Overseas patients

To be entitled to free NHS-funded hospital and community care, you need to be “ordinarily resident” in the United Kingdom. This means you must be legally resident in the United Kingdom. Nationals of countries outside the European Economic Area (EEA) must also have indefinite leave to remain in the UK in order to be “ordinarily resident” here.

An overseas visitor is defined in the Department of Health Overseas Charging Regulations as any person who is not “ordinary resident” in the UK.  This may therefore include British nationals who now live overseas (ex-pats) who may therefore not be entitled to free NHS hospital care.

NHS trusts have a legal obligation to identify patients who are not entitled to free NHS treatment and to make and recover charges for the NHS services provided.  

These obligations are set out in the guidance published by the Department of Health.

To establish your eligibility we may ask you questions about your residential status. You should be prepared to provide evidence if requested. Evidence may include proof of identity and a proof of address dated in the last three months.  Please see the example pre-attendance form for further information [docx] 236KB

Overseas visitors who may or may not quality for free healthcare

Overseas visitors who may qualify for free healthcare

  • A student studying full time in the UK or an individual who has come to work in the UK on a relevant visa.  If you were required to pay the Immigration Health Surcharge as part of your visa application please note free treatment does not include assisted conception.
  • A refugee or an asylum seeker whose formal application to the UK Border Agency is being considered.  You will need to provide documentary evidence such as your Application Registration Card (ARC).  Please note that you will need to pay for any medication prescribed to you. 
  • A citizen who normally lives in a country that is a member of the European Economic Area (EEA) and has a valid European Health Insurance Card (EHIC) in their name.  This card covers emergency treatment only.  You must bring this card with you to hospital.
  • A citizen who normally lives in a country that has a reciprocal healthcare agreement with the UK.  This covers emergency treatment only and does not cover planned treatment.  Please note that if the agreement is withdrawn during your treatment you will become immediately responsible for the cost of the remainder of your course of treatment.
  • You fall within a group of individuals who are entitled to receive healthcare on the same or similar basis as an ordinarily resident person.   For further information in this regard please see pages 12- 15 of The Department for Health's Guidance on Overseas Visitor Charging Regulations or contact our Paying Patients Team for guidance and support.

Find out which identification documents are acceptable for paying patients[doc] 3MB

Who may not qualify for free healthcare

  • An individual without legal status at point of treatment including failed asylum seekers and illegal immigrants.
  • Ex-pats who now ordinarily reside overseas.
  • An individual with a Biometric Residency Permit (BRP) whose card is marked to confirm their “visitor” status.  This may include academic visitors and private medical visitors.

Provision of treatment to overseas visitors in A&E

Treatment received in our Emergency Departments (A&E) is free.  If you are admitted to hospital as an inpatient or receive any outpatient appointments charges will apply. 

  • For those overseas citizens in possession of a valid European Health Insurance Card (EHIC) please present your card to our A&E reception staff.     
  • If your country of residence has a reciprocal agreement covering your emergency treatment in the UK please advise our A&E reception staff.

In these instances we will re-coup the cost of your care from your country of residence.

Payment in advance for treatment

National guidance states that for treatment assessed by a clinician as non-urgent the full estimated cost of treatment must be paid before treatment is provided.  This will include the cost of initial assessment and investigations to make a diagnosis.  Find out  the different ways you can make payments for your treatment [doc] 3MB

We will always provide treatment that a clinician has assessed as immediately necessary or urgent.  All maternity treatment is regarded as immediately necessary.  Treatment is not free however by virtue of it being immediately necessary or urgent and you will still be charged.

There are some NHS services which are free to everyone.  Please see pages 30 and 31 of the Overseas Visitor Charging Regulations.  EEA citizens with an EHIC card should present their card to reception staff.  

Overseas visitors with private health insurance

If you have private health insurance you must provide a letter of guarantee from your insurer to cover the full cost of your treatment.  If you are unable to provide a letter of guarantee you will need to cover the costs of your treatment and seek reimbursement from your insurer.

Who can help me if I have any further questions?

Please contact the Paying Patients Department for further guidance and support or to book an appointment to provide your documentation.  

Our offices are open Monday to Friday 9am-5pm except bank holidays.

The Royal London and Mile End Hospital

Paying Patients Department - overseas team
The Royal London Hospital
1st Floor, John Harrison House
London
E1 1BB

Email: ppo@bartshealth.nhs.uk

Tel: 020 3594 6527, 020 3594 6526, 020 3594 6302

Newham University Hospital

Paying patients department - overseas team
Newham University Hospital
House 12,
Glen Road
London
E13 8SL

Email: ppongh@bartshealth.nhs.uk

Tel: 020 7055 5717, 020 7055 5626, 020 7363 9328

Whipps Cross University Hospital

Paying patients department - overseas team
Whipps Cross University Hospital
Junction 3
Leytonstone,
London
E11 1NR

Email: ppowx@bartshealth.nhs.uk

Tel: 020 8535 6976, 020 8535 6712, 020 8535 6879

St Bartholomew's Hospital

Paying patients department - overseas team
St Bartholomew’s Hospital
3rd Floor, SMLG
West Smithfield, London 
EC1A 7BE

Email: pposbh@bartshealth.nhs.uk

Tel: 020 3765 8565, 020 3765 8566