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Overseas visitors

Important information regarding NHS healthcare costs for Overseas Visitors

The NHS operates a residence-based healthcare system, therefore NHS Hospital treatment is only free to people who live or work in the United Kingdom “Ordinarily Resident”. This is regardless of whether they are a British citizen born in the UK, hold a British passport, lived or worked here in the past, have an NHS number or National Insurance number, are registered with a GP are in receipt of a UK State Pension or have been issued with an HC2 certificate. 

The Department of Health, Charging Regulations place a legal obligation on NHS trusts, to establish whether a person is an overseas visitor to whom charges apply, or whether they are exempt from charges. 

Some NHS services are free to all; these include treatment given in the Accident and Emergency department, treatment for certain infectious diseases, compulsory psychiatric treatment and family planning.

Outside of the above services, hospitals have a legal obligation to establish who is entitled to free NHS treatment. The onus is on the individual patient (within the department of health guidance) to provide whatever evidence he or she thinks is appropriate to support their claim of exemption to NHS Healthcare charges.

Patients that attend this hospital may be asked questions regarding residency and may be asked to provide evidence to show that they have the right to live here and therefore a right to free NHS treatment.

If this hospital determines that patients are not entitled to free NHS treatment, then charges will apply. This will include the full cost of all treatment we provide, (including a *Deposit)  this includes emergency treatment (other than that received in A & E), given by staff employed by this trust and of any prescribed medication even if they are in possession of an HC2 certificate.

There are exemptions which allow people who do not live in the UK to receive NHS treatment for free, however evidence will need to be provided to prove that they meet the exemption criteria. For further information please refer to the Department of Health website.

In order to be classed as being “Ordinarily Resident” a person must have “Indefinate Leave to Remain” in The UK, this is known as ILR.

If a person has ILR and is living in The UK they are entitled to access  NHS healthcare free of charge.  If they do not have ILR and are not living in The UK as their regular order of life, then for the purposes of accessing NHS Healthcare they are Overseas Visitors. For further information please access this link. Moving to England from outside the EEA

If you are an Overseas Visitor you are only entitled to free NHS Healthcare if ONE of the following criteria applies to you:

The NHS Health Surcharge (if you are visiting from outside The EEA)

From 6 April 2015 Overseas Visitors (from outside The EEA) who apply to come to the UK for over 6 months must pay a surcharge as part of their application process.  The cost is £200 per person per year, or £150 per person per year for students.  Overseas Visitors who have paid this surcharge or have had the surcharge granted to them, are then entitled to receive free NHS Healthcare as if they were “Ordinarily Resident” in The UK. 

Overseas Visitors who have not paid the surcharge will have to pay for treatment unless the are declared exempt from NHS Charges due to an exemption clause in The NHS Charging Regulations.

Full details about healthcare surcharges can be found here.

Exemption from NHS Charges due to an exemption clause in The NHS Charging Regulations.

1.     Someone who has arrived in The UK prior to 6 April 15 and retains exemption 

If you arrived in The UK before the above date and at the time were exempt from NHS Charges, because for example you are here as a student or for work purposes, then you will remain exempt from charges until your visa date expires.  This is known as easement.  If you apply to remain in The UK after your visa expires, you will have the opportunity to pay the health surcharge at that future time. 

2.     Persons from fellow EU Member State Nations

If you have recently arrived from a fellow EU Member State Nation and intend to live here you may well be asked to prove that you are “Ordinarily Resident” in The UK.  You will need to provide your passport/citizen card from your country of origin and evidence you are living here, such as a household bill or a wage slip. 

If you are in The UK temporarily from a fellow EU Member State Nation and the need for NHS healthcare arises whilst you are here,you may access this free of charge if you  provide your EHIC Card or a Provisional Replacement Certificate (PRC)  You should also provide your home address where you will be returning to in your homeland. 

If you are in receipt of a UK State Pension and so have an S1 Certificate you should present this.  Equally if you have arranged to have pre planned treatment in The UK whilst residing in another EU Member State Nation you should bring your S2 certificate. 

Please note that you cannot enter The UK specifically for the purpose of accessing NHS Healthcare unless you are doing so on an S2 Certificate arrangement, or you  are doing so as part of a UK government healthcare agreement with another country.

If you are a family member of an EEA national who is resident in the UK, you may not be subject to immigration control, even though you yourself are from outside the EEA. 

