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Will I be Entitled to NHS Treatment?

By: Louise Smith, barrister - Updated: 5 Aug 2017 | comments*Discuss
 
Will I Be Entitled To Nhs Treatment?

Q.

I would like to know more about giving birth in UK. I am not a British Citizen and do not live in the UK however I am married to a British citizen.

I am planning to come to UK prior to my delivery but I would like to know if I will be entitled to receive NHS treatment or will I have to pay for private care?

(Mrs Shahira Hashem, 6 November 2008)

A.

Eligibility for Free NHS Treatment

Entitlement to free NHS treatment in the UK is based on the country of residence and not citizenship. The general rule is that all UK residents are entitled to free treatment. It is up to the hospital administering the treatment to ensure that the patient is eligible for free healthcare.

The test to be applied for eligibility is whether the individual seeking treatment is ordinarily resident in the UK – in other words that they are in the UK legally and are settled there. If the test is satisfied there is no minimum qualifying period of residence before an individual becomes eligible for free treatment.

Categories of Treatment Which are Free to Everyone

Some types of treatment are available to everyone for free, even if they would not ordinarily be eligible for free NHS healthcare. These include:
  • Treatment given in a hospital accident and emergency department or similar treatment administered by an NHS walk-in centre;
  • Family planning services;
  • Compulsory treatment for a psychiatric disorder.
  • Treatment for some contagious diseases – but different rules apply to AIDS/HIV;
Although family planning services are included in this list maternity services are not.

Eligibility for NHS Treatment for Overseas Residents

Some overseas residents may still be entitled to free NHS treatment.

Citizens of the EU, the European Economic Area or Switzerland - or of countries who have a reciprocal agreement with the UK regarding healthcare - may be entitled to free NHS treatment even if they are not resident in the UK. However, eligibility under this category will not generally apply if the overseas resident came to the UK knowing that they needed medical care. The exception is if they were specifically referred to the UK for treatment under a reciprocal agreement.

You say that you do not live in the UK but are coming to the country prior to the birth. If it is your intention to remain in the UK as a resident after the birth and have permission to do so, either in your own right or as a result of your husband’s citizenship, you are likely to be entitled to free NHS treatment.

If your intention is to come to the UK solely to give birth and then return to your country of residence you are unlikely to be entitled to free NHS treatment. You may still be treated in an NHS hospital - but as a private patient. If you presented at an NHS hospital in labour, you would almost certainly receive treatment without having to pay for it in advance. However, if you were deemed ineligible for free treatment the hospital would be obliged to pursue you for payment afterwards.

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Lakesider - Your Question:
A great deal of this seems to depend on how, exactly, "ordinarily resident" is defined. What is the definition? What criteria are used to determine if someone is "ordinarily resident"?My wife is a joint Irish/US citizen, she earns a small part of her income from the UK, does not pay incomes taxes in the UK, we jointly own property in the UK, she has her own bank account in the UK but on average spends less than 25% of her time in the UK. She was accepted on the local GP roll 20 years ago but they have never asked about her residency.I'm British, more than 50% of my time is spent in the UK, most of my income comes from the UK, I pay income taxes in the UK. Thank you.

Our Response:
I agree it is a tricky definition. As a rule, a person is considered to be ordinarily resident as guided by the intent of the person to remain in the UK for a significant period of time. Generally, a person residing more than three years in the UK can be defined as an ordinarily resident, but this is not set in stone. The NHS classifies it as as being NOT dependent upon nationality, payment of UK taxes, national insurance (NI) contributions, being registered with a GP, having an NHS number or owning property in the UK. Ordinarily resident means living in the UK on a lawful and properly settled basis. You can see more via the NHS link here .
AboutImmigration - 7-Aug-17 @ 12:16 PM
A great deal of this seems to depend on how, exactly, "ordinarily resident" is defined. What is the definition? What criteria are used to determine if someone is "ordinarily resident"? My wife is a joint Irish/US citizen, she earns a small part of her income from the UK, does not pay incomes taxes in the UK, we jointly own property in the UK, she has her own bank account in the UK but on average spends less than 25% of her time in the UK. She was accepted on the local GP roll 20 years ago but they have never asked about her residency. I'm British, more than 50% of my time is spent in the UK, most of my income comes from the UK, I pay income taxes in the UK. Thank you...
Lakesider - 5-Aug-17 @ 9:03 AM
MS - Your Question:
Hi,Me and my wife are moving to UK on Tier2 long term visa next week. We just got the news that she is pregnant 9weeks. In the visa fees we also pay NHS charges and got the NHS number. I want to know if she is eligible to get NHS cover for maternity in UK.Thanks

