Overseas patients

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Overseas Patient Team

If you’re visiting the United Kingdom from another country and you use our services, you may have to pay for your healthcare.

Some NHS services are free at the point of use for all patients.  These include:

  • Accident & Emergency Services (within the A&E Department)
  • Family planning services
  • Diagnosis and treatment of specified infectious diseases
  • Diagnosis and treatment of sexually transmitted infections
  • Palliative care services provided by a registered palliative care charity

Some categories of overseas visitor are exempt from charge:

  • Those who have paid the Immigration Health Surcharge, with the exception of Assisted Conception Services. (See below).
  • Those with entitlements under an EU/EFTA reciprocal healthcare agreement
  • Vulnerable patients and those detained, including refugees, asylum seekers and victims of modern slavery amongst others
  • Certain Government employees and war pensioners
  • Those with entitlements under other reciprocal healthcare agreements with certain non-EU countries

Ordinarily Resident

National Regulations stipulate that patients must be ‘Ordinarily Resident’ in the United Kingdom to receive free NHS-funded hospital care.  This means living here lawfully, with a settled purpose at the time of treatment.

Ordinary residence is not based on whether you have paid income tax or national insurance, are registered with a GP and have an NHS number, hold a British passport or own property in the UK.

The same rules apply to everyone, including British nationals who may live overseas.

We will need evidence to prove that you are, or were, legally resident at the time of treatment:

  • one document providing photo-ID, for example – passport, driving licence, national ID card, EU Settlement share code etc.
  • documents confirming your residency, for example – gas, electric, telephone (but not mobile) bill, council tax, bank statement, recent mortgage statement or tenancy agreement, council or housing association rent book etc.

Exit from the European Union

If you are from the European Economic Area (EEA) and came to live in the UK before 31 December 2020, you will need to have status under the EU Settlement Scheme, be able to prove that you have it and also that you are resident in England, to meet the Ordinary Residence criteria.  You can demonstrate your EU Settled Status by providing a Share Code, which can be obtained via the Gov.uk website: View and prove your immigration status – GOV.UK (www.gov.uk)

Visiting from the European Economic Area (EEA) for a short duration

If you are visiting from the EEA or Switzerland for a short duration you will need bring your European Health Insurance Card (EHIC) with you.   This card will cover treatment if the need arose during your visit, but it doesn’t cover medical repatriation to your home country.  It is advisable to also have travel insurance with medical cover.

If you have lost your EHIC you will need to obtain a Provisional Replacement Certificate (PRC) from your home EU member state.  It is your responsibility to provide the correct documentation.

Further information can be found on the European Commission website: European Health Insurance Card – Employment, Social Affairs & Inclusion – European Commission (europa.eu)

If you cannot provide either of these, or have come to the UK specifically to access medical treatment, you will receive an invoice and be required to pay for your treatment.  You may be able to recover the costs from your ‘healthcare abroad team’ when you return home.

If you hold a UK- or EU-issued S1 entitlement form, please contact the Overseas Patient Team to clarify your chargeable status.

UK nationals who are in receipt of a UK pension (and/or other exportable benefit) and who live in an EU or EFTA country, and who hold a valid S1 Certificate will be entitled to healthcare without charge during stays in the UK.

Visiting from outside the EEA for a short duration

If you are visiting England for a short duration from outside the EEA you need to ensure you have personal medical insurance to cover the duration of your visit, even if you are a former UK resident.

Payment of the Immigration Health Surcharge

If you are coming to England for longer than 180 days, you may need to pay the Immigration Health Surcharge (IHS) as part of your visa application.  This means you will be entitled to receive treatment on a similar basis to someone who is ordinarily resident, except for Assisted Conception Services which will be charged for (see below).  You must also pay for other services such as dentistry, prescriptions and eye tests during your stay.

Assisted Conception Treatment

Payment of the Immigration Health Surcharge does not include access to Assisted Conception Services.   Assisted Conception services are defined in the Charging Regulations as ‘any medicines, surgery or procedures that are required to diagnose and treat infertility so that a person can have a child’.

Countries with Reciprocal Healthcare Agreements

The UK has reciprocal healthcare agreements with some non-European Economic Area countries.  The levels of cover vary, but generally only immediate medical treatment is to be provided free of charge, sufficient to allow the overseas visitor to return home.  Immediate treatment is defined as that required to save a patient’s life, prevent a condition from becoming immediately life-threatening or needed promptly to prevent permanent serious damage occurring.

Please check with the Overseas Patient Team to ensure your financial responsibilities are clear, please do not assume all of your treatment will be covered.

Emergency Treatment

Treatment within an Accident & Emergency Department is free of charge for everyone, but if you are later admitted to hospital or need to return for follow-up outpatient appointments charges may apply.

Maternity Treatment

All maternity treatment is considered immediately necessary and will not be withheld whilst a patient’s chargeable status is determined.  However, if a patient is found to be chargeable, charges will still apply and you will receive an invoice after your treatment.

Please also be aware that if you are liable for maternity costs, treatment for your child may also be chargeable if they require additional treatment.

Paying for your care

If you are not eligible for free treatment, you will be charged for any treatment that is provided by staff employed by Worcestershire Acute Hospitals NHS Trust – whether that’s in one of our hospitals or on occasion in the community.

If you fail to pay for NHS treatment for which charges are appropriate, please be aware that any future applications to enter, or remain, in the United Kingdom may be affected and/or denied.

Necessary (non-clinical) personal information may be passed via the Department of Health & Social Care, to the Home Office for the purposes of debt recovery.


Clinical staff will not be able to confirm whether you are eligible for free NHS treatment – your charging status can only be confirmed by the Overseas Patient Team.

We are unable to provide itemised invoices.

Useful links:

The National Health Service (Charges to Overseas Visitors) Regulations place a legal obligation on providers of relevant services to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges.  This is a summary of essential information relating to overseas visitor charging and further information can be found using the links below, which also include information about exempt services and individuals:

Overseas NHS visitors: implementing the charging regulations – GOV.UK (www.gov.uk)

Visiting or moving to England – NHS (www.nhs.uk)