Entitlement to free NHS treatment and overseas visitors
The NHS provides free hospital treatment to people who live in the UK permanently. You must live here lawfully and on a settled basis to receive free treatment. If you are not ordinarily resident in the UK, you may have to pay for your hospital treatment.
NHS trusts have a statutory obligation to identify patients who are not entitled to free NHS treatment and to charge them for the treatment they receive (under the NHS Charges to Overseas Visitors Regulations, 2015).
We will always provide treatment that is immediately necessary or urgent but we reserve the right not to provide treatment that, in the opinion of a clinician, is not immediately necessary or urgent. In this event we will not provide care until the cost has been paid in full, in advance.
Emergency and maternity treatment is regarded as ‘immediately necessary or urgent’ and NHS care will always be provided. Treatment in our Emergency Department (A&E) at St Thomas’ Hospital is exempt from charges, but patients receiving any other emergency care, including maternity, will be charged if they are not eligible for free treatment.
To establish you eligibility, the Trust may ask you questions about your residential status when you register for a clinical appointment. This can apply to any patient regardless of nationality or if you've paid National Insurance contributions or taxes in the past.
We always ask new maternity patients to provide two documents as evidence of their identity and address at their appointment for a 12-week scan.
I am just visiting the UK. Do I have to pay for treatment if I become unwell?
There are a number of circumstances when you might still be entitled to free healthcare.
- If you are visiting the UK and you normally live in a country with a reciprocal healthcare agreement with the UK, you might be entitled to free healthcare if you become unwell during your visit.
- If you are visiting the UK and you normally live in a country that is a member of the European Economic Area healthcare arrangement you will be entitled to free healthcare if you have a valid European Health Insurance Card (EHIC). This card covers emergency treatment only (not pre-planned). You need to bring this card with you to hospital – it must be in your name and within the expiry date.
- You are a refugee or an asylum seeker whose formal application to the Home Office is being considered. A refugee is someone who has been granted asylum in this country. If you are a refugee or an asylum seeker, you will still have to pay for all prescribed medications.
You may be entitled to free healthcare if you have come to study or take up employment in the UK. You need to show evidence, such as a payslip, that you are working for a UK-based employer. Your ‘right to work’ does not count as evidence in this case. If you are studying full-time you need to show evidence that you are attending a full-time course lasting at least six months.
How can I prove that I am entitled to free
If you have received a request to bring your identification documents you should bring these to your first appointment.
To help us to check if you are entitled to free healthcare, you will need to bring two separate documents to your appointment – one to prove your identity and one to prove your address. See section below for which documents you can bring.
All patients admitted to our hospitals, what ever their nationality and residence status, are required to provide correct information when registering their details. If you are living lawfully with a settled purpose in the UK, or are a visitor in one of the categories above, you should be prepared to provide evidence.
Acceptable identification documents
Please bring at least one valid document from each of the lists below.
Proof of identity
Current signed passport
Residence permit issued by the Home Office
EU or Swiss national identity photo-card
Valid UK photo-card driving licence
Valid armed or police forces photographic identity card
Photographic disabled blue badge
Please note, it is best to bring proof of your right to reside in the UK (for example a UK or EEA passport, EEA national ID photo card, Visa or residence permit issued by the Home Office, Biometric Residence Card or Permit, Asylum Registration Card or valid UK armed or police forces photo ID). This will help us to determine your eligibility quicker and avoid delays to your treatment.
Proof of address
- Recent original utility bill (gas, electric, water, telephone) (mobile not acceptable)
- Council tax bill (valid for current year)
- Bank, building society or credit union statement or passbook
- Recent original mortgage statement from recognised lender
- Current council/housing association rent book or tenancy agreement
- Notification letter from Department for Work and Pensions or HM Revenue and Customs confirming your right to benefit or state pension
- We may provide non-clinical information about you to external agencies for the purpose of confirming your entitlement to free NHS treatment or to recover debts owed to the Trust for treatment provided.
- We always try to recover monies owed for treatment provided and may use external debt collection agencies or take court action. We always advise the Home Office about outstanding debts in excess of £500 for more than two months. The Home Office will prevent you from returning to the UK for as long as this debt remains unpaid.