To get free NHS healthcare in England you need to be "ordinarily resident" in the UK. This means you must be living in the UK on a lawful and properly settled basis for the time being. You may be asked for evidence of this.
If you are not ordinarily resident in the UK, you'll be an overseas visitor and may be charged for NHS services. It is strongly recommended that you take out sufficient health insurance to cover your time in the UK.
For a detailed definition of what being ordinarily resident means, see the GOV.UK guidance.
You need a visa or permit if you move to the UK to work, study or to settle. You may need to pay the immigration health surcharge as part of your visa application if you're staying for 6 months or more.
If your healthcare is paid for by an EU Member State or Switzerland, you may be eligible a full or partial reimbursement of your immigration health surcharge.
GOV.UK has full details of when you can have your immigration health surcharge reimbursed
You can only be considered ordinarily resident if you've been given the immigration status of indefinite leave to remain (the right to live here on a permanent basis).
You can find full details about the immigration health surcharge, including exemptions on GOV.UK
In line with our longstanding commitments under the Common Travel Area, Irish citizens will not be subject to the immigration health surcharge.
If you've paid the surcharge or are exempt from paying it, you'll be entitled to free NHS hospital treatment in England on broadly the same basis as someone who is ordinarily resident, with the exception of NHS-funded assisted conception services. Your entitlement will apply from the date your visa is granted until it expires. You'll have to pay some charges, such as prescription or dental charges.
Find out more about paying NHS charges
If you're coming to England for 6 months or less or fail to pay the surcharge when you were required to, you'll be charged for certain NHS services unless an exemption applies or you're covered by a reciprocal healthcare agreement.
If you're a citizen of a country outside of the EU, Norway, Iceland, Liechtenstein and Switzerland and are subject to immigration control, read the section moving to England from outside the EEA, as different rules may apply.
If you were living lawfully in the UK on or before 31 December 2020 you will be able to use the NHS in England as you did previously. If you wish to remain in the UK after 30 June 2021, you should have applied to the EU Settlement Scheme. You may be asked to show your status under this scheme when getting treatment. If you failed to apply by 30 June 2021, you may lose your right to access free healthcare.
If you're an Irish citizen, you do not need to apply to the EU Settlement Scheme, although you can if you wish.
When your health costs in the UK are covered by an EEA country or Switzerland
You may be entitled to healthcare in the UK paid for by an EEA country or Switzerland if you:
- live in the UK and receive either a state pension or certain ‘exportable’ benefits from that country
- live in the UK and work in an EEA country or Switzerland (frontier worker)
- are posted to work in the UK by an employer in an EEA country or Switzerland
- are an eligible family member or dependent of one of the above
You should be issued with an S1 certificate by the relevant State, which shows that you are entitled to healthcare in the UK paid for by that country. If you do not know whether you are eligible you will need to check with the relevant EEA or Swiss health insurance authority to see if they are responsible for your health costs in the UK.
You'll only qualify for an S1 issued by Norway, Lichtenstein or Iceland if you're in scope of the Withdrawal Agreement. If you have an S1 issued by one of these countries, you will not qualify for IHS reimbursement.
You must register your S1 in the UK by sending it directly to the Overseas Healthcare Team:
Overseas Healthcare Services
NHS Business Services Authority
152 Pilgrim Street
Newcastle upon Tyne
Tel: 0191 218 1999, or +44 191 218 1999 from outside the UK
Immigration health surcharge reimbursement for S1 holders
If your UK visa starts on or after 1 January 2021 and you’ve registered an S1 document issued to you by an EU member state or by Switzerland, you may be eligible for a full or partial refund of your immigration health surcharge payment.
To apply, contact the Overseas Healthcare Services team.
You can apply for a refund for any dependants who have registered an EU or Switzerland-issued S1, where you have paid the immigration health surcharge on their behalf.
If they paid the immigration health surcharge themselves, they should apply for the refund.
If an employer or third party has paid the immigration health surcharge for you, you must begin the application on their behalf. The Overseas Healthcare Services team will then contact them for more information to process the application.
Working in England
If you're working in England as a frontier worker or a posted worker, you will need to check with the relevant authorities in your home country about whether they are responsible for your healthcare costs in the UK. You may need one of the following:
- A1 form – proof that you pay National Insurance (NI) contributions in your country and a European Health Insurance Card (EHIC)
- S1 form – issued in your country
If you're a frontier worker or posted worker from Norway, Iceland or Liechtenstein, these arrangements only apply to you if you were working in that capacity in the UK before 31 December 2020.
Studying in England
If you're a student from an EEA country or Switzerland, and began a course of study in England before 31 December 2020, you may continue to use your EHIC or PRC, if you have one, to access free NHS healthcare that becomes medically necessary during your visit, until the end of your course.
If your course extended beyond 30 June 2021, you should have applied to the EU Settlement Scheme. If your course of study in the UK is longer than 6 months, you need to pay the immigration health surcharge as a part of your visa application. You may be eligible for a full or partial reimbursement if you meet the criteria.
If you come to the UK to study from 1 January 2021, you'll need to pay the immigration health surcharge as part of your student visa application if your course lasts for more than 6 months. You may be eligible for a full or partial reimbursement if you meet the criteria.
If your course of study is less than 6 months, you do not need to pay the immigration health surcharge. If you have a valid EU or Switzerland-issued EHIC or are a Norwegian citizen with a valid Norwegian passport, you can access medically necessary treatment during your stay.
If you're a citizen of Iceland or Liechtenstein, you may have to pay for any NHS healthcare you receive. Any treatment that you need to pay for will be charged at 150% of the national NHS rate.
You should buy insurance to cover your healthcare as you would if visiting another non-EU country.
Immigration health surcharge reimbursement for students
You may be entitled to a full or partial refund of your immigration health surcharge payment if all of the following are true:
- you’re a full-time student in UK higher education
- your visa started on or after 1 January 2021
- you have a European Healthcare Insurance Card (EHIC) issued in an EU country or Switzerland
- you do not work in the UK
You will not be able to apply for a refund until 1 January 2022. However, your refund will be backdated to include any immigration health surcharge payments made for a visa starting on or after 1 January 2021.
For students insured by Switzerland, refunds will only be able to be backdated from 1 November 2021 at the earliest since that is the date from which the UK’s agreement with Switzerland on reciprocal healthcare is implemented.
You should consider carefully your healthcare needs before deciding whether to apply for a reimbursement.
If you intend to apply for a refund of your immigration health surcharge payment, you should use your EU or Swiss EHIC for medically necessary treatment during your studies.
Once you have received your reimbursement, you may have to pay for any NHS healthcare you receive that is not deemed medically necessary.
If you obtain an IHS reimbursement you should not work in the UK. Working in the UK is very likely to invalidate your EHIC and you will need to be prepared to pay for any NHS healthcare you receive.