Moving to England from outside the EEA

The NHS operates a residence-based healthcare system. Most NHS services are free to people who are ordinarily resident in the UK and are 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, broadly speaking, living in the UK on a lawful and properly settled basis for the time being, and you will be asked to prove this.

If you are a citizen of the European Economic Area (EEA) or Switzerland, you can become ordinarily resident when you move to England, as long as you meet the criteria above. 

The EEA is a free trade zone between countries of the European Union (EU), Iceland, Norway and Liechtenstein. The regulations on access to healthcare in the EEA also apply to Switzerland.

Indefinite leave to remain (ILR) 

If you are a non-EEA national subject to immigration control, you can only be considered ordinarily resident if you have been given the immigration status of indefinite leave to remain (the right to live here on a permanent basis). 

However, 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.

Immigration health surcharge

If you are coming to the UK on a temporary stay of more than six months, you may be required to pay an immigration health surcharge at the time of your visa application. The standard surcharge fee is:

  • £150 per year per person for students and each of their dependents
  • £200 per year per person for everyone else

The full amount will be paid upfront for the duration of your visa. There are circumstances when you do not have to pay the surcharge such as if you are the dependant of a member of the forces who is not subject to immigration control. You can find full details about healthcare surcharges, including exemptions on the GOV.UK website.

If you have paid the surcharge or you were exempt from paying it, and your visa allows you to be here for more than six months, you will be entitled to free NHS hospital treatment in England on the same basis as an ordinarily resident person. This will apply from the date your visa is granted until it expires.

However, if your visa is curtailed or ended earlier than planned by the Home Office, you will become chargeable for any further NHS hospital treatment from that date on, even if you have paid the surcharge. You will also be charged for any non-exempt treatment you received before the start date of your visa. 

If you apply for an extension of your visa, you might also have to pay a further surcharge. If you apply for, and are granted, indefinite leave to remain, you will not have to pay the surcharge.

Paying the surcharge only gives you access to services the NHS provides. Paying the surcharge does not mean you are treated faster. Doctors will assess the urgency of your condition in the same way as ordinarily resident patients are assessed, and if necessary will be placed on a waiting list. 

Patients in England are required to make contributions towards the cost of their NHS care, such as paying prescription costs or dental charges. You are required to make the same contributions. Read the section about paying NHS charges for more advice.

Note: If you are coming to England for six months or less or did not pay the surcharge when you were required to, you will be charged for certain NHS services unless an exemption applies. See Visitors from outside the EEA.

 

Visas applied for before April 6 2015

The surcharge was introduced on April 6 2015. If you are in the UK now, but you applied for your visa before that date, you may still be eligible for free NHS hospital treatment in England on the same basis as someone who is ordinarily resident.

The following must apply to you:

  • you applied for a visa to come to the UK, or to stay in the UK, for more than 6 months before April 6 2015
  • your visa application was approved and your visa has not expired
  • you are in the UK now
  • if you had applied for your visa after April 6 2015, you would have had to pay the surcharge, or you would have fallen into one of the exemption categories. 

    If the above bullet points apply to you, then your care is covered from the date your visa is granted, until it expires. However, if your visa is curtailed or ended earlier than planned by the Home Office, you will become chargeable for any further NHS hospital treatment from that date onwards.

    If you then wish to apply for a further period of leave to remain, you will have to pay the surcharge, unless you fall into one of the exemption categories. If you wish to apply for, and are granted, indefinite leave to remain, you don’t have to pay the surcharge. 

    Children born in the UK to those here lawfully for more than six months

    If you give birth to a child in the UK, then your child will be entitled to free NHS hospital treatment in England on the same basis as someone who is ordinarily resident. Your child is covered until three months of age, but only if he/she hasn't left the UK during that period. You'll also need to meet one of the below criteria:

    • you have a valid visa of more than 6 months and paid the surcharge for that visa
    • you have a valid visa for more than 6 months, but were exempt from paying the surcharge
    • you have a valid visa for more than 6 months, which you applied for prior to April 6 2015

    You should apply for a visa for your child during the three-month period after your child's birth. If required, you may have to pay the surcharge for your child. Failure to do so means you may be charged for NHS services provided for your child after the three-month period.

    Page last reviewed: 18/08/2015

    Next review due: 18/08/2017

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