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Department of Health Skip to content

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A leaflet providing information to visitors to the United Kingdom about payment for hospital treatment.

OVERSEAS VISITORS TO THE UK USUALLY HAVE TO PAY FOR NHS TREATMENT

National Health Service (NHS) hospital treatment is only free to people who live on a lawful and properly settled basis (‘ordinarily resident’) in the United Kingdom (UK) or who are exempt from charges under the law. If you do not normally live here and you do not meet one of the categories of exemption then you will have to pay for the hospital treatment you receive. This is regardless of whether you are a British citizen or have lived or worked here in the past or have been issued with an HC2 certificate.

IF YOU ARE NOT COVERED BY ANY OF THE EXEMPTION CATEGORIES LISTED IN THIS LEAFLET YOU ARE STRONGLY RECOMMENDED TO ENSURE YOU HAVE ADEQUATE HEALTH INSURANCE TO COVER THE DURATION OF YOUR STAY IN THE UK.

Who decides if I have to pay?

The law says that the hospital providing NHS treatment must establish if each patient is entitled to it free. The hospital will ask you to provide evidence to confirm your eligibility. If the hospital establishes that you can receive free NHS treatment you will still have to pay for statutory NHS charges such as prescription charges unless you are separately  exempt from those. If the hospital decides that you are not entitled to free NHS treatment you will have to pay the full cost of all the treatment you receive, including emergency treatment, given by staff at a hospital or by staff employed by a hospital. This will include the full cost of any prescribed medication even if you are in possession of an HC2 exemption certificate.  The charges cannot be set aside.

Who does not have to pay for their hospital treatment?

There are some services that are free of charge to everyone:

  • Emergency treatment given inside an Accident and Emergency (A&E) department, a minor injuries unit or a NHS Walk-in Centre (emergency treatment given after admission to the hospital is not free to all);
  • Treatment for certain infectious diseases, including sexually transmitted infections (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions that are free to everyone);
  • Compulsory psychiatric treatment;
  • Family planning services.

Overseas visitors are charged for other hospital treatment unless they themselves are exempt.  Some exemption categories cover all NHS hospital treatment, others only cover some treatment.

People fully entitled to NHS hospital treatment free of charge:

  • Anyone who has been lawfully living in the UK for twelve months immediately prior to treatment;
  • Anyone who is working in the UK (or offshore on the UK sector of the Continental Shelf) for an employer who is based in the UK or is registered in the UK as a branch of an overseas employer (this includes self-employed people). You must be actually working, not just looking for work;
  • Any unpaid worker with a voluntary organisation offering services similar to those of a Health Authority or Local Authority social services department;
  • Any full time student on a course of at least 6 months duration, or, if less than 6 months, a course substantially funded by the UK government;
  • Anyone who has come to live permanently in the UK. If you have an outstanding application for permanent residence you are usually chargeable until it is approved;
  • Refugees and asylum seekers whose applications are still being considered;
  • Failed asylum seekers receiving section 4 or section 95 UK Border Agency support;
  • Children in the care of the Local Authority;
  • Those who have been formally identified or suspected as being a victim of human trafficking*;
  • Diplomatic staff working in embassies or Commonwealth High Commissions in the UK;
  • Serving NATO personnel, posted in the UK, who are not using their own or UK armed forces hospitals;
  • UK state pensioners who have lived lawfully in the UK for 10 continuous years at some point, who now live for not more than 6 months each year in another EEA member state (and are not registered as resident there) and not less than 6 months each year in the UK;
  • Anyone who receives a UK war pension, war widows pension or armed forces compensation scheme payment;
  • Members of Her Majesty’s UK armed forces*;
  • UK Civil Servants working abroad who were recruited in the UK and employed by Her Majesty’s Government*;
  • Anyone recruited in the UK who works abroad for the British Council or the Commonwealth War Graves Commission*;
  • Anyone who is working abroad in a job financed in part by the UK Government in agreement with the Government or a public body of some other country or territory*;
  • Anyone working abroad (including self employed people) for not more than 5 years as long as they have lived legally in the UK for ten continuous years at some point;
  • Missionaries working overseas for an organisation principally based in the UK, regardless of whether they are receiving a wage or salary*;
  • Anyone who is detained in prison or by the Immigration Authorities in the UK;
  • Anyone employed on a ship or vessel registered in the UK;
  • The spouse or civil partner and any dependent children of anyone who is exempt under the above criteria, if they are living permanently with the exempt person. Coming to visit the exempt person for a few weeks or months does not give exemption.  * These categories of exemption provide that the spouse/civil partner/dependent children are exempt from charge in their own right so that the principal exempt family member does not have to be in the UK with them at the time of their treatment.

People Entitled to Some NHS Hospital Treatment – this is limited to treatment required for any condition that occurred after arrival in the UK (including pre-existing conditions which acutely exacerbate or need prompt treatment whilst here).

  • Any resident of an EEA member state visiting the UK when they are ‘insured’ into the healthcare system of that member state#;
  • Anyone living in a country with which the UK has a bilateral healthcare agreement (some bilateral healthcare agreements are limited to nationals of that country).
  • Anyone, or the spouse, civil partner or dependant child of anyone, who has lived legally in the UK for 10 continuous years at some point but who is now living in another EEA member state or in countries with which the UK has a bilateral healthcare agreement;
  • Anyone, or the spouse, civil partner or child of anyone, receiving a UK state pension who has either lived legally in the UK for 10 continuous years or has worked as a UK Civil Servant for at least 10 continuous years at some point.

#  Also includes treatment for chronic conditions, including routine monitoring. Such persons must show a valid European Health Insurance Card (EHIC) or Provisional Replacement Certificate.

European Economic Area (EEA) member states:

Austria, Belgium, Bulgaria, Cyprus (Southern), Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Republic of Ireland, Romania, Slovakia, Slovenia, Spain, Sweden, UK, plus Iceland, Liechtenstein and Norway. Switzerland by special arrangement.

Bilateral Healthcare Agreement Countries:

Nationals of, and UK nationals in, the following countries:
Armenia, Azerbaijan, Belarus, Bosnia, Croatia, Georgia, Gibraltar, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, Montenegro, New Zealand, Russia, Serbia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan.

Residents irrespective of nationality of the following countries:
Anguilla, Australia, Barbados, British Virgin Islands, Falkland Islands, Iceland, Isle of Man, Jersey, Montserrat, St. Helena, Turks and Caicos Islands.

This leaflet is a general guide and not a full statement of the current regulations. Please ask at the hospital providing treatment for further information or see the Department of Health website at:

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