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.
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).
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.
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 will in addition need to apply to the EU Settlement Scheme. You may be asked to show your status under this scheme when seeking treatment. If you fail to apply by 30 June 2021, you could 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
Under certain circumstances, your healthcare may be paid for by your country of residence. For example, this may apply to students, pensioners or posted workers.
If you're a pensioner, posted worker or frontier worker, you will need to register your S1 in England by sending it directly to the Overseas Healthcare Services Team:
Overseas Healthcare Services
NHS Business Services Authority
152 Pilgrim Street
Newcastle upon Tyne
Tel: 0191 218 1999 from the UK or +44 191 218 1999 from abroad, Monday to Friday, 8am to 6pm.
If you moved to the UK on or after 1 January 2021 and register an S1 document issued to you by an EU Member State, you may be eligible for a full or partial refund of your immigration health surcharge payment. To apply, you should contact the Overseas Healthcare Services team.
You can apply for a refund for any dependents who have an MS S1, where you have paid the immigration health surcharge on their behalf. If they have paid the immigration health surcharge themselves, they should apply individually.
If an employer or third party has paid the immigration health surcharge for you, you must begin the application on their behalf and the Overseas Healthcare Services Team will contact them for more information to process the application.
State pensioners or benefit holders
If you receive a state pension or certain exportable benefits from a country other than the UK, you will need to check with the relevant authorities to see if they're responsible for your health costs in England. If so, and you do not already have an S1 certificate, you may need to apply for an S1 certificate from your health insurance authority to be covered for healthcare in the UK.
If you do not have an S1 certificate, you may be able to apply for one from your country of residence.
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
These arrangements only apply to frontier workers or posted workers from Norway, Iceland, Liechtenstein or Switzerland, where they 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 extends beyond 30 June 2021, you will need to apply to the EU Settlement Scheme.
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.
If you're from an EU country, you may be entitled to a full or partial refund of your immigration health surcharge payment, if you're a full-time student in higher education and have an EHIC issued by an EU country.
You will not be eligible for a refund if you work in the UK while studying.
You will not able to apply for a refund until 1 January 2022 but your refund will be backdated to include any immigration health surcharge payments made since 1 January 2021.
If you intend to apply for a refund, you should present your EHIC or PRC when accessing medically necessary healthcare.
If you're from an EU country and your course of study lasts for less than 6 months, you will not pay the immigration health surcharge and can continue to use your EHIC or PRC during your studies.
You'll need to present your EHIC or PRC every time you need to access healthcare that becomes medically necessary during your stay. You may also be asked to demonstrate when you began your course in the UK.
If you do not have an EHIC or PRC, you can continue to apply for one from the health insurance authority in your home country.
Norwegian students can access medically necessary healthcare using a valid passport.
An EHIC is not an alternative to travel insurance. You should buy insurance to cover your healthcare as you would if visiting another non-EU country.