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National Health Service for Expats in the United Kingdom

Submitted: July 2013

The National Health Service (NHS) is Britain’s taxpayer-funded healthcare service. It is free, albeit subsidised prescription charges apply in England, mostly for medications, dental care and eye treatment. The UK healthcare system revolves around the NHS, which is a public service administered by the Department of Health.

Management of the NHS is “devolved”. Consequently, there is NHS England, NHS Wales, NHS Scotland, and HSC Northern Ireland (also commonly called “NHS Northern Ireland”). However, this division may be largely unnoticed by patients because of high “cross-border” cooperation at UK level.

A private medical insurance policy might supplement NHS services. See Health Insurance for Expats in the UK

Unconditionally free services

Some services are always free of charge. These include:

  • Emergency treatment See Health Emergencies for Expats in the UK
  • Compulsory psychiatric treatment
  • Compulsory treatment as result of a court order (England and Scotland only)
  • Treatment for some communicable diseases
  • HIV testing and advice, and
  • Family planning services

Residence-based free services

The NHS is normally free if you are “ordinarily resident” in the UK. Residence for NHS purposes is different from tax residence.

NHS hospitals (other than for the above mentioned services) are free if you:

  • Have lived legally in the UK for at least 12 months when you start treatment. Temporary stays outside the UK of up to three months (182 days in England) are disregarded
  • Have come to the UK with the intent of becoming permanent resident
  • Have come to the UK for salaried or self-employed work. In England and Wales, your employer's main place of business (including branches of foreign companies) must be in the UK or be registered in the UK. If you are self-employed, your main place of business must be in the UK.
  • Are temporarily working abroad for less than five years, but you normally work in the UK and you have lived in the UK for a continuous 10-year-period prior to leaving the UK. Tighter rules apply in Scotland.
  • Have been granted asylum, or – in certain circumstances – have made an application for it
  • Get a UK state pension and live in the UK for at least six months a year and live in another EEA country or Switzerland for the other part of the year. If you are a resident of another EEA country or Switzerland, you may still get free NHS hospital treatment if you fall ill during a stay in the UK
  • Are from another EEA country or Switzerland and have a European Health Insurance Card (EHIC) unless you specifically come to the UK to seek treatment, or
  • Are a student following a course of study which lasts at least six months.

Your family members may also be entitled to free treatment if you fall under one of the above categories, but they must generally be living with you whilst you are in the UK.

Free services for certain non-residents

As a general rule, non-residents are not entitled to free routine treatment for a pre-existing condition. However, hospital is free if you are a non-resident and fall ill during a visit to the UK if you:

  • Come from a non-EEA country which has a healthcare agreement with the UK. Check this agreement to determine what you are entitled to

  • Have lived lawfully in the UK for at least 10 continuous years, and you are now living in an EEA country, Switzerland, or a country with which the UK has a healthcare agreement. Your spouse, civil partner and dependent children are also entitled to free NHS hospital treatment if they fall ill. They must be living with you throughout your stay in the UK
  • Get a UK state pension and you normally live in a non-EEA country. You must have lived lawfully in the UK or have made Crown Service for at least 10 continuous years. Your spouse, civil partner and dependent children are also entitled to free NHS hospital treatment if they fall ill. They must be living with you throughout your stay in the UK
  • Have been granted permission to enter the UK for medical treatment (“leave to enter”), and have received permission from the Secretary of State to get free treatment in NHS England because of exceptional humanitarian reasons.

If you are not entitled to free NHS treatment, the hospital may ask you to pay in full in advance, or to sign an undertaking to pay. This does not apply if you require emergency treatment immediately, but you are expected to return to your home country once your health stabilises.

General Practitioners and dentists for expats

A GP or dentist has some flexibility to determine if you are resident in the UK to get free treatment. Therefore, it is critical to demonstrate that your stay in the UK has some degree of stability or permanence.

A GP or dentist may also accept you as a temporary resident if you stay in the UK for less than three months. This is not automatic however, and a GP or dentist may also offer to accept you as a private patient, for which you would be charged. For more information on GP registration, see Doctors & Hospitals for Expats in the UK

Emergencies outside the hospital are normally free.

 

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