Visitors from the European Economic Area (EEA) or Switzerland

Unplanned treatment on a temporary visit to England

The NHS in England is a residence-based system, unlike many other countries, which have insurance-based healthcare systems. This means that all visitors to England may have to pay for NHS healthcare, depending on their circumstances.

If you are a visitor from the European Economic Area (EEA) and you fall ill or have a medical emergency during your temporary stay in England, then you'll need a valid European Health Insurance Card (EHIC) issued by your home country. If you can't show a valid EHIC, you may be charged for your treatment.

Your EHIC will cover you for treatment that becomes necessary during a visit to England, until you return to your country. It also covers you for the treatment of pre-existing medical conditions and for routine maternity care, providing the reason for your visit is not specifically to give birth.

Bear in mind that the healthcare system in England may be different from that in your home country. The EHIC might not cover everything you would expect to get for free back home.

The EHIC is not an alternative to travel insurance. It will not cover any private medical healthcare, being flown back home, or lost or stolen property. Therefore, it is important to have both an EHIC and a valid private travel insurance policy.

If your EHIC has been lost or stolen during your visit in England and you need a replacement, then you'll have to contact the relevant organisation in your home country to request a Provisional Replacement Certificate (PRC).

If you do not have an EHIC and cannot obtain a PRC, you may have to pay for treatment at the standard NHS rate.

Seeking planned treatment in England

If you are coming to England specifically for planned treatment, you will need to make all necessary arrangements yourself in advance. Planned treatment is not covered by the EHIC. If you do not have valid documentation, you may be charged for treatment.

There are currently 2 potential routes available for people for the EEA wishing to have planned treatment in England.

The S2 route

You will need to arrange an S2 form from the relevant organisation in your home country before you travel to England.

The S2 only relates to state-provided treatment and you will not be required to pay anything yourself, except any mandatory patient contributions that patients in England would have to pay, such as prescription costs.

The EU Directive route

You are able to purchase state or private healthcare in England and seek reimbursement for this treatment from your country of residence. Reimbursements can be up to the amount the treatment would have cost in your country.

If you come to England via the EU Directive route, it is advised that you seek prior authorisation from the relevant organisation in your country first, as this is often a requirement.

Note: the EU Directive route does not apply to visitors from Switzerland.

Holders of a registered UK-issued S1 form

Do you live in another EEA country or Switzerland and your healthcare is paid for by the UK by virtue of an UK-issued S1 form and you have registered the S1 with the relevant authorities abroad?

If this applies to you, then you are entitled to return to England to receive treatment for free, just like someone who is ordinarily resident in England. However, this does not apply to family members of frontier workers.

If you are a family member of a frontier worker you can receive NHS treatment for free that becomes medically necessary during a temporary visit to England. However, you need to be able to present a copy of your S1 form.

If you return to England to have NHS treatment you will need to follow the same processes as people living in England. For example, most hospitals require a GP referral, issued by a GP in England before you can have hospital treatment.

You may also need to show a copy of your S1 or ask the healthcare provider to contact Overseas Healthcare Services to verify the status of your S1. You could also apply for an S2 form for the treatment from the relevant institution in your country of residence, which can then be accepted for the treatment instead of proof of a registered S1. For more information on this process, contact the NHS provider directly to check what their referral requirements are.

You may also seek healthcare through a GP appointment as you would if you were living in England. GPs can agree to register you as a temporary patient as long as you are in the area for more than 24 hours but less than 3 months. For more information, see the access NHS services in England section.

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

Page last reviewed: 10/09/2018
Next review due: 10/09/2021