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 on 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 for the time being, and you'll be asked to prove this.
If you're 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.
Indefinite leave to remain (ILR)
If you're 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).
But if you're a family member of an EEA national who's resident in the UK, you may not be subject to immigration control, even though you yourself are from outside the EEA.
Immigration health surcharge
If you're coming to the UK on a temporary stay of more than 6 months, you may be required to pay an immigration health surcharge at the time of your visa application.
The standard surcharge fee is:
- £300 per year per person for students and each of their dependants
- £400 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're 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 GOV.UK.
If you have paid the surcharge or were exempt from paying it, and your visa allows you to be here for more than 6 months, you'll be entitled to free NHS hospital treatment in England on a similar basis to an ordinarily resident person.
This will apply from the date your visa is granted until it expires.
But any new course of treatment for NHS-funded assisted conception services will not be free to surcharge payers (or people exempt from paying it), unless another exemption applies.
If your visa is curtailed or ended earlier than planned by the Home Office, you can be charged for any further NHS hospital treatment from that date on, even if you have paid the surcharge.
You'll 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're treated faster.
Doctors will assess the urgency of your condition in the same way ordinarily resident patients are assessed, and if necessary you'll be placed on a waiting list.
If you're coming to England for 6 months or less or did not pay the surcharge when you were required to, you'll be charged for certain NHS services unless an exemption applies.
Visas applied for before April 6 2015
The surcharge was introduced on April 6 2015. If you're in the UK now but 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's 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're in the UK now
- if you 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, your care is covered from the date your visa is granted until it expires.
But if your visa is curtailed or ended earlier than planned by the Home Office, you'll 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'll 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 do not have to pay the surcharge.
Children born in the UK to those here lawfully for more than 6 months
If you give birth to a child in the UK, your child will be entitled to free NHS hospital treatment in England on the same basis as someone who's ordinarily resident.
Your child is covered until 3 months of age, but only if they didn't leave 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 3-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 3-month period.
Page last reviewed: 10 September 2018
Next review due: 10 September 2021