How to access NHS services in England if you are visiting from abroad

This information is for people who are visiting England from abroad. The way the NHS charges overseas visitors for healthcare has changed. If you are a migrant, visitor and former resident of the UK, you must pay for your care when in England. For those visiting England and are not entitled to healthcare from the NHS, medical treatment will only be provided if deemed clinically urgent or immediately necessary, and payment will be required. 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.

If you are a visitor to the UK from an EU country and fall ill or have a medical emergency during a temporary stay in England, you can use a valid European Health Insurance Card (EHIC) issued by your home country to access healthcare.  

The EHIC (or a Provisional Replacement Certificate (PRC)) will cover treatment that becomes medically necessary during a visit. It also covers the treatment of pre-existing medical conditions and routine maternity care, providing the reason for visiting is not specifically to give birth or receive treatment. 

An EHIC or PRC is not an alternative to travel insurance, and we always advise that visitors have both when travelling to the UK. It does not cover private medical healthcare, being flown back home, or lost or stolen property. If you do not provide relevant documentation, charges will be calculated at 150% of the national NHS rate. 

If you visit England for more than six months, you will need to pay the immigration health surcharge unless you’re exempt from paying it. The total amount will be paid upfront for the duration of your visa. 

Who needs to pay?

You usually need to pay the 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 

You might need to pay a healthcare surcharge (called the ‘immigration health surcharge’ or IHS) as part of your immigration application. 

Whether you need to pay depends on the immigration status you’re applying for. 

Immigration status checks by the NHS: guidance for overseas patients 

NHS-funded hospital treatment is only free of charge to people who are ordinarily resident in the UK or exempt from charges by law. Your immigration status is relevant to establishing if you are ordinarily resident in the UK or if some of the exemption from charge categories apply to you. When the NHS does not have accurate information about your immigration status, it needs to seek this information from the Home Office. 

Services exempt from charges

  • Accident and Emergency (A&E) services. However, this does not include any follow-up services as an inpatient or outpatient.
  • Some primary care services 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

Reciprocal Healthcare Agreements

The UK has these with some non-EEA countries. However, there are variations in the level of free healthcare provided. Please check with the hospital Overseas Visitors Team and do not assume all your services will be covered. Please note that reciprocal and bilateral agreements do not apply if you are having elective planned treatment or treatment that can be carried out in your country of origin.

Please note that a European Health Insurance Card (EHIC) does not apply if you are having elective planned treatment or treatment that can be carried out in your country of origin.

Charges

Overseas visitors seeking healthcare while in England may be interviewed by the hospital Overseas Visitors Team. If the hospital is satisfied you are an overseas visitor, you will be charged for the relevant services provided. 

If you refuse to pay or say you cannot pay, a payment plan may be negotiated at our discretion. 

Overseas visitors with travel insurance will be required to pay for their treatment and claim from their insurer when they get home.

The chargeable visitor should note that outstanding debts must be reported to the Home Office.

Unless the UK has made an individual agreement with EEA countries for reciprocal arrangement, EU visitors will be chargeable.

Each NHS service is different, therefore your hospital may not be able to provide you with an exact treatment price for your care until you have been discharged. 

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

Disclaimer:   The content of this page has been provided by NHS.UK and GOV.UK and is for general information only. It is subject to change without notice.