Overseas Patients

Overseas visitors who need healthcare while in the United Kingdom may not be entitled to free healthcare from the National Health Service.
 
We understand that your visit to our hospital may be very stressful for you and we would like to make it as easy as possible when it comes to your understanding of the information that may be required by our staff to establish entitlement to NHS services. To be considered ordinarily resident, you must be living in the UK on a ‘lawful and properly settled basis for the time being’ – you may be asked to prove this.
 
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.
 
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, contact the Overseas Visitors department 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.
 
Immediately necessary or urgent services, including maternity services – Clinically assessed immediate, urgent and maternity care will not be withheld on the basis of ability to pay even though they remain liable for the treatment cost.
 
Non-urgent or elective treatment – We are required by law to withhold treatment from chargeable overseas visitors until the estimated full cost of the service has been paid. This decision will be based on clinical opinion.
 
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 who will be happy to help you:
 
Contact
020 7288 3820

Visitors from the EEA and Switzerland

If you are a visitor from the EEA, you will need to present a valid European Health Insurance Card (EHIC) or other healthcare documents (such as S2 or S1 forms) or you may be charged for your care. If you don’t have an EHIC card you can apply for one from the country where you normally live through www.ehic.europa.eu and selecting your national flag.
 
It’s also possible to get a Provisional Replacement Certificate (PRC) if you don’t have your EHIC, this is an emergency document and will provide the same level of cover as the EHIC and is normally dated for the period of your visit to the country. Please contact your national healthcare provider to request this document.

Visitors from the Rest of the World

If you are visiting England 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 conditions to the country.
 
If you are coming for more than six months, you may need to pay the Immigration Health Surcharge https://www.gov.uk/healthcare-immigration-application as part of your visa application. This means you will be receive treatment on the same basis as an ordinary resident of the country.
 
You’ll still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and Assisted Conception services. Should you need NHS treatment and you have not arranged insurance, or paid the health surcharge, you will be charged at 150% of the standard NHS rate, unless an exemption category applies to either you or the treatment.

Students

If you are a student you will require an EHIC card (EEA students only), a copy of your Passport and Visa, Biometric Residents Permit (BRP), or proof of travel insurance to cover your whole stay in the UK. We will also require a letter from the UK school, college or university you are studying at confirming that you are on a course there, and whether it is a full or part-time course, how long it’s for and also confirmation of your attendance rate.

Chargeable Patients

If we are unable to ascertain your entitlement to free NHS treatment, or find that you are a chargeable patient, you will be asked to make payment for your treatment costs. This payment 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 vary as the treatment progresses. Immediately necessary or urgent services, including maternity services – Clinically assessed immediate, urgent and maternity care will not be withheld on the basis of ability to pay even though you remain liable for the treatment cost. If you’re insured please see below.
 
Non-urgent or elective treatment – We are required by law to withhold treatment from chargeable overseas visitors until the estimated full cost of the service has been paid. This decision will be based on clinical opinion. Insured Patients – Should your medical expenses be covered by travel or health insurance you may not need to pay at the time of your treatment but we will need to assess this based on the information available to us at the time of your attendance and after consultation with your insurance company.
 
Whilst we will provide you with an estimation of your treatment costs, we will assess the actual once you are discharged from our care and issue a final invoice as soon as possible after this. Please note that this may differ from the estimate provided as this will depend on your diagnosis and your treatment pathway. Any overpayment will be refunded once the final invoice has been issued.

Patients from countries with Reciprocal or Bilateral arrangements

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.
 
Anguilla, Australia, , Bosnia & Herzegovina, British Virgin Islands, Falkland Islands, Faroe Islands (applies to Faroese residents who are Dutch nationals) Gibraltar, Isle of Man, Jersey, Kosovo, Macedonia, Montenegro, Montserrat, New Zealand, Serbia, St Helena, Turks and Caicos Islands.

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.
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