Taking the complexity out of immigration
We look at overseas visitors to the UK from the EEA and non EEA countries and and access to healthcare
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Overseas Visitors and UK Healthcare

It is holiday season and millions of travellers from all over the world are expected the visit the UK. Most visitors will have adequate medical insurance. Yet what happens if your travel insurance doesn’t go far enough or you don’t have travel insurance at all, but require healthcare. And what impact will rule changes have from October 2017. We answer those questions, and more, in this post on overseas visitors and healthcare.

In 2015, there were 36.1 million visitors to the UK from overseas visitors, 5.1% higher than in 2014. In 2016, the number of overseas visits to the UK reached record levels of 37.6 million. 

Access to healthcare treatment during a person’s travels depends on whether the visitor is travelling from within or outside of Europe.

EEA NATIONALS

For those visitors to the UK, from within the Economic European Area (EEA), it is recommended to apply for the European Health Insurance Card (EHIC). The EHIC entitles EEA nationals to access necessary treatment at a reduced cost, or sometimes at no cost, in certain European countries with state provided healthcare, and is free.

Treatment for pre-existing medical conditions are covered. Yet, the EHIC has its limitations. For instance, it will not cover private medical healthcare costs such as the cost of being flown back to the European country of residence. And while routine maternity care is covered, it will not cover the cost of specifically travelling to the UK to give birth within the UK’s National Health Service (NHS)

For this reason, it is highly recommended that EEA nationals travelling to the UK on holiday hold both an EHIC card and valid and adequate travel insurance.

Only EEA nationals from the following countries are required to hold adequate medical and travel insurance and need not possess a EHIC:

  • The Channel Islands, including Guernsey, Alderney and Sark
  • The Isle of Man
  • Monaco
  • San Marino
  • The Vatican

If an EEA national visiting the UK finds themselves in need of medical treatment, they may dial 112, the free European emergency number, for immediate assistance.

The EU Directive route

The European Union (EU) Directive route entitles EEA visitors to purchase NHS or private healthcare in England and seek reimbursement for medically necessary treatment from their country of residence. The reimbursements are limited to the amount the treatment would normally cost in their home country. It does not cover emergency treatment and prior authorisation may be required

NON-EEA VISITORS

Visitors to England, more specifically, from outside of the EEA must have personal medical provisions or travel insurance to cover for the length of their visit.

If a visitor requires certain emergency treatment, the NHS will not turn the person away and some NHS services and treatments are free, making them exempt from charges.

These include:

  •  Accident and emergency services
  • Family planning services though it does not include infertility treatment
  • Treatment for most infectious diseases, including sexually transmitted infections (STIs)
  • Treatment required for a physical or mental condition caused by torture, female genital mutilation (FGM), domestic violence or sexual violence and yet charges will apply if the visitor enters England for the purpose of seeking that treatment

What happens if they then seek unplanned medical treatment from the NHS? Unfortunately, it’s not uncommon visitors to book their travel and omit or forget to purchase travel insurance or even seek the minimum travel insurance cover available. In such cases, overseas visitors receive a medical bill for fees chargeable at 150% of the NHS standard rate. Ouch!

Different rules apply for overseas visitors requiring medical assistance in Scotland, Wales and Northern Ireland.

It is also worth pointing out that some non-EEA visitors may be exempt from NHS charges. They include those traveling for longer than 6 months to work, to study or join family members, as they will have paid a separate Immigration Health Surcharge.

Changes to Healthcare rules from October 2017

As of 23 October 2017, non-EEA nationals must pay for non-urgent treatment and services, in advance. Visitors will be given an estimate of the treatment costs and will be expected to pay for this upfront, or treatment will not be provided.

From October 2017, failure to pay such charges will adversely impact upon any future immigration applications.

Reciprocal Agreements

Exemptions also apply to visitors from countries that have reciprocal healthcare agreements with the UK.

The reciprocal agreements entitle visitors, from specified countries, to access immediate emergency medical treatment free of charge. They are:

  • Anguilla
  • Australia
  • Bosnia and Herzegovina
  • British Virgin Islands
  • Falkland Islands
  • Gibraltar
  • Isle of Man
  • Jersey
  • Kosovo
  • Macedonia
  • Montenegro
  • Montserrat
  • New Zealand
  • Serbia
  • St Helena
  • Turks and Caicos Islands

The nature and access to free treatment will differ for each country under their respective reciprocal agreements. http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/NonEEAcountries/Pages/Non-EEAcountries.aspx

The agreements do not normally apply when the person has travelled to the UK for the purpose of obtaining healthcare.

There are non-EEA countries which previously held reciprocal healthcare agreements with the UK. Those agreements came to an end on 2016. As a result, visitors from the following countries must ensure they have adequate travel and health insurance, as they will be charged for accessing healthcare and treatment on the NHS.

  • Armenia
  • Azerbaijan
  • Barbados
  • Belarus
  • Georgia
  • Kazakhstan
  • Kyrgyzstan
  • Moldova
  • Russia
  • Tajikistan
  • Turkmenistan
  • Ukraine
  • Uzbekistan

On another note, from 21 August 2017, employers of overseas visitors working on UK-registered ships will be charged for NHS fees incurred.

Conclusion

With travel season well underway, it is important, whether you are from within the EEA or a non-EEA national, to know what emergency and non-urgent treatment and services you can access in the UK. Having adequate travel and medical insurance can provide a great deal of comfort, but if that, for whatever, reason is not the case, there may be other measures in place to help you get the treatment you need at reduced costs. By being informed, you can ensure you have a safe and enjoyable holiday, avoid a huge bill and at worse, for non-EEA nationals in particular, prevent adverse consequences in any future immigration applications.

Happy travels!

 

Key information

Call 999 if someone is seriously ill or injured and their life is at risk

Call NHS 111 if you urgently need medical help or advice but it’s not a life-threatening situation. You can also call NHS 111 if you’re not sure which NHS service you need.

 

Written by Carla Thomas – Managing Director at Thomas Chase immigration. Thomas Chase Immigration provide an end-to-end immigration service to individuals and families to help make the process as smooth as possible

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If you would like further guidance or assistance with an immigration matter, contact us at Thomas Chase Immigration to arrange a consultation. Or learn more about immigration from our blogs.

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