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This page provides information about overseas visitors, including how to prove residency, and what happens if you do not pay for necessary NHS treatment.
NHS Entitlement – The Law in England
All NHS hospitals have a legal duty to establish whether you need to pay for treatment and, where appropriate, charge you for your care.
Anyone who is not ordinarily resident in the UK, including former UK residents, is considered an overseas visitor and may be charged for NHS services if no exemption applies.
Ordinary Residence
The Royal Cornwall Hospitals Trust is committed to identifying potentially chargeable patients in a supportive and non-discriminatory way. We do this by reviewing patient activity and contacting those who meet specific and objective criteria.
We will never ask for evidence based on appearance, accent, name or language. We take special care to avoid unconscious bias when making our enquiries.
You are usually considered a UK resident if you live in the UK on a lawful and settled basis. It is not guaranteed by:
- British nationality
- Having an NHS number
- Having paid (or currently paying) National Insurance contributions and UK taxes
- Being registered with a GP
- Owning property in the UK
- Visiting family members who live in the UK
Documents to prove your residency
You can use the following documents as proof of UK residency. The first item we need is evidence of your right to live in the UK, and an additional document to prove that you do.
Evidence of your right to live in the UK
- UK or Irish Passport
- Proof of EU Settled or Pre-Settled Status (including a certificate of application)
- eVisa or Home Office Share Code
- Valid armed forces or police photographic identity card
Proof of address
- A recent original utility bill such as gas, electric, water or landline telephone. (We do not accept mobile phone bills.)
- Council tax bill for the current year
- Recent original mortgage statement from a recognised lender
- Current council house or housing association tenancy agreement, or rent book
- Notification letter from the Department for Work and Pensions confirming your National Insurance number, entitlement to benefits or state pension
Visitors from the EEA or Switzerland
Even though the UK left the EU on 31st January 2020, you can still use your European Health Insurance Card (EHIC) to cover treatment which is needed during your stay. If you do not have an EHIC, you will need to get a Provisional Replacement Certificate (PRC). A PRC will provide the same cover as an EHIC until you return home.
If you do not have either of these documents, and cannot prove an exemption, you must pay for your treatment. You can recover the costs from your healthcare abroad team when you return home.
It is your responsibility to apply for a PRC and provide it the hospital. To apply for a PRC contact your country’s issuing authority. You can find their contact details on the European Commission website.
International Healthcare Agreements
The UK has several international healthcare agreements in place that cover necessary treatment needed during a visit to the UK. This is usually limited to treatment that cannot wait until you return home. The list of countries can be found here.
Chargeable Overseas Visitors
If you are not ordinarily resident in the UK, and no exemption or healthcare agreement applies, then you will be charged for the treatment you receive. Urgent or immediately necessary treatment cannot be delayed while we check your status, or if you cannot pay. This means that sometimes you will not be notified of charges until after the treatment has gone ahead. This does not mean that the treatment was free. One of the Overseas Visitors team will contact you as soon as possible to discuss payment.
If you are admitted to hospital as an emergency and you have medical insurance, please contact your insurers straight away to start your claim, and contact our team by email or telephone with your claim reference number.
If you do not pay
If you do not pay for necessary NHS treatment, future applications to remain or enter the UK may be denied. We share non-clinical information with the Home Office via the Department of Health and Social Care for this purpose. For more information on information sharing with the Home Office please visit the Gov.uk website
NHS Services which are free to all
Some NHS services are free to all patients including GP appointments, minor injury units, 111, ambulance services and the Emergency Department. For more information on accessing the NHS if you are visiting from abroad visit the NHS website How to access NHS services.
There are also exemptions for infectious diseases, victims of certain types of violence and treatment provided to specified vulnerable individuals. If you feel that you meet any of these exemptions, please contact us so that we can support you with your claim.
If you need more help
Contact the Overseas Visitors Team from Monday to Friday between 9am and 5pm:
- Phone +44(0)1872 252245
- Email rcht.overseas@nhs.net
If you do not speak English, please email us in your native language and we will be able to translate this.