Overseas Visitors and/or Patients

Eligibility for NHS care

We understand that visiting a hospital/accessing health services in a different country may be very stressful. Here at Harrogate and District NHS Foundation Trust 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 team to establish your eligibility for NHS treatment.

People classed as “ordinarily resident” in the UK will not be charged for NHS hospital treatment.

To be considered ordinarily resident, you must be:

  • Legally resident in the UK
  • Live in the UK on a lawful and properly settled basis for the time being

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. For a detailed definition about what ordinarily resident means, see the Department of Health Overseas Charging Regulations.

An overseas visitor is defined as any person who is not “ordinarily resident” in the UK. This may include British nationals who now live overseas (ex-pats) who may therefore not be entitled to free NHS hospital care. British nationality, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS Number or owning property in the UK do not necessarily confirm a status of ‘ordinarily resident’.

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 may still be charged.

Checking eligibility

The Department of Health Overseas Charging Regulations place the responsibility on individuals to prove their eligibility for NHS treatment. We would ask for your co-operation in providing the evidence requested to avoid incurring charges for any treatment provided to you now or in the future.

Visitors from the European Economic Area (EEA) or Switzerland

If you are a visitor from the EEA or Switzerland, you will need to present a valid 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 outside the European Economic Area (non-EEA)

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. Please bring your insurance documentation with you when you come to the hospital.

If you are coming for more than six months, you may need to pay the immigration health surcharge as part of your visa application. For more information please click here.

Should you need NHS treatment and you have not arranged insurance, or paid the health surcharge, you will be charged, unless an exemption category applies to either you or the treatment.


Students from the EEA/Switzerland who are studying in the UK remain insured in their home state and are required to provide a valid NON UK EHIC/PRC. For Non EEA Students a copy of your passport, visa or Biometric Residents Permit (BRP), or proof of travel insurance to cover your whole stay in the UK.

Chargeable Patients

If we are unable to ascertain your eligibility for NHS treatment, or find that you are a chargeable patient, you will be asked to pay for your treatment costs. This payment will be based on your initial clinical diagnosis. Please be aware that your final invoice may vary as the treatment progresses.

Clinically assessed immediately necessary, 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 treatment – For chargeable overseas visitors, full payment of the estimated cost of treatment will be required in advance. Please be aware that your final invoice may vary as the treatment progresses.

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, we will require a Guarantee of Payment from your insurance company to cover the entire cost of your care. If your insurer has agreed to pay for some, or all, of the cost of your NHS treatment and then refuses or is unable to pay, you will be liable to pay the remaining outstanding balance of the charges.

While we will provide you with an estimation of your treatment costs, we will assess the actual costs 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 estimated costs provided as this will depend on your diagnosis and your treatment pathway. Any overpayment will be refunded once the final invoice has been issued.

Non-payment – We would ask that you settle your invoice as soon as possible after receiving it. If you have any financial difficulties please let us know so we can work with you to explore payment options. Unpaid invoices outstanding for two months will be referred to debt collection and in some circumstances if the debt is over £500 referred to the UK Border Agency; this may affect future applications to enter or remain in the UK.

Reciprocal healthcare agreements

The UK has reciprocal healthcare agreements with some countries outside the non-European Economic Area (EEA).

Within the reciprocal healthcare agreements there are a number of variations in the level of free treatment provided to visitors travelling to the UK. Generally, only immediate medical treatment* is to be provided free of charge, to allow the overseas visitor to return home for further care – e.g. follow up treatment or outpatient appointments.

Please ensure you check with our Overseas Visitors Team to ensure your financial responsibilities are clear and do not assume all your treatment will be covered.

If you’re being treated under a reciprocal agreement and it is terminated during the course of your treatment then you will become liable for all further costs.

*Immediate treatment is defined as to save the patient’s life/prevent a condition from becoming immediately life-threatening or needed promptly to prevent permanent serious damage occurring.

Prescription costs and dental charges

Patients in England are required to make contributions towards the cost of their NHS care, such as paying prescription costs or dental charges. You will be required to make the same contributions.

Interpreter and translation services

We are committed to ensuring that all of our patients, including non-English speakers, receive the support and information they need to access services, communicate with healthcare staff and make informed decisions about their care and treatment.

Wards, clinics and departments can access speech and sign language interpreter services for patients who require them. Speech interpreter services are generally provided using a telephone-based service.

If you or your carer need communication support please contact the ward, clinic or department you are visiting as soon as possible.

If you are unsure who to contact then please contact our Patient Experience Team.

Further information

Contact us

If you have any queries please get in touch. We look forward to hearing from you.

Telephone: 01423 555430

Email: [email protected]