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Access to NHS Care in the UK

In April 2015, changes were made to the way the NHS charges overseas visitors for NHS hospital care. These changes also affect some former residents of the UK. The changes were made so that the NHS does not lose out on income from migrants, visitors and former residents of the UK, who may be required to pay for their hospital treatment costs while in England.

Within England, free NHS hospital treatment is provided on the basis of someone being ‘ordinarily resident’. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK. The changes which came into effect from April affect visitors and former UK residents differently, depending on where they now live.

Treatment in A&E departments and at GP surgeries remains free for all.

Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled.

Anyone who is not ordinarily resident is subject to the National Health Service (Charges to Overseas Visitors) Regulations 2011.  These regulations place a responsibility on NHS hospitals to establish whether a person is ordinarily resident; or exempt from charges under one of a number of exemption categories; or liable for charges.

Nationality or past or present payments of UK taxes and National Insurance contributions are not taken into consideration when establishing residence.  The only thing relevant is whether you ordinarily live in the UK.

People who live outside the European Economic Area, (EEA), including former UK residents, should now make sure they are covered by personal health insurance, unless an exemption applies to them. Anyone who does not have insurance will be charged at 150% of the NHS national tariff for any care they receive.