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Department of Health Skip to content

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Are you spending more than three months living outside the UK?

Extended holidays

If you are going abroad for a one-off extended holiday for a few months, then you will continue to be fully exempt from charges for NHS hospital treatment when you return to resume your permanent residence in the UK. The same will apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education) if they are living with you in the UK on a permanent basis.

Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily resident if they are living permanently in the UK with you.  If they are not living permanently in the UK then the Regulations will apply and in order to be entitled to free hospital treatment they will have to meet one of the categories of exemption in their own right.

In common with those ordinarily resident in the UK, anyone who is exempt from charges for hospital treatment will have to pay statutory NHS charges, e.g., prescription charges, unless they also qualify for exemption from these, and will have to go on to waiting lists for treatment where appropriate.

Living as an “insured” resident of a European Economic Area (EEA) country?

If you go to live permanently (or for more than 3 months each year) in another EEA member state and become an “insured” resident of that member state (i.e., become insured for the purposes of state healthcare in that country) then, under European Community Social Security Regulations, you will be entitled to “all necessary treatment” free of charge when you are visiting the UK.  This means treatment the need for which arises whilst in the UK, including pre-existing conditions which acutely exacerbate unexpectedly, or, in the opinion of a clinician, would be likely to acutely exacerbate without treatment.  It also covers the treatment of chronic conditions, including routine monitoring.  It does not cover elective treatment such as pre-planned operations without special arrangement.  

In order to show to an NHS trust that you are an insured resident of another member state you will need to produce a valid European Health Insurance Card (EHIC) issued by that member state, or a Provisional Replacement Certificate.  Failure to produce this may mean that you are charged for your treatment and you will have to apply to your member state of residence to be reimbursed.

If you are living in one of these member states but are not insured there, and have previously had ten or more continuous years’ lawful residence in the UK at any point, then you will be exempt from charges for treatment the need for which arises during a visit to the UK.  Unlike for insured residents, this does not cover routine treatment for chronic conditions.  Similar to those insured, it also does not include pre-planned elective treatment. 

Please see the menu on the left-hand side for the full list of EEA member states.

Living in a bilateral healthcare agreement country?

If you have at some point lived lawfully in the UK for 10 continuous years, and subsequently choose to go and live permanently (or for more than 3 months each year) in a country with which the UK has a bilateral health agreement, then, when you are visiting the UK, you will be exempt from charges for treatment for a condition which arises after your arrival here.  Routine treatment of a pre-existing condition, or pre-planned operations etc, will be chargeable. This partial exemption will also apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education) if they are living with you in the UK for the duration of your visit.  NB – This level of exemption will also apply if you live in an EEA member state but do not become an “insured” resident there. 

Please see the menu on the left-hand side for the countries with which the UK has a bilateral healthcare agreement.You will only be fully exempt from charges if you meet one of the other exemption criteria, for example because you are working abroad and have been doing so for less than 5 years.

Living in a non-bilateral healthcare agreement country?

If you choose to go and live permanently (or for more than 3 months each year) in a country with which the UK does not have a bilateral health agreement, then you will not normally be eligible for free NHS hospital treatment during a visit to the UK, no matter how long you may have lived here in the past. You may, however, be exempt from charges if you meet one of the other exemption criteria, for example because you are working abroad and have been doing so for less than 5 years.

Living in both the UK and another country?

If you spend more than 3 months living in another country on a regular basis each year, for example because you spend four months living in a second home during the winter but return to the UK for the rest of the year, then you may not be eligible for free hospital treatment while you live here. If the other country is one with which the UK has a bilateral health agreement then the partial exemptions described above will apply to you. If the other country is not one with which there is a bilateral health agreement, then you will not be entitled to free NHS hospital treatment during the time you live here, unless you meet one of the other exemption criteria.

If you are in receipt of an UK state retirement pension then a different part of the Regulations applies to you. Please see the separate page Are you a UK State Pensioner spending more than 3 months living outside the United Kingdom?

Returning to the UK after a period of time living away?

If you go anywhere abroad for more than three months, either for a one-off extended holiday for a few months or to live permanently for several years, but then return to the UK to take up permanent residence here again, then you will be entitled to receive free NHS hospital treatment from the day you return. So will your spouse, civil partner and children (under the age of 16, or 19 if in further education) if they are also living with you permanently in the UK again.

Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily resident if they are living permanently in the UK with you.  If they are not living permanently in the UK then the Regulations will apply and in order to be entitled to free hospital treatment they will have to meet one of the categories of exemption in their own right.

In common with those ordinarily resident in the UK, anyone who is exempt from charges for hospital treatment will have to pay statutory NHS charges, eg prescription charges, unless they also qualify for exemption from these, and will have to go onto waiting lists for treatment where appropriate.

What documents will I need if I require hospital treatment?

Individual hospitals are responsible for deciding whether, in accordance with the regulations, a patient is liable to be charged for treatment or not. In order to establish entitlement, hospitals can ask you to provide documentation that supports your claim for free treatment, such as evidence of where you live, moving permanently back to the UK etc, as appropriate. 

Can I access primary care services?

GPs have a measure of discretion in accepting applications to join their patient lists. It is advisable to approach a GP practice and apply to register on its list of NHS patients. The practice may choose to accept or decline your application. An application may be refused if the practice has reasonable grounds for doing so. A practice would not be able to refuse your application on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. If you have difficulty in registering with a GP, you should get in touch with your local primary care trust (PCT).

Do I have to pay for emergency treatment if I have an accident?

Regardless of residential status or nationality, emergency treatment given at primary care practices (a GP) or in accident and emergency (A&E) departments or a walk-in centre providing services similar to those of a hospital A&E department is free of charge.

In the case of treatment given in an A&E department or walk-in centre the automatic exemption from charges will cease to apply once the patient is formally admitted as an inpatient (this will include emergency operations and admittance to high dependency units) or registered at an outpatient clinic. To continue to receive free treatment after that point, the person will have to be exempt from charges in their own right.

Am I entitled to help with the costs of non-emergency NHS treatment?

For information on help with health costs please see HC11 Are you entitled to help with health costs? which is available from main post offices, social security offices and NHS Hospitals. HC11 is also available at:

What if I don't meet one of these exemptions from charges?

If you are not ordinarily resident or exempt under the regulations, charges will apply for any hospital treatment you receive and cannot be waived. If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK. There is no facility to purchase healthcare insurance from the NHS: therefore any necessary insurance must be organised privately.

Please note the above information gives general guidance only and should not be treated as a complete and authoritative statement of law. In all cases, the regulations place the responsibility of deciding who is entitled to receive free treatment with the hospital providing it.

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