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Eligibility for free hospital treatment under the NHS

Who is entitled to free NHS treatment; and some common questions and answers.

Anyone who is deemed to be ordinarily resident in the UK is entitled to free NHS hospital treatment in England. “Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled.

Anyone who is not ordinarily resident is subject to the National Health Service (Charges to Overseas Visitors) Regulations 2011.  These regulations place a responsibility on NHS hospitals to establish whether a person is ordinarily resident; or exempt from charges under one of a number of exemption categories; or liable for charges.

What about British Nationals? I have paid taxes in the past.

Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence.  The only thing relevant is whether you ordinarily live in the UK.

How do I know if I have to pay ?

The Regulations state that the hospital providing treatment is responsible for establishing who is entitled to free NHS hospital treatment. They will make their decision in accordance with the Regulations. The hospital can ask you to provide evidence to support any claim to free treatment and it is your responsibility to do so if asked. If the hospital decides you are eligible for free NHS treatment you will still have to pay statutory NHS charges such as prescription charges unless you are otherwise exempt. If the hospital decides you are not entitled to free NHS treatment charges will apply and cannot be waived.

What if I do not 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.

What do I have to pay for? 

All treatment given by staff at a hospital or by staff employed by a hospital may be subject to a charge with the following exceptions; which are free to all;

  • Treatment given in an accident and emergency department (excludes emergency treatment given elsewhere in the hospital);
  • Treatment given in a walk in centre providing similar services to those of an accident and emergency department of a hospital;
  • Treatment for certain communicable diseases (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions that are charge free);
  • Compulsory psychiatric treatment.
  • Family planning services

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 hospital treatment with the hospital providing treatment.

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