Some people from overseas might be able to have National Health Service (NHS) treatment in certain situations.
The rules about who can and can’t have NHS treatment can get quite complicated. This information is meant as a guide, as we are unable to cover every situation. Most of this information is about the law in England. There are different charging regulations in Wales, Scotland and Northern Ireland. But there are a lot of similarities.
Make sure you get as much information as you can to find out if you are eligible for free treatment. One way to do this is look at health service information online. This depends on where you are in the UK:
If you are visiting the UK and need urgent treatment, you can call an ambulance (999) or go to a hospital accident and emergency (A&E) department.
All the treatment you get in accident and emergency departments is free.
Services free at the point of use for all
There are some services in the UK that are free at the point of use for all people.
- accident and emergency (A&E) services - this includes everything provided at an A&E department of an NHS hospital. This doesn’t include emergency services if you then become an inpatient or if you need an appointment as an outpatient
- some family planning services
- diagnosis and treatment of some infectious diseases
- diagnosis and treatment of sexually transmitted infections
- palliative care services - if they are provided by a charity or a community group outside of the NHS
- services provided by the NHS111 advice line (in England and Scotland)
- treatment for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence - except where you have travelled to the UK for the purpose of getting this treatment
- services in GP surgeries (in England)
Treatment for cancer does not fall into these categories. Chemotherapy, radiotherapy and surgery are not free at the point of use for all people.
People who are exempt for charges
There are some people who are also exempt from charges. If you fall into any of these categories, the normal rules about eligibility do not apply. This includes for cancer treatment.
You are exempt if you:
- are a refugee
- have applied for asylum here
- are receiving support under section 95 of the Immigration and Asylum Act 1999 from the Home Office
- are a child looked after by a local authority
- are a victim, or suspected victim, of modern slavery
- are receiving treatment as under a court order
- are in prison or an immigration removal centre
There are also exemptions for UK Government employees and war pensioners. These include UK armed forces members and those working in employment overseas that is financed in part by the UK Government.
Who else can have NHS treatment?
There is not a health insurance system in the UK. Generally, you can only have NHS treatment if you are a resident of the UK. This means an overseas visitor is any person who is not ‘ordinarily resident’ in the UK.
You are not ordinarily resident in the UK simply because you:
- have British nationality
- have a British passport
- are registered with a GP in the UK
- have an NHS number
- own property in the UK
- have paid (or are currently paying) National Insurance contributions and taxes in the UK
For most people from overseas it’s not necessary for the NHS to consider if you are ordinarily resident here. You are entitled to some free medically necessary care if you can show a:
- non UK European Health Insurance Card (EHIC)
- provisional replacement certificate (PRC)
- S2 form - this allows movement through EU countries for medical treatment in certain circumstances
What treatment you are eligible for depends on the rules about which form you have.
Returning to settle
UK citizens who return to the UK on a settled basis will be classed as ordinarily resident. This means you will be eligible for free NHS care immediately. This includes cancer care.
You might be asked for proof you are returning to settle for in the UK.
People who live in a European Economic Area (EEA) state or Switzerland (including non EEA nationals)
What is the European Economic Area?
The EEA is made up of the 28 member states of the European Union (EU). It includes the UK for now. Also Iceland, Lichtenstein and Norway.
The countries in the EU are:
- Republic of Cyprus (not Northern Cyprus)
- Czech Republic
Switzerland has a separate agreement with the EU. This means it matches the EU regulations about charging for healthcare.
Medically necessary treatment in the UK (until you return to your home country)
If you’re an overseas visitor living in an EEA state, you may be insured under your public healthcare insurance system from your home country. This means you won’t be charged for medically necessary treatment on the NHS if you have your relevant EEA healthcare document.
How you become insured can change from country to country. But you should be entitled to hold a European Health Insurance Card (EHIC) or Provisional Replacement Certificate (PRA) from the country you are insured in.
Your EHIC card should look like this.
Coming to the UK for treatment
If you live in a European Economic Area country or in Switzerland, you may be able to have treatment in the UK if it’s not available where you live. You would need a special form (S2 or DA1) which you get from your own doctor. Most people have the right to free health care in the UK if you have a UK issued S1 form which is registered in another state in the EEA, or Switzerland
This is for people who receive:
- an exportable UK pension
- contribution based Employment Support Allowance
- another exportable benefit
People from outside the European Economic Area (EEA) coming to the UK for 6 months or more
You might be coming to, or remaining, in the UK for 6 months or more from outside the EEA.
If this is the case, you are required to pay an immigration charge (called the health surcharge). At the moment, this is £400 per year. Or £300 for students and their dependents and Youth Mobility Scheme Visa holders.
You send this fee to the Home Office alongside your immigration application fee.
People are generally able to receive the same services as a person ordinarily resident in the UK if they:
- have immigration permission to be in the UK and have paid the surcharge
- are exempt
- their fee has been waived by the home office
If you have indefinite leave to remain in the UK or are not subject to immigration control (for example a diplomat posted to the UK) you don’t have to pay the surcharge.
Visiting for less than 6 months
If you're visiting England from a non EEA country for less than 6 months, you need to have personal medical insurance, even if you're a former UK resident.
Reciprocal agreements and international obligations
Some countries might pay for their residents to come to the UK for treatment. This is usually limited to immediate medical treatment. They have what is called a bilateral, or reciprocal, agreement with the UK government.
The rules around these reciprocal agreements can be quite complex. You will need to provide proof you are either:
- a national
- a citizen
- a lawful resident
What level of healthcare you are entitled to in the UK depends on the agreement.
The countries that currently have a reciprocal agreement with the UK, generally for all insured persons of that country, are:
- Bosnia and Herzegovina
- New Zealand
You might also qualify if you are a resident of these countries, whatever nationality you are:
- British Virgin Islands
- Falkland Islands
- Isle of Man
- St. Helena
- Turks and Caicos Islands
There is a reciprocal agreement between the UK and the Faroe Islands for residents who are Danish Nationals.
You can check with your own government health department to see if your government can sponsor your treatment.
Private cancer treatment in the UK is generally available for anyone who is able to pay. Unfortunately, cancer treatment can be very expensive. Remember, you will also need to pay for accommodation near the hospital while you are having treatment.
Citizens’ rights after the UK leaves the EU
There will be no change to the rights and status of EU citizens currently living in the UK until 30 June 2021, or 31 December 2020 if the UK leaves the EU without a deal. You and your family can apply to the EU Settlement Scheme to continue living in the UK. The scheme will open fully by 30 March 2019.