FREQUENTLY ASKED QUESTIONS
THE MAIN OVERSEAS VISITORS WEBPAGE PROVIDES LINKS TO FACTSHEETS ABOUT CERTAIN GROUPS (WORKERS; STUDENTS; ASYLUM SEEKERS/REFUGEES; FORMER UK RESIDENTS WORKING ABROAD; UK PASSPORT HOLDERS LIVING ABROAD; UK PENSIONERS VISITING SCOTLAND; AND HOLIDAYMAKERS IN THE UK) OF OVERSEAS VISITORS' HEALTH RIGHTS WHILE IN SCOTLAND.
Some common questions (from patients) and answers are detailed below:
Am I exempt from all NHS charges?
In common with those ordinarily resident in the UK, anyone who is exempt from charges for hospital treatment will have to pay statutory NHS charges, e.g., prescription charges, unless they also qualify for exemption from these, and will have to go on to waiting lists for treatment where appropriate.
Can I access primary care services?
GPs have a measure of discretion in accepting applications to join their patient lists. It is advisable to approach a GP practice and apply to register on its list of NHS patients. The practice may choose to accept or decline your application. An application may be refused if the practice has reasonable grounds for doing so. A practice would not be able to refuse your application on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition. If you have difficulty in registering with a GP, you should get in touch with your local NHS Board.
Do I have to pay for emergency treatment if I have an accident?
Regardless of residential status or nationality, emergency treatment given at primary care practices (a GP) or in Accident and Emergency departments or a walk-in centre providing services similar to those of a hospital Accident and Emergency department is free of charge.
In the case of treatment given in an Accident and Emergency department or Walk-in Centre the exemption from charges will cease to apply once the patient is formally admitted as an in-patient (this will include emergency operations and admittance to High Dependency Units) or registered at an outpatient clinic.
What about British Nationals? I hold a UK passport/have paid taxes in the past/own a property in the UK?
Nationality, ownership of property in the UK or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence. The only thing relevant is whether you ordinarily live in the UK.
How do I know if I have to pay ?
The Regulations state that the hospital providing treatment is responsible for establishing who is entitled to free NHS hospital treatment. They will make their decision in accordance with the Regulations. The hospital can ask you to provide evidence to support any claim to free treatment and it is your responsibility to do so if asked. If the hospital decides you are eligible for free NHS treatment you will still have to pay statutory NHS charges such as prescription charges unless you are otherwise exempt. If the hospital decides you are not entitled to free NHS treatment charges will apply and cannot be waived.
What if I do not meet one of these exemptions from charges?
If you are not ordinarily resident or exempt under the Regulations, charges will apply for any hospital treatment you receive and cannot be waived. If this is the case you are strongly advised to take out private healthcare insurance that would cover you for the length of time you are in the UK. There is no facility to purchase healthcare insurance from the NHS therefore any necessary insurance must be organised privately.
Are any services/treatments exempt from NHS charges?
All treatment given by staff at a hospital or by staff employed by a hospital may be subject to a charge with the following exceptions, which are free to all:
Treatment given in an accident and emergency department (excludes emergency treatment given elsewhere in the hospital);
Treatment given in a walk in centre providing similar services to those of an accident and emergency department of a hospital;
Treatment for certain communicable diseases (excluding HIV/AIDS where it is only the first diagnosis and connected counselling sessions that are charge free);
Compulsory psychiatric treatment.
Family planning services.
What documents will I need if I require hospital treatment?
Individual hospitals are responsible for deciding whether, in accordance with the regulations, a patient is liable to be charged for treatment or not. In order to establish entitlement, hospitals can ask you to provide documentation that supports your claim for free treatment, as appropriate.
Are you taking up or resuming permanent residence in the UK?
Under the current Regulations, anyone who is taking up or resuming permanent residence in the UK is entitled to free National Health Service (NHS) hospital treatment in Scotland. If your intention is to live permanently in the UK you will be exempt from hospital charges from the date of your arrival in the country but you should expect to be asked to prove your intention and that you are legally entitled to live here. This exemption applies to your spouse, civil partner and children (under the age of 16, or 19 if in further education).
If you do not have an automatic right to take up permanent residence but have applied to the UK Border Agency for leave to enter/remain on a settled basis, you will be chargeable for any hospital treatment up to the point your application is granted or until you accrue, at least, 6 months lawful residence in the UK, although this can vary.
Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and dependent children will also be considered ordinarily resident.
Are you coming to the UK to marry a person living in the UK?
Under the current Regulations anyone who comes to the UK to take up permanent residence is fully exempt from charges for National Health Service (NHS) hospital treatment in England. A person who has been given leave to enter the UK by the Home Office to marry or become the civil partner of someone who is ordinarily resident here may be regarded as taking up permanent residence, and therefore exempt from charges for NHS hospital treatment. This exemption would extend to your children (under the age of 16, or 19 if in further education).
Once you are living here permanently and have married or become a civil partner you will become ordinarily resident in your own right and the Regulations will cease to apply to you.
Are you spending more than 3 months living outside the UK?
Extended holidays?
If you are going abroad for a one-off extended holiday for a few months, then you will continue to be fully exempt from charges for NHS hospital treatment when you return to resume your permanent residence in the UK. The same will apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education).
Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and children will also be considered ordinarily resident.
Living as an "insured" resident of a European Economic Area (EEA) country?
If you go to live permanently (or for more than 3 months each year) in another EEA member state and become an "insured" resident of that member state (i.e., become insured for the purposes of state healthcare in that country) then, under European Community Social Security Regulations, you will be entitled to "all necessary treatment" free of charge when you are visiting the UK. This means treatment the need for which arises whilst in the UK, including pre-existing conditions which acutely exacerbate unexpectedly, or, in the opinion of a clinician, would be likely to acutely exacerbate without treatment. It also covers the treatment of chronic conditions, including routine monitoring. It does not cover elective treatment such as pre-planned operations without special arrangement.
In order to show to an NHS Board that you are an insured resident of another member state you will need to produce a valid European Health Insurance Card (EHIC) issued by that member state, or a Provisional Replacement Certificate. Failure to produce this may mean that you are charged for your treatment and you will have to apply to your member state of residence to be reimbursed.
If you are living in one of these member states but are not insured there, and have previously had ten or more continuous years' lawful residence in the UK at any point, then you will be exempt from charges for treatment the need for which arises during a visit to the UK. Unlike for insured residents, this does not cover routine treatment for chronic conditions. Similar to those insured, it also does not include pre-planned elective treatment.
Living in a bilateral healthcare agreement country?
If you have at some point lived lawfully in the UK for 10 continuous years, and subsequently choose to go and live permanently (or for more than 3 months each year) in a country with which the UK has a bilateral health agreement, then, when you are visiting the UK, you will be exempt from charges for treatment for a condition which arises after your arrival here. Routine treatment of a pre-existing condition, or pre-planned operations etc, will be chargeable. This partial exemption will also apply to your spouse, civil partner and children (under the age of 16, or 19 if in further education). NB - This level of exemption will also apply if you live in an EEA member state but do not become an "insured" resident there.
You will only be fully exempt from charges if you meet one of the other exemption criteria, for example because you are working abroad and have been doing so for less than 5 years.
Living in a non-bilateral healthcare agreement country?
If you choose to go and live permanently (or for more than 3 months each year) in a country with which the UK does not have a bilateral health agreement, then you will not normally be eligible for free NHS hospital treatment during a visit to the UK, no matter how long you may have lived here in the past. You may, however, be exempt from charges if you meet one of the other exemption criteria, for example because you are working abroad and have been doing so for less than 5 years.
Living in both the UK and another country?
If you spend more than 3 months living in another country on a regular basis each year, for example because you spend four months living in a second home during the winter but return to the UK for the rest of the year, then you may not be eligible for free hospital treatment while you live here. If the other country is one with which the UK has a bilateral health agreement then the partial exemptions described above will apply to you. If the other country is not one with which there is a bilateral health agreement, then you will not be entitled to free NHS hospital treatment during the time you live here, unless you meet one of the other exemption criteria.
Returning to the UK after a period of time living away?
If you go anywhere abroad for more than three months, either for a one-off extended holiday for a few months or to live permanently for several years, but then return to the UK to take up permanent residence here again, then you will be entitled to receive free NHS hospital treatment from the day you return. So will your spouse, civil partner and children (under the age of 16, or 19 if in further education).
Once you are living here permanently you will become ordinarily resident and the Regulations will cease to apply to you. Your spouse, civil partner and children will also be considered ordinarily resident.