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Overseas patients

What is an overseas patient?

An overseas patient is someone who is not ordinarily resident in the UK and does not permanently live in the UK. If you are visiting the UK, or have been living outside the UK for more than six months, you may have to pay for NHS hospital treatment whilst you are here. This is regardless of whether you are a British citizen or have lived or worked here in the past.

If you are on holiday or visiting the UK and the need for your treatment is urgent and cannot wait until you return home, your hospital care will be the same as for any NHS patient. The only difference is that some overseas visitors may have to pay for their NHS hospital treatment, whilst for others there are agreements between international governments to cover the cost, and special arrangements apply for countries in the European Union.

What is the Trust policy on overseas patients?

The Trust follows the Department of Health Regulation to identify and charge overseas patients for hospital treatment they receive. If you can show that you have lived in the UK legally for the last 12 months or more, or a former UK resident of 10 years or more now employed outside the UK for no more than five years, then you will be entitled to free NHS hospital treatment. Examples of acceptable proof of residence are a housing contract, utility bills and bank statements. Examples of acceptable proof of right of residence are a valid passport and entry clearance documents such as valid visa, valid to enter/remain stamp, proof of employment.

What will happen when I arrive at hospital?

Upon arrival at hospital you will be asked to confirm how long you have lived in the UK. If you have not, or cannot prove you have, lived in the UK for the last 12 months you may be asked further questions. You may then be asked to sign an 'undertaking to pay,' if your treatment is not exempt from charges. The hospital will advise if you are liable to pay and the cost of your treatment will be explained. If the complete cost of the treatment is not known at this point, you will be given a guide price and you will be entitled to a refund if this is more than the actual cost of your treatment. You will be asked to pay before you receive your treatment.

What do I have to do?

If you believe you are liable to pay please ensure you bring payment with you. The Trust accepts Cash or Cheque payments. When you pay you will be provided with a receipt for your records. If you are unable to pay the full amount prior to receiving your treatment, it will not affect the level of urgent care you will receive. If you have any questions please contact the General Managers for each specialty. You can also find further information on the Department of Health website.

Who can receive all NHS hospital treatment free of charge?

You can get free NHS hospital treatment if you are lawfully entitled to be in the UK and usually live here. This is called being ordinarily resident. Some people from abroad who are not ordinarily resident in the UK can receive all NHS hospital treatment free of charge. If you are entitled to free NHS hospital treatment, family members including your spouse, civil partner and dependent children will also be able to get free treatment, but only if they are lawfully allowed to live in the UK. In many cases, they must also be living with you throughout your stay to qualify. You can receive free NHS hospital treatment if you:

  • have been living legally in the UK for at least 12 months when you start treatment, and did not come to the UK for private medical treatment. Temporary absences from the UK of up to three months (in England, up to 182 days) are ignored
  • have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse
  • have come to the UK to work, either as an employee or self-employed person. In England and Wales, if you are employed, your employer's main place of business must be in the UK or be registered in the UK. This could be, for example, a branch of an overseas company. If you are self-employed your main place of business must be in the UK
  • normally work in the UK, but are temporarily working abroad for less than five years. You also need to have lived in the UK continuously for at least ten years before going overseas.
  • In Scotland, you normally work in the UK but are temporarily working abroad. You must have lived in the UK continuously for at least ten years and taken home leave in the UK at least once every two years. However, if you are studying abroad you may not be entitled to free NHS treatment
  • are receiving a UK war pension
  • have been granted, or made an application for temporary protection, asylum or humanitarian protection
  • in Wales, have applied for asylum
  • in England, are an failed asylum seeker in certain circumstances, or in Scotland and Wales, are a failed asylum seeker
  • in England, are a child the local authority has taken into care
  • have been identified as having been trafficked from abroad or are believed to have been trafficked from abroad
  • are imprisoned in the UK or detained by UK immigration authoritie
  • get a UK state retirement pension and live in the UK for at least 182 days a year (in Scotland and Wales, six months a year) and live in another European Economic Area (EEA) member state or Switzerland for the other part of the year. If you have registered as a resident of another EEA state or Switzerland, you may be entitled to free NHS hospital treatment if you fall ill during a trip back to the UK
  • are from a European Economic Area (EEA) country or Switzerland and have a European Health Insurance Card (EHIC). The EHIC does not cover coming to the UK just to get medical treatment but it allows you to get free care if you're referred to the UK for pre-planned treatment with an E112 or S2 certificate
  • are a student following a course of study which lasts at least six months, or a course that is substantially funded by the UK, Welsh, Scottish or Northern Ireland Governments.

EEA countries are the European Union countries and Liechtenstein, Iceland and Norway.

Visit the website for more information about which countries are in the European Union.

Visitors who can sometimes receive NHS hospital treatment free of charge

You are entitled to free NHS hospital treatment if you are one of the following people and fall ill during your visit. You are not entitled to routine treatment for a pre-existing condition.

You are entitled to receive free NHS care if you:

  • come from a country outside of European Economic Area and your country has signed a health care agreement with the UK. What you are entitled to depends on the agreement
  • get a UK state retirement pension or another state benefit and normally live in a non-EEA country. You must have lived lawfully in the UK for at least ten years continuously in the past, or worked for the UK government for at least ten years continuously. Your spouse, civil partner and dependent children are also entitled to free NHS hospital treatment if they fall ill. They must be living with you throughout your stay in the UK
  • have lived lawfully in the UK for at least ten years continuously in the past and are now living in an EEA member state, or Switzerland, or in a country with which the UK has a healthcare agreement. Your spouse, civil partner and dependent children are also entitled to free NHS hospital treatment if they fall ill. They must be living with you throughout your stay in the UK
  • in England, you have been granted leave to enter the UK for medical treatment. If you want free care, you must apply to the Secretary of State before you try to get treatment. Permission will only be given if there are exceptional humanitarian reasons to justify this. If you have been granted leave to enter the UK to accompany someone who is entitled to treatment for exceptional humanitarian reasons, you are also entitled to free NHS hospital treatment if you fall ill during your visit

Visit the website for more information about which countries are in the European Union.

To find out which non EEA countries have a healthcare agreement with the UK, visit www.nhs.uk.

In addition, people from some countries can get free hospital treatment if they have been referred to the UK for that treatment, under the terms of the reciprocal agreement. There are also special arrangements with certain countries which enable people from outside the UK to get free treatment. The Department of Health can give details of countries with which the UK has a reciprocal agreement and for which there are special arrangements.

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