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Overseas Visitors

If you’re visiting us from another country and you use our services, you may have to pay for your care.

  • you may have to pay for your care even if you’ve previously been a UK resident;
  • we are legally required to collect payment before any planned care (elective treatment) takes place.

Healthcare is Residency Based – it is not based on whether you have paid Tax or National Insurance, are registered with a GP and have an NHS number, holding a British Passport or owning a property in the UK.

Ordinarily Resident

A person is Ordinarily Resident if they are living in the United Kingdom: lawfully, voluntarily, and for settled purposes as part of the regular order of their life for he time being, whether for a long or short duration.

We will need some evidence to prove that you are or were legally ordinarily resident at the time of treatment.

We require one photo identification – passport or driving licence or an official document with a photograph.

We also require three items of the following, which must be relevant to the period the patient accessed the hospital for treatment to prove residency:

  • an original, recent utility bill (gas, electric, water, or telephone – but not a mobile phone bill)
  • council tax bill (current year)
  • bank, building society, or credit union statement or passbook
  • an original, recent mortgage statement from a recognised lender
  • current council, or housing association rent book or tenancy agreement
  • notification letter from Department for Work and Pensions confirming your right to benefit or state pension.

Please note - we may ask you to provide proof you’re exempt from fees at any time, including during your outpatient appointment.

Visiting from the EEA

If you are visiting from the EEA (European Economic Area) or Switzerland you need to bring your EHIC (European Health Insurance Card) with you. This card will only cover treatment if the need arose during your visit. If you have lost your EHIC you will need a PRC (Provisional Replacement Certificate). The onus is the visitor to provide the correct documentation.

Please visit the European Commission Website and enter your search criteria. Alternatively you can download the EHIC app to your smartphone and within the “I lost my card” section, select your country and your health insurance fund contact telephone, email and website address will be made available.

If you cannot provide either of these, or have come to the UK to access specific treatment, you will receive an invoice, and you will be required to pay for your treatment and recover the costs from your ‘healthcare abroad team’ when you return home.

Visiting from outside the EEA

If you are visiting England from a non-EEA country, you need to ensure you are covered for healthcare through personal medical insurance for the duration of your visit, even if you are a former UK resident. This is a requirement of your entry conditions to the country.

If you are coming for more than six months, you may need to pay the immigration health surcharge ( IHS ) as part of your visa application. This means you will be receive treatment on the same basis as an ordinary resident of the country.

Should you need NHS treatment and you have not arranged insurance, or paid the health surcharge, you will be charged at 150% of the standard NHS rate, unless an exemption category applies to either you or the treatment.

Please note you need to have fully comprehensive health insurance, which covers any pre-existing conditions, should you need to be treated in a hospital. The liability of payment lies with the patient or parents or guardian if the patient is a child. If the insurer deems that the condition was pre-existing – the patient or patient’s parents or guardian if a child – will need to pay our invoice. Insurance may also have a policy excess or a fixed amount so please check with your insurance company or medical assist company. Should you need to access healthcare and have insurance the onus is on the patient to register the claim with their insurer, and arrange a sharing agreement and have ours completed for GDPR (General Data Protection Regulation).

Countries with Reciprocal Healthcare Agreements

The UK has reciprocal healthcare agreements with some non-European Economic Area (EEA) countries.

Within the reciprocal agreements there are a number of variations in the level of free treatment provided to visitors travelling to the UK.  Generally, only immediate medical treatment is to be provided free of charge, to allow the overseas visitor to return home for other needs i.e. follow up treatment or outpatient appointments. Immediate treatment is defined as to save the patient’s life/prevent a condition from becoming immediately life-threatening or needed promptly to prevent permanent serious damage occurring.

Please ensure you check with the Overseas Visitors Team to ensure your financial responsibilities are clear and DO NOT ASSUME all your treatment will be covered.

If you’re being treated under a reciprocal agreement and it is terminated during the course of your treatment then you will become liable for all further costs.