Our Response:
All nationals from outside of Europe, coming to live in the UK for longer than six months will be required to pay a ‘health surcharge’ in order to gain access to the UK’s National Health Service (NHS). You can see more via the gov.uk link here. NHS maternity care is provided free of charge to women who are; considered to be ‘ordinarily resident’ in the UK, or EEA nationals who are insured by another European state, or exempt from charges (including people who have paid the health surcharge), please see link here .
AboutImmigration - 28-Jul-17 @ 12:10 PM
Hi, Me and my wife are moving to UK next week on Tier 2 long term visa. We just came to know she is 9 weeks pregnant. We have paid NHS charges with Visa fees. Will she get NHS maternity care for free? Will there be any charges? Thanks
MS - 27-Jul-17 @ 2:34 AM
Hi, Me and my wife are moving to UK on Tier2 long term visa next week. We just got the news that she is pregnant 9weeks. In the visa fees we also pay NHS charges and got the NHS number. I want to know if she is eligible to get NHS cover for maternity in UK. Thanks
MS - 27-Jul-17 @ 2:20 AM
Melissa - Your Question:
I am an American citizen. My husband is English. While waiting for his American green card we were in England. I was on a tourist visa. There was a delay in his green card status, and our son was born in England. I am now being charged for the birth. If my husband and son are both British citizens, why am I being charged?

Our Response:
The NHS in England is a residence-based system and free to those who have settled/resident status. This means that all visitors (even former British citizens who are not classed as being 'ordinarily resident') have to pay for NHS healthcare. If you were visiting the UK from the US, you would have needed to ensure you were covered for healthcare through personal medical or travel insurance for the duration of your visit. If you needed NHS treatment and you had not arranged insurance, the policy is to charge at 150% of the standard NHS rate, unless an exemption category applies to either you or the treatment you received.
AboutImmigration - 25-Jul-17 @ 12:21 PM
Paraschiva- Your Question:
Hello, I recently have my baby in this year. I have give birth to my baby on March. Before 2 weeks I recive a later.invoice that.I have to pay 4600 £.I have one year here in England with my boyfriend, I didn't work but my boyfriend he work. I have nino, I want to know if I can do something to don't pay. We have only one salary so we can't pay so much.

Our Response:
If you had medical treatment in the UK and were not eligible for treatment on the NHS, then there is little you can do.
AboutImmigration - 24-Jul-17 @ 4:21 PM
I am an American citizen. My husband is English. While waiting for his American green card we were in England. I was on a tourist visa. There was a delay in his green card status, and our son was born in England.I am now being charged for the birth. If my husband and son are both British citizens, why am I being charged?
Melissa - 24-Jul-17 @ 3:15 PM
Hello, I recently have my baby in this year. I have give birth to my baby on March. Before 2 weeks I recive a later..invoice that.I have to pay 4600 £.I have one year here in England with my boyfriend,I didn't work but my boyfriend he work. I have nino,I want to know if I can do something to don't pay. We have only one salary so we can't pay so much.
Paraschiva - 23-Jul-17 @ 6:31 PM
Mima - Your Question:
Hi. Im a british citizen who has recently moved back to the uk. Im 19 weeks pregnant and im curently living with my sister. I have been denied job seekers allowance for not living in the uk for the last 3 months. I do have 1 proof of adress and a british passport. My question is, does the gp have the right to deny me free maternity care.

Our Response:
In order to have free care on the NHS you need to be classed as being 'ordinarily resident' in the UK. Your entitlement to free NHS treatment depends on the length and purpose of your residence in the UK, not your nationality.An overseas visitor is any person who is not classed as being ordinarily resident in the UK. Citizens who return to the UK on a settled basis will be classed as ordinarily resident, and once verified will be eligible for free NHS care immediately.
AboutImmigration - 18-Jul-17 @ 3:12 PM
Hi. Im a british citizen who has recently moved back to the uk. Im 19 weeks pregnant and im curently living with my sister. I have been denied job seekers allowance for not living in the uk for the last 3 months. I do have 1 proof of adress and a british passport. My question is, does the gp have the right to deny me free maternity care.
Mima - 18-Jul-17 @ 2:45 PM
SJW - Your Question:
Hi, my mom and I are both British Citizens and live in South Africa. My mom goes to the UK every other year or so to see family and has a state pension. This year when we went, my mom got really sick and was rushed to hospital emergency. They thought she may have a blood clot from the flight. Needless to say, after the emergency treatments etc it wasn't a blood clot. What followed was a hefty hospital bill. My questions are, why is my mom not covered by the HNS, why will they not give me an itemized bill and why are they not prepared to reduce the charges. My mom does not get any state benefits in South Africa, because she is British and now she is liable for this bill that to be honest, she cant afford. what do we do? Any advise or assistance will be greatly appreciated. Thanks

