If you visit the UK and you are a citizen of an EU country, or Norway, Iceland, Liechtenstein or Switzerland, you may have to pay for NHS healthcare.
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 EU, Norway, Iceland, Liechtenstein or Switzerland 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 cannot show a valid EHIC, you may be charged for your treatment.
Your EHIC will cover you for treatment that becomes medically 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 or receive treatment.
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 a visitor from an EU country, Norway, Iceland, Liechtenstein or Switzerland and are coming to the UK for planned health treatment, you will need to make all the necessary arrangements yourself in advance. Planned treatment is not covered by the EHIC. If you do not have valid documentation, you will be charged for treatment.
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 can pay for state or private healthcare in England and seek reimbursement (money back) for that treatment from the country where you live. Reimbursements can be up to the amount the treatment would have cost in your country.
If you come to England using the EU Directive route, you should check if you need to request authorisation from the relevant organisation in your country first.
The EU Directive route does not apply to visitors from Switzerland.
UK nationals and others whose healthcare in the EU is paid for by the UK
If you are a UK national living outside the UK, you should not expect to be able to use NHS services for free when visiting the UK. You should take out appropriate travel insurance when visiting the UK, as you would when visiting any other country.
If you are living in an EU country, Norway, Iceland, Liechtenstein or Switzerland and the UK government currently pays for your healthcare, you will be able to use NHS services in England without charge when visiting the UK. People who have their healthcare paid for by the UK include people who get a UK State Pension or some other UK benefits, and posted workers, who are people working abroad for UK companies or organisations.
You should check before visiting the UK whether your family members are also eligible for free healthcare in England. If you are a family member of a frontier worker you can receive NHS treatment for free if it 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 the UK permanently and you are ordinarily resident, you will be able to access NHS care without charge.
If you need to access NHS treatment while you are visiting England, 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 A1 or ask the healthcare provider to contact Overseas Healthcare Services to verify the status of your S1 or A1. You could also apply for an S2 form for the treatment from the relevant organisation in your country of residence. This 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 can also make an appointment with a GP 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.
You will need to pay for some types of NHS care in the same way as people who live in England, for example, paying for prescriptions or dental treatment.
Page last reviewed: 30 January 2020
Next review due: 30 January 2023