[Skip to content]



If we are satisfied that the patient is an overseas visitor then we must charge the patient for the NHS care they receive.

If there are any doubts over the validity of exemption for a patient the patient should also be charged for their treatment.

If the patient refuses to pay or states that they have no funds available to pay (this is treated as a refusal to pay) then a payment plan can be negotiated in order to settle the debt, however this is at our discretion.

It is not acceptable for an invoice not to be raised for treatment because it is believed or claimed that there is an inability to pay.

Overseas visitors with travel insurance will be required to pay for their treatment and then claim back from their insurer on their return home.

Treatment is not made free of charge by virtue of being provided on an immediately necessary or urgent basis.  Charges found to apply cannot be waived.  However, any patient undergoing "immediately necessary" treatment will be reassured that this will not be withheld or withdrawn in the event of the patient being unable to pay.


Tariff and payments

The Overseas Visitor Team has access to the national/ NCA tariff so that they can advise the patient what the likely cost of treatment will be.  Overseas visitors treated as emergencies will normally be charged National Tariff rates, overseas visitors presenting for elective treatment will be charged private patient rates.

Payments will be taken from overseas patients at the earliest opportunity.


Deceased Patients

Where a patient dies without making or completing a payment to the Trust the debt then becomes recoverable from the deceased's estate.  An offer from relatives or another person to meet the debt can be accepted, but will not be actively pursued, unless it was they who had signed the ‘undertaking to pay’ form.


Recovery of Income

Reasonable measures are taken to pursue overseas visitors' debt and international debt recovery agencies will be employed.

Patients should be aware that under immigration rules 320, 321, 321A and 322. a person with outstanding debts for NHS treatment of over £1,000 that are not paid within three months of invoicing, may be denied a further immigration application to enter or remain in the UK.

In the absence of prompt, full settlement or a reasonable repayment schedule, non-clinical information relating to the debt is provided routinely to the Home Office and may be used by the Home Office to apply the above immigration rules.  The information will remain active for the purpose of the above rules until the debt is settled and a record of the settled debt will also be retained, both subject to normal limitation periods.

In the event that a person may seek entry to the UK or make an advance immigration application after settling an NHS debt in the previous three months, they are advised to retain and carry evidence of payment for potential examination by Home Office officials.