Overseas patients 

Overseas visitors who need healthcare while in the United Kingdom may not be entitled to free healthcare from the National Health Service.

The Department of Health charging regulations place a legal obligation on NHS trusts to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges.

To carry out these assessments, UCLH has a dedicated Overseas Visitors team who specialise in assessing patients to establish whether a patient is liable for charges or if an exemption applies. This may involve asking the patient to provide documents to prove or support entitlement. Patients who are assessed as not entitled to free care will be required to pay for their treatment and will be asked to pay a deposit on account.

It is the responsibility of the patient to provide evidence, when requested, to demonstrate that they are entitled to free NHS treatment. When evidence is not provided, treatment will be charged for.

If you are unsure of your entitlement or status – please contact the Overseas Visitors Officers at 0203 447 8348 or email overseasvisitorsofficers@uclh.nhs.uk who will be happy to help you.

  • EU Regulations / European health insurance card (EHIC)

    If you are travelling from a European country to the UK you will need to show a valid EHIC otherwise you will have to pay for your care directly. You will also be asked to provide the following:

    • a copy of your passport
    • your full address abroad

    The EHIC must be produced (or a provisional replacement certificate) prior to discharge from the hospital or prior to an outpatient appointment, or you will be liable to pay all fees associated with your care and claim your care back through your home country.

    The EU Regulations apply to all countries within the European Economic Area, which is made up of the member states of the EU:

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

    Please note that your EHIC does not apply if you are having elective planned treatment. You will need to obtain an E112/S2 from your local Health Authority in your country of origin prior to an appointment being given in the UK. In the event, elective planned treatment is provided prior to receipt of an E112/S2, you will be charged for your treatment.

  • Patients from countries with reciprocal or bilateral arrangements with the UK for healthcare

    The UK has reciprocal healthcare agreements with the following non-European economic area countries (EEA):

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

    Overseas visitors who can present evidence that they are nationals, citizens or lawful residents of one of these countries may be treated as exempt from charges in respect of treatment that the relevant agreement entitles them to. 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 the person has travelled to the UK for the purpose of obtaining healthcare.

    Assessment of eligibility under reciprocal or bilateral arrangements can be complex so please contact the Overseas team for advice. 

    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.

  • Insurance

    If you are liable for the charges associated with your care you may choose to use your travel insurance or health insurance to fund your care. If you have insurance cover, it is your responsibility to contact the company to gain a ‘letter of guarantee’ and authorisation numbers from your insurers authorising your treatment.

  • Consequences of Non Payment

    You should be aware that under paragraphs 320(22) and 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.

    In the absence of prompt full settlement or a reasonable repayment schedule, non-clinical information relating to this debt is provided routinely to the Home Office and may be used by the Home Office to apply the above Immigration Rules. The information will remain active for the purpose of the above rules until the debt is settled and a record of the settled debt will also be retained, both subject to normal limitation periods.

    In the event that you may seek entry to the UK or make an advance immigration application after settling an NHS debt in the previous two months, you are advised to retain and carry evidence of payment for potential examination by Home Office officials.

  • Frequently Asked Questions (FAQ)

  • 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 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.

  • 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 within the UK. All patients admitted to this hospital, whatever their nationality and living status, may be required to provide correct information 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 acceptable documents can be found below.

  • What happens if I need to attend the accident and emergency department?

    You will not be charged for treatment you receive in A&E. However, if you are admitted or transferred to another ward, you may have to pay.

  • I am just visiting the UK. Do I definitely have to pay for treatment if I become unwell?

    There are a number of circumstances under which you could 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, you might be entitled to free healthcare if you become unwell during your visit to 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). This card does not entitle you to pre-planned treatment – only emergency treatment.
    • If you have come from abroad to take up employment or studies in the UK, you might be entitled to free hospital treatment. However, it will not be enough to show your ‘right to work’. You need to be able to show evidence that you are actually working for a UK-based employer. If you are in full-time study, you need to be able to show that you are attending a full-time course of not less than six months duration.
    • If you are a refugee or an asylum seeker whose formal application to the UK Border Agency is still being considered, you will not have to pay hospital charges. A refugee is someone who has been granted asylum in this country. If you are a refugee or an asylum seeker you will still have to pay for all prescribed medications.
  • The doctor told me that I would not have to pay

    The only person who can formally advise whether you are eligible for NHS treatment is a UCLH Overseas Officer. 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.

  • How will I know if I have to pay?

    The Overseas Visitors Team (contact details below) can provide you with more detailed information if you are unsure whether you are entitled to free hospital treatment.

  • If I am not eligible for free treatment, what will I have to pay for?

    You will be charged for any treatment given to you, by any member of staff in any of our services, both in the hospital or in the community. Exceptions may apply under certain circumstances, but we will discuss this with you if it applies to you.

  • I can’t afford it. What should I do?

    If a patient states that they cannot afford to pay for their treatment, the Finance Department 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 of how to contact the Finance Department when they receive an invoice

  • What is changing? - Department of Health Pilot

    From 24 July 2017, we are asking all patients attending their first appointment in pilot clinics to provide two forms of identification. The two pilot clinics are when a patient meets a midwife for the first time in our Maternity Service and the first appointment in Clinical Neurophysiology Department for non-emergency patients.

    These new processes will enable us to assess whether patients are eligible for free NHS treatment, in line with Department of Health regulations. This is part of a national 3 month pilot programme led by the Department of Health and NHS Improvement.

    This process will not apply to urgent care, including surgery or A&E. No patient visiting UCLH will have urgent care delayed.

    Our Overseas Visitors team will be in the pilot clinics and will work with patients to assess their eligibility and to support them and discuss payment arrangements if they are not eligible for free NHS treatment.

    For more information please contact the UCLH Overseas Visitors Office on 0203 447 78348 or email overseasvisitorsofficers@uclh.nhs.uk.

  • Acceptable documents

    The following documents can be used as proof of identity:

    • Current signed passport
    • Residence permit issued by UK Border Agency
    • EU or Swiss National Identity Photo-card
    • Valid armed forces or police photographic Identity Card
    • Valid UK photo-card driving licence
    • Photographic disabled blue badge
    • Citizen card or national identity card
    • Council issued bus pass (e.g. Freedom Pass) for senior citizens only

    The following documents can be used as proof of address:

    • Recent original utility bill (gas, electricity, water, land line phone bill) (mobile not accepted)
    • Local Authority council tax bill for the current year
    • Bank, building society or credit union statement of passbook
    • Original mortgage statement from recognised lender issued within the last year
    • Current council/housing association rent book/card or tenancy agreement
    • HMRC self-assessment letter or tax demand dated within the current financial year
    • Recent payslip / P45 / P60
    • Notification letter from Department for Work and Pensions confirming your right to benefit or state pension
    • Solicitor letter within the last three months confirming recent house purchase/land registry confirmation of address
    • Recent letter from School/University/Place of employment

    Should a patient be identified as chargeable (not eligible for free NHS treatment), we will communicate this to the patient and advise them of the anticipated cost Our Overseas Visitors Office will work with patients to discuss payment arrangements however care will not be delayed or withheld.

    Emergency Department attendances and urgent care will be provided as normal. No patient visiting UCLH will have urgent care delayed.