Guidance for overseas visitors to the UK

We understand that your visit to our hopitals may be stressful for you, and we would like to make it as easy as possible for you to understand the information our staff will need to establish entitlement to NHS services.

'Ordinarily resident' status

Hospital treatment is free of charge to people classed as 'ordinarily resident' in the UK. Determining residency is not as straighforward as, for example, the place where you were born, payment of UK taxes, National Insurance contributions, being registered with a GP (doctor), having an NHS number or owning property in the UK.

To be considered 'ordinarily resident', you must be living in the UK on a 'lawful and properly settled basis for the time being' - and you may be asked to prove this.

The Department Of Health Overseas Charging Regulations place the responsibility on to individuals to prove entitlement to free NHS treatment. We ask for your cooperation in providing the evidence requested, to avoid your liability for the cost of any treatment provided to you, now or in the future.

What is the law on overseas visitors?

The Department of Health Overseas Charging Regulations require all NHS hospitals to identify and charge all overseas visitors for the treatment they receive.

Establishing residency

Upon arrival in our hospital you wil be asked to confirm for long you have lived in the UK and you may be asked to complete a form and provide documents to prove you are ordinarily resident in the UK.

If you cannot provide documents, you may have to make an interim payment equal to the estimated cost of your treatment before you can be given an appointment or receive any treatment.

Maternity services or any treatment which the doctor or nurse thinks is immediately necessary will not be withheld. However, charges will still apply and you will receive an invoice for your treatment.

Important points to note

A person does not become 'ordinarily resident' in the UK simply by:
  • Having British nationality
  • Holding a British passport
  • Being registered with a GP
  • Having an NHS number
  • Owning property in the UK
  • Having paid - or currently paying - National Insurance contributions and taxes in the UK.
Whether a person is 'ordinarily resident' is a question of fact, for which a number of factors are taken into account.

What type of documents can I provide?

The following documents can be used as proof of identity; and you must provide one photographic document plus any other document as proof of address:

  • A current, signed passport
  • A Biometric Residence Permit, issued by the Home Office
  • EU or Swiss national identity photocard
  • Application Registration Card (ARC)

The following documents can be used as proof of address. They must contain your current address and be dated within the last six months:

  • A valid UK driving licence
  • A recent original utility bill eg. gas, electricity, water, telephone landline (mobile phone bill not acceptable)
  • Council Tax bill (current year)
  • Bank, building sociaety or credit union statement
  • Recent, original mortgage statement from a recognised lender
  • Notification letter from the Department for Work and Pensions (DWP) confirming your National Insurance Number, entitlement to benefits or state pension
  • Current council or housing association tenancy agreement or rent book

Patients living in the European Economic Area (EEA)

If you access our services because the need arose during your visit to the UK, you will need to show your European Health Insurance Card (EHIC) or a Provisional Replacement Certificate (PRC).

If you do not have these documents with you, and cannot demonstrate that you have an exemption to charges, you will be required to pay for your treatment and recover the costs from your 'healthcare abroad team', when you return home.

How can I obtain a Provisional Replacement Certificate (PRC)?

It is up to you to apply for a PRC and provide it to the hospital. Please go to the European Commission website and enter your search criteria. Alternatively, download the EHIC app to your smartphone and within the section called "I lost my card", select your country. Your health insurer's telephone number, email and website address will then be made available.

Visitors from the rest of the world

If you are visitng the UK from a non-EEA country, you need to ensure you are covered for healthcare through personal medical insurance for the duration of your visit, even if you are a former UK resident. This is a requirement of your entry to the country. This may be in the form of existing medical insurance from your home country or as travel insurance.

If you are coming for more than six months, you may need to pay the Immigration Health Surchargeas part of your visa application. This means you will receive treatment on the same basis as a citizen of this country. Should you need NHS treatment and you have not arranged insurance, or paid the health surcharge, you will be charged in line with NHS rates unless an exemption category applies to either you or the treatment.

Students

If you are a student you will require an EHIC (EEA students only), a copy of your passport and visa, Biometric Residents' Permit (BRP) or proof of travel insurance that covers your whole stay in the UK. We will also require a letter from the UK school, college or university at which you are studying, confirming that you are taking a course there and whether it is full-time or part-time, its duration and confirmation of your rate of attendance.

Chargeable patients

If we are unable to establish your entitlement to free NHS treatment, or find that you are a chargeable patient, you will be asked to make payment of your treatment costs. The treatment will be based on your initial clinical diagnosis and we will try to provide you with an idea of the cost in advance. Please be aware that this can increase as the treatment progresses.

As previously stated, immediately necessary or maternity services will not be withheld on the basis of ability to pay even though you remain liable for the treatment cost. If you are insured, please see below.

Non-urgent or elective treatment must be witheld by law from chargeable overseas visitors until the estimated full cost of the treatment has been paid. The decision will be based on clinical opinion.

Insured patients

Patients with insurance will not need to pay at the time of treatment if their insurance provider supplies the hospital with a letter of guaranteed payment before your discharge from our care. This will be assessed based on the information available to us at the time of your attendance and after consultation with your insurance company.

Although we provide you with an estimate of your treatment costs, we will assess the actual cost once you are discharged from our care and we have issued a final invoice (which happens as soon as possible after discharge). Please note this may differ from the estimate, depending on diagnosis and eventual treatment. Any overpayment will be refunded once the final invoice has been issued.

Failure to pay

We ask that you settle your invoice immediately on receiving it. If you have financial difficulties please let us know, so that we can work with you to explore payment options.

Invoices outstanding for more than two months may be referred to debt collection and, in some circumstances, to UK Visas and Immigration, and this may affect future applications to enter or remain in the UK. Necessary (non-medical) personal information may be passed via the Depertment of Health to the Home Office for this purpose.

Free treatment

Some NHS services are free of charge to everyone. This includes family planning services and treatment for certain infectious diseases. Treatment in the Emergency Department is free only up to the point that an overseas visitor is admitted as an inpatient or given an outpatient appointment. This means that emergency treatment elsewhere in the hospital, or urgent treatment after admission, is chargeable.

Contact us

The Overseas Team is available Monday-Friday, 9am-4pm on 0044 (0)1895 279713, or via the hospital switchboard on 0044 (0)1895 238282. Email: thh-tr.overseasdepartment@thh.nhs.net

Finance Department (Accounts Receivable)

Telephone: 0044 (0)1895 279790
Email: thh-tr.overseasdepartment@nhs.net

Man and woman in silhouette seen from behind approaching the UK border at Heathrow Airport

Overseas Team
Monday-Friday, 9am-4pm on 0044 (0)1895 279713, or via the hospital switchboard on 0044 (0)1895 238282. Email: overseasdepartment
@thh.nhs.net