Our Response:
If your mother does not live in the UK, then unfortunately for her she is not entitled to free treatment via the NHS. Within the UK, free NHS treatment is provided on the basis of someone being classed as ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. You can see more via the gov.uk link here . I cannot advise what your mother can do, as she would have needed to have paid for health care insurance in order to be covered. Anyone who does not have insurance is charged at 150% of the NHS national tariff for any care they receive.
AboutImmigration - 14-Jul-17 @ 2:49 PM
Hi, my mom and I are both British Citizens and live in South Africa.My mom goes to the UK every other year or so to see family and has a state pension.This year when we went, my mom got really sick and was rushed to hospital emergency.They thought she may have a blood clot from the flight.Needless to say, after the emergency treatments etc it wasn't a blood clot.What followed was a hefty hospital bill.My questions are, why is my mom not covered by the HNS, why will they not give me an itemized bill and why are they not prepared to reduce the charges.My mom does not get any state benefits in South Africa, because she is British and now she is liable for this bill that to be honest, she cant afford.what do we do?Any advise or assistance will be greatly appreciated.Thanks
SJW - 14-Jul-17 @ 10:03 AM
I ama British citizen living in the US as a permanent resident alien since 1996. My wife is a US citizen with a US passport. We are planning to move to, settle in and reside permanently in the UK. (How) will she receive healthcare? Where can I find more information about her entitlement as the spouse of a UK citizen where we are both permanently resident in the UK, please?
MKS - 28-Jun-17 @ 4:52 PM
HI there My wife is US citizen, I am British. She came here on the visiting family visa and will apply for LTR in August, she has demonstrably moved here permanently, and is enrolled for University in September (fees paid), shipped things here and we are co-signed for Council Tax etc. The NHS guidance says: ============ Being properly settled in the UK for the time being: In the past, the Department of Health has suggested that someone who has been here for less than six months is less likely to meet the ‘settled’ criterion of the ordinary residence description, but this is only a guideline. For a British citizen, an EEA national and for a non- EEA national with ILR or a non-EEA national not subject to immigration control, it is perfectly possible to be ordinarily resident here from the day of arrival, when it is clear that that person has, upon arrival, taken up settled residence. ============ My question is, how and where do we test / apply this criteria. Do we just go to the local GP and try and register, or is there a way to do it otherwise.
PJ Hardy - 9-Jun-17 @ 9:33 AM
HI there My wife is US citizen, I am British. She came here on the visiting family visa and will apply for LTR in August, she has demonstrably moved here permanently, and is enrolled for University in September (fees paid), shipped things here and we are co-signed for Council Tax etc. The NHS guidance says: ============ Being properly settled in the UK for the time being: In the past, the Department of Health has suggested that someone who has been here for less than six months is less likely to meet the ‘settled’ criterion of the ordinary residence description, but this is only a guideline. For a British citizen, an EEA national and for a non- EEA national with ILR or a non-EEA national not subject to immigration control, it is perfectly possible to be ordinarily resident here from the day of arrival, when it is clear that that person has, upon arrival, taken up settled residence. ============ My question is, how and where do we test / apply this criteria. Do we just go to the local GP and try and register, or is there a way to do it otherwise.
PJ Hardy - 8-Jun-17 @ 4:42 PM
My aunt and Uncle were former residents of Scotland but now live in Canada. They have dual citizenship with Britain and Canada and are in receipt of a British pension. Do they need medical insurance to come to Scotland for a holiday? Are they entitled to free nhs care? They both hold a Canadian passport.
Andi - 4-Jun-17 @ 9:49 AM
Merle - Your Question:
Is a British born woman who has lived in NZ for 50 years and recently become a NZ citizen entitled to free health care if necessary while visiting the UK?

