Overseas visitors who are visiting the UK for over six months

If you are planning a visit to the UK for over six months and have a bleeding disorder, here’s what you need to know about accessing the National Health Service (NHS) for treatment.

Those not ordinarily resident in the UK, including former UK residents, are overseas visitors and may be charged for NHS services. It is your responsibility to provide evidence when requested, to demonstrate that you are entitled to free NHS treatment. When evidence is not provided, your treatment will be charged.

Understanding Eligibility

Generally, overseas visitors are not automatically entitled to free NHS treatment. However, there are exceptions for those staying longer than six months.

  • Immigration Health Surcharge: If you paid this surcharge as part of your visa application, you’ll be entitled to NHS-funded hospital treatment on a similar basis as a UK resident (excluding assisted conception services).

Important Points

  • Pre-Existing Conditions: The NHS covers treatment for pre-existing conditions, including bleeding disorders.
  • Registration with a general practitioner (GP): Once eligible, register with a local GP for routine care and referrals to specialists if needed.
  • Charges may apply: Some services, such as prescriptions in England, might incur charges, even with the surcharge paid.

Before you arrive

You must pay the immigration health surcharge when applying for a visa to come to the UK for six months or more. This entitles you to NHS-funded healthcare on the same basis as someone who is ordinarily resident from the date your visa is granted and for as long as it remains valid. You must pay for those services a UK ordinary resident must also pay for, such as dentistry and prescriptions in England and assisted conception services.

Who needs to pay the Immigration health surcharge?

You usually need to pay the Immigration healthcare surcharge if you’re applying for a visa or immigration application: 

  • for more than 6 months if you’re applying outside the UK 
  • for any length of time if you’re applying inside the UK 

You do not need to pay if you’re applying for a visitor visa or to remain in the UK permanently. 

Pay for UK healthcare as part of your immigration application. Whether you need to pay depends on the immigration status you’re applying for. 

Reciprocal Healthcare Agreements

The UK has reciprocal healthcare agreements with the following non-EU countries:

Anguilla, Australia, Bosnia and Herzegovina, British Virgin Islands, Falkland Islands, Faroe Islands, Gibraltar, Isle of Man, Israel, Jersey, Kosovo, Montenegro, Montserrat, New Zealand, North Macedonia, Norway, Serbia, St Helena, Turks and Caicos Islands.

However, there are variations in the level of free healthcare provided. Generally, only immediate medical treatment is to be provided free of charge to allow the overseas visitor to return home for other needs. Also, the agreements do not usually apply when someone travels to the UK to obtain healthcare. Assessment of eligibility under reciprocal or bilateral arrangements can be complex, so please seek prior advice from the Overseas team at a hospital where you plan to visit in the UK. Do not assume all your services will be covered. Please note that reciprocal and bilateral agreements do not apply if you have elective planned treatment or treatment that can be carried out in your country of origin. Also, if the agreement is withdrawn during your treatment, you will immediately be responsible for the cost of the remainder of your course of treatment.

Charges

If you are unsure whether you are entitled to free hospital treatment, the hospital’s Overseas Visitors Team can provide more detailed information. Please get in touch with them before visiting the UK.

If a patient states that they cannot afford to pay for their treatment, the Accounts Receivable Team may be able to offer arrangements for the patient to pay in instalments in some circumstances. Charges will not be waived. Patients will be given details on contacting the Accounts Receivable Team when they receive an invoice.

You should be aware that under paragraphs 320(22), 322(12) and 3.14 of Appendix V of the Immigration Rules, a person with outstanding debts of over £500 for NHS treatment that is not paid within two months of invoicing may be denied a further immigration application to enter or remain in the UK. The chargeable visitor should note that outstanding debts are reported to the Home Office.

The only person who can formally advise whether you are eligible for NHS treatment is an Overseas Officer in the hospital. If a doctor or nurse tells you that you do not have to pay, they may be referring to the treatment you receive in the Emergency Department (sometimes also known as Accident & Emergency or Casualty Department) only.

Holiday insurance/private medical insurance. Who can help me progress with my claim?

If you have private health insurance, you will be required to cover the costs to the NHS for all treatment it provides and then subsequently seek reimbursement from your insurer. 

The clinical team that treated you will have provided a discharge summary to support your insurance claim. You should contact them directly to validate any further documentation required. Matters regarding your invoice should be raised first with the Overseas Visitors Team, who can provide you with general non-clinical guidance.

Invoices will not be sent to your insurance company they will be sent to you. You will need to make arrangements with your insurance company for reimbursement.

For all overseas patients confirmed as not eligible for free NHS treatment, charges are made at 150% of the NHS tariff as per the Department of Health guidelines.  The Trust would prepare an estimate invoice and review it later (10 weeks) to establish the actual cost when the episode has been clinically coded. If any high-cost drugs or consumables are prescribed/used – these costs would not be known until the episode has been clinically coded.

The Overseas Visitor team would also need to establish if treatment was classed as immediate and necessary or thought not to be non-urgent. Where possible, they would request upfront payments. However, they would ask the clinician to complete a clinical patient assessment form to determine whether upfront payment is required.

The UK government always advises visitors to the UK to take out travel or health insurance with the necessary coverage for their needs. This is particularly important for those with pre-existing health conditions. Appropriate insurance means visitors can recoup any treatment costs from their insurer. 

Services exempt from charges

  • Accident and Emergency (A&E) services. However, this does not include any follow-up services for inpatient or outpatient patients.
  • Some primary care services are provided at walk-in centres.
  • Family planning (does not include termination of pregnancy)
  • Diagnosis and treatment of specified infectious diseases and sexually transmitted infections.
  • Treatment for a physical or mental condition caused by:
    • Torture
    • Female genital mutilation
    • Domestic violence
    • Sexual violence

UK nationals who no longer live in the UK

Because the NHS is a residency-based system, UK nationals who move abroad permanently lose their entitlement to free NHS care.

UK nationals living and working in EU countries, Norway, Iceland, Liechtenstein or Switzerland on or before 31 December 2020 and their family members may be eligible to use NHS services without charge. They are advised to check with the relevant authority in the member state where they live for further information before travelling to the UK.

UK nationals who moved to the EU on or after 1 January 2021 should not expect to use NHS services for free when visiting the UK unless they have an EHIC, PRC or S2 to show that their healthcare costs are funded by the EU country where they reside, or another exemption applies.

Any treatment that must be paid for will be charged 150% of the national NHS rate.

Visitors are advised to have travel or health insurance, especially for pre-existing conditions, to cover any healthcare costs they might incur during their stay. Appropriate insurance means visitors can recoup any treatment costs from their insurer.

Please note that the information on this page is provided by GOV.UK and NHS.UK for general information only and is subject to change without notice.