Accessing the NHS as an immigrant
The NHS is the UK’s national provider of medical services, it is government-funded and free at the point of use for British citizens. Immigrants living in the UK can also be entitled to free NHS services, however, this depends on the type of service and the individual’s immigration status.
There are some NHS services that are free for all overseas nationals in the UK, these include primary care services such as:
- Hospital treatment in an Accident and Emergency (A&E) department (this does not include any further NHS hospital treatment)
- GP services including consultations in primary care and treatment provided at a GP practice.
- Diagnosis and treatment of some infectious diseases
- Family planning services
- Compulsory psychiatric treatment
- Treatment for conditions that are a result of torture, female genital mutilation (FGM), domestic violence, or sexual violence
However, secondary care services are not free for all. To access these services free of charge immigrants must fall into one of the relevant categories. It’s worth noting that even if you are eligible for free NHS access, there are some services that you may be charged for, including optical and dental care.
The immigration health surcharge
The immigration health surcharge, also known as the NHS surcharge, is a fee that is part of most applications for UK visas that are valid for longer than 6 months. Immigrants who are not ordinarily resident in the UK must pay this fee to be able to access NHS services. The fee is mandatory, even if you have private health insurance. The immigration health surcharge fee is usually as follows:
- £624 per year for a regular UK visa
- £470 per year for children, students and Youth Mobility visas
Immigrants applying for short-term visas to stay in the UK for 6 months or less (including fiance visa applicants) do not have to pay the fee but will not be entitled to free NHS care whilst here. However, the majority of immigrants applying for limited leave to remain will need to pay the fee, even when applying to stay for less than 6 months.
Immigrants who work for the NHS are no longer required to pay for NHS surcharge to be able to access NHS treatment. Other people who are also exempt from the fee include:
- Diplomats and members of visiting armed forces who are not subject to immigration control
- Dependants of a member of the UK’s armed forces or another country’s armed forces who is exempt from immigration control
- Applicants for a visa for the Isle of Man or the Channel Islands
- British Overseas Territory citizens resident in the Falkland Islands
- Asylum seekers and applicants for humanitarian protection and their dependants
- Those applying to stay as the victims of modern slavery, human trafficking or domestic abuse and their dependants
Once you have paid the immigration health surcharge you will be able to get free NHS treatment in the same way that British citizens can.
Do EU citizens still get free access to the NHS?
Prior to Brexit and the end of free movement, EU citizens were able to access the NHS free of charge, now that free movement has officially ended many EU citizens are confused about what healthcare they are entitled to in the UK. EU, European Economic Area (EEA)and Swiss nationals who were resident in the UK prior to the 31st December 202o will continue to be entitled to free NHS hospital treatment and other healthcare services.
However, EU citizens who started living in the UK after this date can only access the NHS for free if one of the following applies:
- They have a UK visa and have paid the immigration health surcharge
- They have a UK visa and are exempt from paying the immigration health surcharge
- They are ordinarily resident in the UK and have Indefinite Leave to Remain
- They have permission to be in the UK as a family member of an EEA citizen who was living in the UK by 31 December 2020
It’s worth noting that the European Health Insurance Card (EHIC) will remain valid until their expiry dates, after which they are due to be replaced by the new Global Health Insurance Card. An EHIC entitles citizens from the EU, Switzerland, Norway, Iceland and Liechtenstein to free urgent treatment in the UK if they become ill or have an accident whilst in the country. It also covers routine maternity care and treatment that is medically necessary for pre-existing conditions. Both long-term EU nationals as well as short-term overseas visitors from the EU can continue to use the European Health Insurance Card.
Access to healthcare for those ordinarily resident in the UK
Immigrants who are classed as “ordinarily resident” in the UK can access the NHS for free and are not required to pay the NHS surcharge. The Department for Health and social care defines someone who is ordinarily resident as a person “in the UK when that residence is lawful, adopted voluntarily, and for settled purposes as part of the regular order of their life for the time being, whether of short or long duration.”
This definition includes:
- British citizens
- Foreign nationals who have naturalised as a British citizen
- Overseas nationals who are settled in the UK (hold Indefinite Leave to Remain)
Those who are ordinarily resident in the UK do not need to pay the NHS surcharge and are automatically entitled to the free healthcare services available.
Who will be charged for NHS hospital treatment and care?
Overseas visitors, including both EEA and non-EEA nationals, who have travelled to the UK and have not paid the immigration health surcharge will be charged for accessing NHS services. Usually, this includes those visiting the UK on a tourist visa but it also includes those who hold long-term multiple entry visas.
It is recommended that before travelling to the UK, you get private medical insurance. If you do not have this, and you require NHS care during your stay then you will be charged 150% of the standard NHS rate. Usually, the hospital will ask you to pay for the full cost of your treatment in advance. If you cannot pay, you will not be refused NHS treatment unless it is non-urgent as all patients are given urgent or necessary treatment in the UK whether or not they are able to pay. Failure to pay, however, could affect your ability to apply for a UK visa in the future.
Does the NHS check immigration status?
Because NHS services are only free for those ordinarily resident in the UK or those who are exempt from charges, the NHS may carry out checks on the immigration status of overseas nationals seeking treatment. They may do this by seeking information from the Home Office about your immigration status. The Home Office has a Status Verification and Enquiries Checking (SVEC) service that enables the NHS to do this and will be used to determine whether you are entitled to free treatment.
The NHS will not share your medical information with the Home Office but they can legally check your immigration status without your permission and the Home Office can share your information with law enforcement bodies for the purpose of national security issues and the investigation and prosecution of crime.
It’s worth noting that no immigration checks are required for the testing and treatment of COVID-19 and there are also no charges for COVID-19 test or treatment.
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