For more information about applying to join family living permanently in the UK, visit GOV.UK.

3.     Persons from non EEA countries which have a Reciprocal Healthcare Agreement (RHA) with The UK. 

If you are visiting from a non EEA country which has a Reciprocal Healthcare Agreement (RHA) with The UK.you will be entitled toimmediately necessary healthcare free of charge.  You must however provide evidence that you are from one of these countries. 

4.     Asylum seekers 

If you are an asylum seeker and arrived in The UK prior to the granting of surcharge exemptions, you will be entitled to free NHS Healthcare if ONE of the follow applies to you. 

a.     Your application has been successful and you have been granted refugee status.

b.     Your application is still outstanding

c.     Your application has failed but you are appealing against this

d.     You are in receipt of S4 or S95 support

e.     You are supported by The 2015 care act. 

 For further information please refer to the Department of Health website.

If you have come to The UK from Overseas and DO NOT FALL IN TO ONE of the following categories: 

a.     I am “Ordinarily Resident” in The UK

b.     I have paid or been granted The Health Surcharge

c.     I qualify for free healthcare because I am covered by an NHS Legislation exemption.

d.     I have received treatment that is of itself entirely exempt from charge. 

You will be liable for charges if you receive NHS Treatment.

Immediately necessary or urgent treatment

If your doctor considers that the treatment you need is immediately necessary or urgent you will be treated straight away or as soon as possible based on your clinical need. Charges still apply for this treatment including a *deposit and you will be asked for payment either before, during or after you have received the treatment.  If you are seeking treatment that is neither immediately necessary nor urgent, again charges still apply and a *deposit will be sought before commencement of the treatment.

*(Please about deposits see under methods of payment)

As all Maternity care is deemed to be “immediately necessary”, patients are encouraged to be in receipt of all maternity care available. However charges still apply and a *deposit will be sought before or during commencement of the treatment.

Treatment that is not deemed to be immediately necessary can be withheld from patients if they are unable or unwilling to pay and are not eligible for free healthcare.

Methods of payments

The trust accepts payment by cash, debit card or credit card.  It is also our policy to take a deposit up front of treatment.  If you are admitted as an inpatient we would ask for a £1500 deposit.  If you attend an outpatient appointment then we would ask for a £150 deposit. 

Please note if you are exempt from charges you should bring the evidence you need to prove exemption from charges with you when you attend hospital, otherwise you will be asked for payment. Any deposits/payments made prior to proof of exemption would be returned in full, if exemption was proven.

Payments amounts

If you are scheduled to attend an outpatient appointment you can be informed of the cost prior to arrival should you require this.  If you have been admitted to hospital then we can provide you with an estimated cost for treatment you receive on request which is based on NHS Tariffs applied throughout the UK. We will not be able to quote an exact price for your care until you have been discharged; where upon all of your treatment will have been updated on the hospital system. We will then send you an invoice for the complete package of care, minus any deposits you have paid.

Payments tariffs

Since 6 April 2015 the costs of treatment for patients from a country in The European Economic Area (EEA) differs from that of being treated as a “World Wide” patient. European patients are charged at 100% of treatment costs. World wide patients are charged at 150% of treatment costs. This is because EEA Country residents are protected by European Law. This decision is a government directive and not a policy created by Calderdale and Huddersfield NHS Foundation Trust.

In accordance with the Charging Regulations the Trust has a legal obligation to make and recover charges for NHS treatment in relation to any person who is not ordinarily resident in the United Kingdom. This is not optional and no one in the Trust has the authority to waive these charges. For further information regarding the current regulations for overseas visitors, please visit the Gov.uk website.

Insurance

If you are liable for the charges associated with your care you may choose to use your travel insurance or health insurance to fund your care, it is therefore your responsibility to contact your Insurance Company to claim your charges back.

Where can I obtain further information?

If you wish to enquire about anything at all regarding the treatment of Overseas Visitors by Calderdale & Huddersfield NHS Foundation Trust, please contact The Overseas Visitors team:

By telephone on 01422 222963

or e-mail

philip.ashworth@cht.nhs.uk. Overseas Visitor Supervisor

Or

jacqueline.sellars@cht.nhs.uk Records Services Manager/Overseas Lead       

You can also find further information at the NHS England Overseas Visitors webpage or Department of Health Overseas Visitors Charging Regulations

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