Emergency Treatment

Treatment within ED (Emergency Department previously A&E) is free ONLY within the ED area. If a patient is admitted to the hospital from that area as an in-patient or needs to return as an outpatient, day case or in-patient – charges will apply.

Maternity services

We do not withhold treatment in this area, however charges will still apply and you will receive an invoice after your treatment. Please also be advised that if you are liable, your child may also be liable for charges should they need to be treated.

Assisted conception

Whilst NHS treatment is free of charge for those Non EEA nationals who have paid the Immigration Health Surcharge (IHS) this no longer includes Assisted Conception services. Please contact the overseas visitors team to discuss how the Royal Berkshire Hospital execute the guidelines.

Paying for your care

If you are not eligible for free treatment, you will be charged for any treatment we provide – whether that’s in hospital or in the community.

We are legally required to collect payment before any planned care takes place

If you have to pay for your treatment, please contact our overseas visitors’ team on:

EU Exit (Brexit)

If you are from the EEA and settled in the UK, you need to have EU Settled Status and prove that you have it and are still Ordinarily Resident. 

If you fail to pay for NHS treatment for which charges are appropriate, your future application to enter, or remain in the UK may be denied.

Necessary (non-medical) personal information may be passed via the Department of Health to the Home Office for this purpose.


Clinical staff will not be able to confirm whether you are eligible for charges – this can only be provided by the Overseas Visitors Team. The NHS does not provide itemised invoices; invoices are prepared in the same way as we charge the Clinical Commissioning Group and it is based on an Health Resource Group coding. Please do not ask for a breakdown of charges, as it is not possible – this is not a private invoice, it is a chargeable invoice.

Overseas Visitors & Counter Fraud

Here at the Royal Berkshire NHS Foundation Trust we take fraud seriously. In our area of work, we encounter patients ‘borrowing’ other peoples NHS number, bringing family into the UK solely to use the NHS without intending to pay, and overstaying on VISA’s and not telling the truth. In the case of borrowing peoples NHS number, this is dangerous to the person whose ID has been used as it could interfere with their existing care pathway. We will report any patient or friends and relatives, purposely trying to defraud the NHS to our local count fraud specialist. If escalated to involve the police, you could end up with a criminal record.

Useful Links

Frequently Asked Questions

To receive free hospital treatment, you will need to provide evidence that you are legally living within the UK.

All patients who are treated at our trust, whatever their nationality and living status, are required to provide correct information when registering their details. If you are living in the UK on a settled basis then you should be prepared to provide evidence.

You will be asked where you have lived in the last 6 months and to provide ID along with evidence to support your ordinarily resident status. If your status is unclear or not enough documents have been provided, you may need a further interview with our overseas patients’ office.

You will not be charged for treatment that you receive in the Emergency Department. However, this does not include emergency treatment given in any other department in the hospital.

You will be charged for any treatment given to you, by any member of staff in any of our services, both in the hospital or in the community. Exceptions may apply under certain circumstances, but we will discuss this with you if it applies to you.

The overseas visitors team can provide you with more detailed information if you are unsure whether you are entitled to free hospital treatment. You will be asked to provide evidence of entitlement – the overseas visitors team can advise you of what documents are acceptable.

If you live in a country that has a Reciprocal healthcare agreement with the UK, you may be entitled to free healthcare. Our overseas office can advise you

If you are a European national with a valid European Health Insurance Card (EHIC) you will be entitled to free emergency treatment, but not planned care. If you are unable to show a valid EHIC, you will need to pay for your treatment

If you have private healthcare insurance, you must provide us with a letter of guarantee from your insurer confirming they will cover the costs. If you are unable to present a letter of guarantee, you will need to cover the cost of the treatment and seek reimbursement from your insurer

If you are a refugee or asylum seeker whose formal application is being considered by the UK Border Agency, you will need to provide the overseas officer with documentary evidence of your asylum claim before treatment commences. If this is confirmed then you will be entitled to receive free treatment

Visitors from countries with no Reciprocal agreement and people who have no legal rights to be in the UK, including failed asylum seekers and illegal immigrants, are not entitled to free hospital treatment

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