Accessing Free NHS Hospital Treatment
The NHS in England provides free hospital treatment to people who are ‘ordinarily resident’ in the UK. This means people living lawfully in the UK, voluntarily and for settled purposes as part of the regular order of their life. People who do not normally live in this country (including UK citizens who now live overseas) are not automatically entitled to use the NHS for free. All patients, including those born in the UK, need to provide satisfactory documentary evidence of entitlement (i.e. that they are ‘ordinarily resident’) in order to receive free hospital care; otherwise they will be directly charged for their treatment unless they are able to supply EHIC, S1 or S2 documentation.
No-one can be charged directly for NHS primary medical care but if you are aware that a patient is chargeable or holds an EHIC, S1 or S2, it is helpful if you let the hospital know this when referring the patient to secondary care. The hospital’s overseas visitor manager will use this information to recover the costs of care provided in hospital.
EHIC (Formerly known as E111)
European Health Insurance Cards (EHICs) are used by visitors and students from countries in the European Economic Area (EEA). EHICs allow the UK to recover costs of NHS healthcare provided during their stay, from their home country.
An EHIC covers treatment which cannot wait until the patient’s return to their home country. This includes pre-existing medical conditions and routine maternity care, providing the reason for a visit to the UK is not specifically to give birth.
Many EEA nationals live in the UK on a settled basis and are ‘ordinarily resident’ (see Accessing Free NHS Hospital Treatment above) – they are entitled to free NHS care and do not need to have an EHIC. However, if they do hold an EHIC, because they remain insured for healthcare by their home Member State, and they retain their principal long-term residence in that country then these costs can still be recovered from their home country through the EHIC.
Students from EEA countries, studying in the UK are an example of a group of people who may be living on a settled basis but who are likely to remain insured for healthcare by their home Member State because they regard that country as the place of their long-term residence. If any students from the EEA register at your practice and show you their EHIC, it is helpful if you tell them they need to present it again if they go to hospital so that the costs of their hospital treatment can be recovered from their home country.
If a patient is entitled to an EHIC but doesn’t have one, they can apply for a Provisional Replacement Certificate (PRC) which can be quickly issued and used by the hospital where the patient is receiving treatment. No-one should be denied NHS primary medical care or refused registration at a GP practice because they cannot provide an EHIC.
S1 forms (Formerly known as: E106, E109,E120, E121)
S1 forms are issued to people who live in one EEA country, but have their healthcare costs covered by another EEA country. People entitled to apply for an S1 include state pensioners and those in receipt of certain benefits e.g. survivors’ benefits and certain disability benefits. It also includes people who have been posted to work in another country (once they have lived there for two years) and frontier workers (people who commute across a border to get to work). Family members are also covered by the S1 form.
S1 forms must be registered in order for the money to be recovered. You can register S1 forms by sending them to the Overseas Healthcare Team at the Department for Work and Pensions who will process the form. S1 forms can also be faxed or scanned and emailed. Contact details can be found at the back of this leaflet. Registering an S1 form allows the UK to claim around £4,500 per person, per year, towards their healthcare costs, regardless of how much healthcare the person needs.
Most people submit their S1 form issued by their home country when they register with a GP. It is the patient’s responsibility to ensure the form is registered with the Overseas Healthcare Team but GP practices can offer to post it off for them. There is no deadline for processing S1 forms. If you think a registered patient might hold an S1 form or be eligible to claim one it is worth asking them.
By registering the form once it automatically means that £4,500 is recovered every year – you do not have to re-register it each year. Any money claimed goes back into the NHS.
No-one should be denied NHS primary medical care or refused registration at a GP practice because they cannot provide an S1.
S2 forms (Formerly known as E112)
S2 forms are issued to people who choose to have their healthcare, usually hospital treatment, in a different EEA country to the one where they live. These forms are processed by the hospital where the individual is receiving treatment.
Overseas Healthcare Team (OHT) - Contact details
Overseas Healthcare Team (OHT)
Department for Work and Pensions
Room M0401, Durham House
Washington, Tyne & Wear, NE38 7SF
OHT helpline for NHS staff
Telephone: 0191 224 7700
Need more information on the rules around charging visitors and migrants for NHS healthcare?
Visit: The NHS webpage by clicking HERE