government.

e. people working overseas who have had at least 10 years' continuous residence in the UK and have either been working abroad for not more than 5 years, or have been taking home leave in the UK at least once in every 2 years or have a contractual right to do so, or have a contractual right to the cost of their passage to the UK at the end of their engagement.

f. i. nationals of the European Economic Areas (from 1.1.1995, the fifteen European Community member states of Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden and the UK plus Iceland, Liechtenstein and Norway) who are resident in any of them; refugees and stateless persons living in them and the dependants and survivors of these people regardless of their own nationality. (This exemption applies only to treatment the need for which arose during the visit.)

ii. nationals of any European Economic Area country, refugees, stateless persons and their dependants or survivors living in them (as specified in 3fi) who are referred to the UK specifically for treatment with form E112 or E123.

g. nationals (list A) and residents irrespective of nationality (list B) of the following countries with which the UK has reciprocal agreements:-

A.

Bulgaria

B.

Anguilla*

Romania

 

Czech and Slovak Republics

 

Australia

St Helena*

 

Gibraltar*

 

Barbados

Sweden

 

Hungary

 

British Virgin Islands*

Turks and Caicos

 

Malta*

 

Channel Islands*

Islands*

 

New Zealand

 

Falkland Islands*

 

 

Russia

 

Iceland

 

 

former Soviet Union states*

 

Isle of Man*

 

 

(except Latvia, Lithunia and Estonia)

 

Montserrat*

 

 

Yugoslavia*

 

Poland

 

 i. who require treatment the need for which arose during the visit to the UK.
ii. who are referred to the UK for treatment (usually only from countries asterisked) under arrangements made by appropriate authorities in those countries. (NB: Residents of Iceland and Sweden who are EEA nationals are covered by Category 3fi or 3fii; Category 3gi applies to residents of those countries who are not EEA nationals.)

h. seamen on UK-registered ships; offshore workers on the UK sector of the continental Shelf.

i. UK war disablement pensioners and war widows.

j. UK state pensioners living overseas. (This exemption is limited to treatment the need for which arose during the visit.)

k. refugees and others who have sought refuge in the UK.

l. (i) anyone formally detained by the Immigration Authorities
(p) anyone who is a prisoner. (Note: for prisoners on remand, this exemption applies until 12 months after arrival in the UK. For convicted prisoners, this exemption applies until 12 months after arrival in the UK, or 6 months after committal to prison by the Courts, whichever is the earlier.)

m. diplomatic staff at embassies and Commonwealth high commissions in London.

n. EEA nationals working is another EEA member state but paying compulsory UK class I or II national insurance contributions. (See paragraph 3fi above for definition of EEA national.)

o. nationals of countries that are signatories to the European Social Charter but with whom the UK has no reciprocal agreement-currently Cyprus and Turkey. (This exemption is limited to those nationals who are genuinely without resources to pay for medical assistance and the need for the treatment arose during the visit.)

p. NATO service personnel (posted in the UK) not using their own or UK armed forces hospitals.

q. the husband or wife and children (under the age of 16, or under the age of 19 if at school or a college of further education) of any person described above in (a)-(p) and below in paragraph 6.

r. anyone who is entitled to receive industrial injury benefit from Israel. (This exemption is limited to treatment the need for which arose during the visit to the UK and in connection with the industrial injury to which the benefit refers.)

4. The charges do not apply to the following services:-

a. treatment in Accident and Emergency departments. (NOTE: a patient who is admitted to hospital as an in-patient, even from an Accident and Emergency department, as would generally happen for serious injuries, is liable to be charged, as would be a patient referred to an out-patient clinic).

b. diagnosis and treatment of certain communicable diseases, including sexually transmitted diseases. (For HIV/AIDS see paragraph 7).

c. compulsory psychiatric treatment (i.e. when the patient is detained, or when it is a condition of a probation order that the patient should receive psychiatric treatment.)

5. There are no NHS charges for certain district nursing, midwifery or health visiting services; for the emergency ambulance service; or for family planning services.

6. A person living here for a settled purpose for not less than 6 months will be accepted as ordinarily resident and therefore not liable to charges under the Regulations. A student enrolled in a course of study, the prescribed duration of which is not less than 6 months, is similarly entitled (see also paragraph 3q above).

7. Free treatment for HIV/AIDS at a special clinic for the treatment of sexually transmitted diseases is limited to a diagnostic test for the evidence of infection with HIV and counselling associated with that test or its result. An overseas visitor with HIV/AIDS referred to a hospital from such a clinic will be liable for charges unless otherwise exempt. Hospital out-patients must pay for any drug or medicine which is designed to treat HIV.

8. Any further advice should be obtained from the Patient Services Manager at the hospital where treatment is to be sought.




 


Published by the NHS Executive
© Crown Copyright 2000
This page last updated 14 August 2000