Our Response:
In April 2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK - please see link here.
AboutImmigration - 30-May-17 @ 12:16 PM
Is a British born woman who has lived in NZ for 50 years and recently become a NZ citizen entitled to free health care if necessary while visiting the UK?
Merle - 29-May-17 @ 8:02 PM
My work colleague currently lives in Korea but is transferring to the UK to live and work at the head office on a permanent contract. He is Polish. Will he be entitled to NHS free treatment immediately or is there a waiting period? If a dating period will his EHIC card suffice?
Reb21 - 23-May-17 @ 5:32 PM
As a British by descent passport holder, I will be coming to study in England. My Australian born daughter will be moving with me. I believe she is not eligible for a passport. How can I find out if she will be eligible for government assistance such as NHS whilst in England? Thank you
Rebecca - 14-May-17 @ 11:42 AM
I will be moving to the UK to study for at least 3 years (I'm Dutch). Would I need to keep my Dutch health insurance to receive nhs health care or do I receive? this anyway?
Chantal - 11-May-17 @ 11:06 PM
.feza - Your Question:
I am an englishman living in germany with my girlfriend and two children who was born in germany.we want to move back to the u.k soon.my girlfriend and son have ongoing medical conditions.wud they be entitled to free health care?

Our Response:
In April 2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK. The changes were made so that the NHS does not lose out on income from migrants, visitors and former residents of the UK, who may be required to pay for their hospital treatment costs while in England, please see link here.
AboutImmigration - 10-May-17 @ 12:38 PM
I am an englishman living in germany with my girlfriend and two children who was born in germany.we want to move back to the u.k soon.my girlfriend and son have ongoing medical conditions.wud they be entitled to free health care?
.feza - 9-May-17 @ 11:31 PM
Nikki - Your Question:
Hello ,My name is Vijaykumar. 28 years old.I m an Indian citizen. I was in London for 5 years till last year. As last year , I had very major bowel operation on my body at Kings geogre hospital 26/1/2016. For some circumstances , I had to come India to see my family and my family doctor. I have been in India now it's for 1 year. As my visa has been finished too.But, Since I had major bowel operation. I am not feeling well at my stomach. As I do hv a lot pain sometimes. I can not relieve my pain. I have been to some doctor. But I am not satisfied in India with some doctor. I want to come uk for my treatment. Is my treatment will be free? And what will be the procedure? Unfortunately , I can not live with my pain. I need treatment soon for my good health. Plz help me asap.

Our Response:
I'm afraid as you do not live in the UK, you would not be entitled to free NHS treatment in the UK even if you came to the UK. In order to be allowed free treatment, a person has to be considered as 'ordinarily resident', please see link here.
AboutImmigration - 2-May-17 @ 10:17 AM
Hello , My name is Vijaykumar. 28 years old. I m an Indian citizen. I was in London for 5 years till last year. As last year , I had very major bowel operation on my body at Kings geogre hospital 26/1/2016. For some circumstances , I had to come India to see my family and my family doctor. I have beenin India now it's for 1 year. As my visa has been finished too. But, Since I had major bowel operation. I am not feeling well at my stomach. As I do hv a lot pain sometimes. I can not relieve my pain. I have been to some doctor. But I am not satisfied in India with some doctor. I want to come uk for my treatment. Is my treatment will be free? And what will be the procedure? Unfortunately , I can not live with my pain. I need treatment soon for my good health. Plz help me asap.
Nikki - 1-May-17 @ 4:50 AM
Toby - Your Question:
I am a British citizen having residency in New Zealand. I am visiting my parents in the UK for a month. I have now found out I am pregnant and my 12 week scan falls within that month. Am I entitled to have my scan on the NHS as New Zealand has bilateral agreement with the UK.

Our Response:
In April 2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK. Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April affect visitors and former UK residents differently, depending on where they now live, please see gov.uk link here.
AboutImmigration - 27-Apr-17 @ 1:52 PM
IamaBritish citizen having residencyin New Zealand. I am visiting my parents in the UK for a month. I have now found out Iam pregnant and my 12 week scan falls within that month. Am I entitled to have my scan on the NHS as New Zealand has bilateral agreement with the UK.
Toby - 26-Apr-17 @ 10:29 PM
Hello,I came in UK in October 2016 with a spouse visa,now I have BRP,I am a permanent resident in Uk,GP registered,my husband paid IHS when did the application.I would like to know if I am entitled to free surgery treatment.Thank you!
Elda - 14-Apr-17 @ 9:25 AM
Brummie - Your Question:
Is a British born woman who has lived in Turkey for 50 years, married to a Turkish man (now deceased) and now has dual nationality, entitled to free health care treatment during a visit to the UK?

Our Response:
Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April affect visitors and former UK residents differently, depending on where they now live, please see link here.
AboutImmigration - 13-Apr-17 @ 12:51 PM
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