The National Health Service (NHS) is a residency-based healthcare system that works on the concept of ordinary residence regardless of nationality, holding a British/Irish passport, owning a property in the UK, having an NHS number, being registered with a GP or having paid or paying taxes in UK. An overseas visitor is anyone who is not ordinarily resident in the United Kingdom (UK) and as such may be subject to charge for healthcare received during the course of a visit to the UK. If you are visiting the UK or have been living outside the UK for more than six months, you may have to pay for NHS treatment. The Belfast Trust Access to Healthcare Team are obliged by law to find out if people using our services are eligible for free care, or whether we need to charge for the treatment received. The individual is primarily responsible for providing documentation to prove eligibility however, the Access to Healthcare Team are here to assist the individual to gather this information.
All individuals apart from those receiving treatment that is exempt (as per the Persons Not Ordinarily Resident Regulations 2015) are required to complete a questionnaire and asked to provide documents to support their Ordinary Residence in NI or their exemption as an eligible visitor.
All information and documentation can me made available in minority ethnic languages to meet the needs of those not fluent in English.
Legislation
The Persons Not Ordinarily Resident Regulations 2015 legislation for charging overseas patients.
View and prove your immigration status: get a share code – GOV.UK (www.gov.uk)
Further information and Entitlement to NHS Services and first time registration in other languages
Please select one of the options for a Brief Overview of each heading:
-
Emergency Treatment
The accident and emergency department is the only department that is exempt from charges up to the point of admission as an inpatient to a ward, or if referred to a clinic for an outpatient appointment. Please note this exemption does not apply to emergency treatment provided after admission to a ward, CCU, ITU / HDU.
-
Outpatient Appointments
All clinic and outpatient appointments including x-rays, maternity, physiotherapy are chargeable unless you meet an exemption.
-
Visitors from the EEA (European Economic Area)
Any visitor from a European Economic Area (EEA) member state must show their European Health Insurance Card to access free healthcare. A valid EHIC entitles the patients to free treatment for conditions that arose during the visit, which cannot wait until they return home.
If you cannot show either an EHIC or Provisional Replacement Card (PRC), you will be liable to pay for treatment.
-
Countries with a bilateral healthcare agreement
Any visitors from countries with whom the UK has a Bilateral Healthcare Agreement will need to show proof that they are a national / resident (as appropriate) of the country, e.g. passport, residence permit, identity card, social security card, utility bill, passport etc. in order to be exempt from charges according to the agreement in place.
Pre-existing conditions that acutely exacerbate whilst in the UK, or in the opinion of a clinician need prompt treatment to prevent them from acutely exacerbating, e.g. dialysis, are also included.
-
Immediately necessary treatment
Immediately necessary treatment is that which a patient needs:
- to save their life, or
- to prevent a condition from becoming immediately life-threatening, or
- promptly to prevent permanent serious damage from occurring.
This treatment will always be provided irrespective of whether a patient has been informed of, or agreed to pay, charges. Also it will not be delayed or withheld to establish the patient’s chargeable status or to seek payment.
All maternity services, including routine antenatal treatment, are treated as being immediately necessary.
-
Non-urgent treatment
Non-urgent treatment is routine elective treatment that could wait until the patient can return home.
The Trust will not provide non-urgent treatment unless the patient pays the full estimated cost of the treatment in advance. However, in order to decide if a patient’s need for NHS hospital treatment is urgent or can safely wait until they return home, clinicians will need to know when a patient can reasonably be expected to return home. The decision can be made on the basis of this information.
The decision will be reassessed if the patient informs the Trust that their return date has been postponed for valid reasons or if their medical condition unexpectedly changes.
-
Maternity Services
Overseas patients who require maternity treatment during the course of their visit to NI
If you are not ordinarily resident meaning someone who is living lawfully in the UK, and you do not meet an exemption, you will be charged for your maternity care.
You are required to show evidence to support your exemption, examples include:
- A valid European Health Insurance Card (EHIC) or S2 certificate issued in your European country of residence – Please note an EHIC card may not be used if the sole purpose for your visit to NI is to deliver your baby. There may be some instances where the EHIC may be accepted for planned delivery eg for migrant mothers wishing to return home to be with family for support, however this is assessed on a case by case basis and you MUST seek prior approval from your competent state before travelling and advise the maternity unit of your intention to deliver whilst on your visit.
- A valid visa of more than 6 months issued with a BRP having paid the Health Surcharge.
- A guarantee of payment issued by your insurance company covering maternity services, must be provided if possible prior to treatment.
- A valid passport or identity card if you are resident of a bilateral agreement country.
-
Charges, tariff & payments
Overseas Visitors with travel insurance will be required to pay for their treatment and then claim back from their insurer when they return home, unless the Insurance company provides a Guarantee of Payment.
In line with the Current Government Regulations overseas visitors treated from the EEA without a European Health Insurance Card or PRC (Temporary Certificate) will be charged 100% tariff cost and Non-EEA overseas visitors also charged 100% of tariff cost.
The Trust accepts the following forms of payment: cash, credit / debit card, bank transfer or cheque (this would need to be submitted and cleared in advance of treatment)
Please note the Trust does not accept American Express.A final invoice will be raised upon discharge and any over or under payment or refund due will be arranged with the patient at this time.
Overseas visitors if chargeable will also be required to pay for their prescriptions in the same way as a resident of the UK does at the current prescription charge rate.
- FAQs for Patients
- Further Support / Advocacy Services
Contact details
If you have any further questions or have any queries surrounding the evidence you will need to submit, please contact:
Sarah Craig
Access To Health Care Manager
Royal Victoria Hospital
Sarah.Craig@belfasttrust.hscni.net
028 9615 5436
Patricia Francis
Office Manager
Royal Victoria Hospital
Patricia.Fracis@belfasttrust.hscni.net
028 9615 6938
Alternatively, you can contact the Team on:
028 9615 2211
Or
AccessHealthcare@belfasttrust.hscni.net