What is the NHS?
The NHS is a state funded organisation which provides free hospital treatment to people who are legally living in the UK on a permanent basis. If you are not ordinarily resident in the UK, you will be subject to the National Health Services (Charges to overseas Visitors) Regulation 2011. You may have to pay for your hospital treatment, even if you have a British passport, or have paid National Insurance contributions and taxes in this country in the past.
What happens if I attend the accident and emergency department (A&E)?
You will not be charged for treatment that you receive in our emergency department. However, where emergency treatment is provided after admission to the hospital as an inpatient or outpatient , this will be chargeable to a non-exempt overseas visitor.
Are certain diseases exempt from charge?
Certain diseases where treatment is necessary to protect the wider public health, are exempt from charge. This exemption will apply to the diagnosis, even if the outcome has a negative result. A list of exempt diseases are available from the Department of Health.
How can I prove that I am entitled to free hospital treatment?
In order to receive free hospital treatment, you will need to provide evidence that you are legally living in the UK. All patients admitted to this hospital, whatever their nationality and living status, are required to provide examples of evidence when registering their details. If you are living in the UK on a settled basis then you should be prepared to provide evidence.
Examples of evidence:
- proof of right to live in the UK
- UK national or EEA/Swiss national right of abode in accordance with immigration (European Economic Area) Regulations 2006
- has right of abode in the UK
- non-EEA family member of EEA national excising EU treaty rights
- has a route to settlement with a spouse/civil partner/fiancé visa
- has appropriate entry clearance by Home Office i.e. indefinite leave to enter/remain stamp in passport
- resuming permanent residence – evidence confirming this intention
I am just visiting the UK. Do I definitely have to pay for treatment if I become unwell?
No, there are a number of circumstances under which you may be entitled to free healthcare.
If you are visiting the UK and you normally live in a country that has a bilateral healthcare agreement with the UK.
If you are visiting the UK and you normally live in a country that is a member of the European Economic Area healthcare arrangement.
You will be entitled to free healthcare provided that you have a valid European Health Insurance Card (EHIC). However, this card only covers free treatment when the need for it arises during a visit and pre-existing conditions that acutely exacerbate here, or in the opinion of a Clinician need prompt treatment to prevent them from acutely exacerbating.
The routine monitoring of chronic/pre-existing conditions is NOT included and free treatment will be limited to that which is urgent in that it cannot wait until the patient can reasonably return home.
The Trust will charge a patient for treatment if a valid EHIC card is NOT present.
I am from a British Overseas Territory (BOT), do I have to pay for treatment?
BOT of Anguilla, the British Virgin Islands, the Falkland Islands, Montserrat, St Helena and the Turks & Caicos Islands can refer patients specifically for treatment. With the exception of the Falkland Islands, this is limited to four patients per BOT per year.
Referral arrangements are made by the relevant BOT through Department Work & Pensions Overseas Healthcare Team (DWP). If you are hoping to be referred, you should contact the relevant BOT in the first instance. Patients must be in receipt of a formal confirmation to cover them for treatment.
However, if a patient from a BOT is claiming free NHS treatment under Regulation 8(2)(e) – taking up permanent residence. The following evidence will be required:
Forging ties with the UK—e.g. acquiring housing, children are attending school in the UK, looking for work, job seekers allowance, application/granted benefit, transfer of assets to the UK.
Cutting ties with former place of residence—e.g. sale of goods and properties, overseas, receipts to show shipping goods, ending of a rental agreement, end of employment contract.
If I am not eligible for free treatment, what will I have to pay for?
NHS bodies are legally obliged to charge liable patients for treatment, and recover all money. You will be charged for any treatment given to you outside of the Emergency Department, both in the hospital and the community.
What is immediately necessary, urgent and non-urgent treatment?
Only clinicians can make an assessment as to a patient’s need for treatment. However, no matter what category, liable patients are expected to pay all treatment costs.
Immediately necessary—is the treatment a patient needs (including maternity treatment), to save their life, to prevent a condition from becoming life-threatening, to prevent permanent serious damage from occurring.
NHS Bodies must provide treatment, whether or not the patient has been informed of, or agreed to pay.
Urgent treatment— treatment cannot wait until the patient can reasonably be expected to return home. Payment should be secured before treatment is scheduled.
Non-urgent treatment—routine elective treatment, could wait until the patient returns home. NHS bodies should NOT provide non-urgent treatment if the patient does not pay in advance.
If you require any further information please contact the relevant Overseas Visitors Team below. Alternatively you can email us on OverseasIncomeTeam@ULH.nhs.uk
Lincoln County and Grantham Hospitals – 01522 573917 or Mobile 07585 985218
Pilgrim Hospital – 01205 446032
Louth County, Johnson, John Coupland and Skegness Hospitals – 07584 887325
Below is a guide for migrants which explains how the NHS works in multiple languages:
How the NHS works infographic – English
How the NHS works infographic – Russian