Do I have to pay for National Health Service treatment?
The title of this article may sound a bit of a political hot topic but the question ‘’do I have to pay for National Health Service treatment?’’ is a question that top London immigration solicitors are frequently asked. That is because the rules and regulations surrounding who is entitled to various National Health Service treatments is surprisingly complicated to understand without the best London immigration solicitors’ advice.
Who is charged for National Health Service treatment?
In essence, if you are an overseas visitor and you are not what is referred to as ‘’ordinarily resident’’ in the UK you may need to pay for some types of National Health Service treatment. The definition of who is an ‘’overseas visitor’’ and who is ‘’ordinarily resident’’ is a bit of a legal minefield.
With growing pressure on the National Health Service and an increasingly vocal voice being expressed about the cost of treating non UK nationals on the National Health Service, who were viewed in the media as ‘’health tourists‘’, the government decided in 2015 to introduce additional charges, naming the scheme ‘’the Immigration health surcharge’’.
What is the Immigration health surcharge?
The Immigration health surcharge is an upfront cost or charge for National Health Service treatment for anyone applying for a visa to enter the UK for more than six months. The surcharge is currently £200 for each year of the visa or £150 per year for a student or Tier 5 visa applicant. The Minister of State for Immigration has however said that the government intends to increase the Immigration health surcharge.
The Immigration health surcharge is payable even if an applicant for a visa has private health insurance that will cover the cost of any medical treatment in the UK and is not refundable if no recourse is made to National Health Service treatment during the visa applicants stay in the UK.
Overseas visitors paying for treatment
In October 2017 new regulations came into force requiring hospitals to make overseas visitors pay for their National Health Service treatment in advance. There is an exception to the payment rule as the regulations state that treatment can be given despite non-payment if withholding medical help would prevent or delay immediately necessary or urgent treatment, such as cancer or maternity care.
What happens if National Health Service treatment is immediately necessary and urgent?
If the patient cannot pay and the treatment is provided because it is immediately necessary or urgent the overseas patient will owe the treatment costs to the National Health Service. If the debt is over £500 the Home Office will not usually extend the patient’s visa or grant them a new visa.
If the patient cannot pay and the treatment is not immediately necessary or urgent, the National Health Service hospital is not allowed to treat the patient.
What is the definition of an overseas visitor?
For the purposes of the National Health Service charging schemes an overseas visitor is defined as someone who is not ordinarily resident in the UK. That definition does not help migrants, employers or National Health Service staff much as there can be a lot of debate as to whether someone has become ‘ordinarily resident’ in the UK especially when the impact of the classification will effect whether or not the cost of very expensive medical procedures have to be repaid to the National Health Service.
What is the definition of ‘’ordinarily resident’’ in the UK?
An overseas visitor is someone who is ‘’not ordinarily resident’’ in the UK, but what does ‘’ ordinarily resident’’ actually mean? top London immigration solicitors advise that:
• ‘’Ordinary residence’’ means living in the UK for settled purposes;
• If a migrant has Indefinite Leave to Remain they are classed as ordinarily resident in the UK. Equally Migrants who only have leave to remain in the UK for a limited period are classed as not ordinarily resident in the UK;
• If a migrant is either an EEA or Swiss national living in the UK they are classed as ordinarily resident and so is any none EEA national family members of EEA or Swiss nationals who are living with them in the UK under EU law;
• There is no set period of time that you have to live in the UK for before you become ordinarily resident in the UK – a migrant can become ordinarily resident in the UK from the day they come to the UK if they have emigrated to the UK on a permanent basis;
• Migrants who need leave to enter the UK but do not have the appropriate visa or leave are classed as not ordinarily resident in the UK.
Administering the charging scheme for National Health Service treatment is therefore no easy task given the complexity of the definition of ordinary residence and the many different types of migrants and visitors to the UK.
What NHS services are free for overseas visitors?
There are some National Health Service services that are available without charge namely:
• General Practitioner services and family planning; and
• Accident and emergency treatment at a hospital; and
• Treatment for some infectious diseases; and
• Treatments for sexual or domestic violence or torture or female genital mutilation; and
• Psychiatric treatment of a compulsory nature.
Who has to pay for NHS hospital treatment?
Overseas visitors who are not exempt from charges need to pay for National Health Service non-emergency hospital treatment as well as:
• People who are in the UK illegally , for example visa over stayers;
• EEA nationals who are visiting the UK and do not have a European Health Insurance Card (EHIC) ;
• British citizens who live outside the UK and are visiting unless they live in the EEA and have an EHIC;
Who does not have to pay for NHS hospital treatment?
This question is more complex for top London immigration solicitors to answer than asking who has to pay for National Health Service hospital treatment. That is because there are various categories of patient who do qualify for free treatment on the NHS namely:
• People who are ordinarily resident in the UK; and
• Overseas visitors who are not ordinarily resident in the UK but are exempt from paying charges such as:
o Non-EEA nationals who are from countries with which the UK has reciprocal healthcare arrangements; and
o EEA/Swiss nationals who have a European Healthcare Insurance Card; and
o British citizens who live in the EEA and have an EHIC; and
o Refugees and Asylum seekers.
National Health Service treatment summary
The National Health Service was created on the core principles that it would meet the needs of everyone; that it would be free at the point of delivery and that treatment would be based on clinical need and not ability to pay. Those 1940s guiding principles are straight forward but, in the opinion of top London immigration solicitors, if you fall within the category of an overseas visitor, a visa applicant (or their employer’s sponsor) or even a non-resident British citizen, it is vital that you find out where you stand when it comes to National Health Service treatment costs before you find yourself at the point of delivery given the complexity of the rules and regulations.
OTS Solicitors are specialist in Immigration law. The firm is recommended for Immigration law in the Legal 500. OTS Solicitors have Law Society accredited solicitors status as trusted specialists in Immigration law. For information and advice on visa applications; entitlement to treatment or any alternative aspect of personal or business immigration law please call us on 0203 959 9123 to arrange an appointment to speak to one of our experienced London immigration solicitors who will be happy to help.