Guidance

Healthcare for EU citizens living in or moving to the UK

Information on accessing healthcare for citizens from EU countries, Norway, Iceland, Liechtenstein and Switzerland living in or moving to the UK.

What you need to do

If you were living in the UK on or before 31 December 2020, you should:

  • have applied to the EU Settlement Scheme by 30 June 2021, if you were eligible
  • have applied for a frontier worker permit by 1 July 2021, if you were eligible
  • apply for an S1 certificate, if you are eligible
  • register your S1 certificate

If you did not apply to the EU Settlement Scheme by 30 June 2021, you may be able to make a late application. The Home Office will determine whether there are reasonable grounds for this.

Read more about eligibility for the EU Settlement Scheme and who has a later deadline to apply.

If you are moving to the UK, you should:

  • check if you need a visa or permit to come to the UK
  • check if a family member needs a visa or permit to join you in the UK
  • pay the immigration health surcharge, if required
  • apply for an S1 certificate if you are eligible and do not have one
  • register your S1 certificate

Getting healthcare in England

Except where otherwise stated, this information is about getting healthcare in England. The way you access healthcare in Scotland, Wales and Northern Ireland could be different from England.

The NHS operates a residence-based healthcare system. Most NHS services are free to people who are ordinarily resident in the UK. This means living in the UK on a lawful and properly settled basis for the time being. You may be asked to prove this when seeking healthcare.

If you are not ordinarily resident in the UK, you will be an overseas visitor and may be charged for NHS services.

For a detailed definition of what being ordinarily resident means, see the guidance on ways in which people can be lawfully resident in the UK.

Living in the UK before 31 December 2020

If you are a citizen of an EU country, Norway, Iceland, Liechtenstein or Switzerland, and were living lawfully in the UK on or before 31 December 2020, you will be able to use the NHS in England.

For those resident in the UK after 30 June 2021, you must have applied to the EU Settlement Scheme to maintain your entitlement to free NHS healthcare.

You will only be entitled to free NHS healthcare if you have been granted settled or pre-settled status, or on proof of application, where a decision is still pending.

If you did not apply to the EU Settlement Scheme by 30 June 2021, you may be able to make a late application. The Home Office will determine whether there are reasonable grounds for this.

In line with our longstanding commitments under the Common Travel Area, Irish citizens do not need to apply to the EU Settlement Scheme, although they may do so if they wish. Irish citizens living in the UK will continue to access healthcare in the UK on the same terms as a UK resident.

For more information on the EU Settlement Scheme, see the Home Office guidance.

You may be entitled to NHS healthcare paid for by an EU country, Norway, Iceland, Liechtenstein or Switzerland if you hold an S1 certificate - for example, because you receive either a State Pension or certain ‘exportable’ benefits from that country, or if you are a frontier worker (someone who lives in an EU country, Norway, Iceland, Liechtenstein or Switzerland, and works in the UK), or a posted worker (someone who usually works in one country but is sent temporarily to work in to another).

If you do not have an S1 certificate, you can apply for one from the relevant health insurance authority.

If you are studying in the UK, you may use your European (EHIC) or Global Health Insurance Card (GHIC) for medically necessary healthcare until the end of your course in the UK.

Moving to the UK

If you move to the UK to work, study or to settle, you will be subject to immigration control. This means you will need a visa or permit from the Home Office to be lawfully in the UK. You may need to pay the immigration health surcharge as part of your visa application.

You can only be considered ordinarily resident if you’ve been given the immigration status of indefinite leave to remain (the right to live here on a permanent basis).

Immigration health surcharge

If you are coming to the UK for more than 6 months, you may be required to pay an immigration health surcharge at the time of your visa application. The full amount will be paid upfront for the duration of your visa.

In line with our longstanding commitments under the Common Travel Area, Irish citizens will not be subject to the immigration health surcharge.

See full details about the immigration health surcharge, including exemptions.

If your healthcare is paid for by an EU country, Norway, Iceland, Liechtenstein or Switzerland, you may be eligible for a full or partial reimbursement of your immigration health surcharge.

To find out when you can have your immigration health surcharge reimbursed, see ‘When your healthcare costs in the UK are covered by an EU country, Norway, Iceland, Liechtenstein or Switzerland’ below.

If you’ve paid the surcharge or are exempt from paying it, you will be entitled to free NHS hospital treatment in England on a similar basis to an ordinarily resident person, with the exception of NHS-funded assisted conception services. Your entitlement will apply from the date your visa is granted until it expires. You will have to pay some charges, such as prescription or dental charges.

If you are coming to England for 6 months or less or fail to pay the surcharge when you are required to, you’ll be charged for certain NHS services unless an exemption applies or you are covered by a reciprocal healthcare agreement.

Working in the UK

If you are a frontier worker from the EU, Norway, Iceland, Liechtenstein or Switzerland (someone who lives in an EU country, Norway, Iceland, Liechtenstein or Switzerland and works in the UK), you can access NHS healthcare if you are eligible for an S1 form or EHIC issued by your home country.

If you are a posted worker from the EU, Norway, Iceland, Liechtenstein or Switzerland (someone employed or self-employed in an EU country, Norway, Iceland, Liechtenstein or Switzerland but temporarily sent to work in the UK), you can access healthcare in England if you are eligible for an S1 form or EHIC issued by your home country.

Family members of citizens of EU countries, Norway, Iceland, Liechtenstein or Switzerland

If you are a citizen of an EU country, Norway, Iceland, Liechtenstein or Switzerland and have a family member who wishes to join you in the UK, they must apply for a family visa or permit.

If you were living in the UK on or before 31 December 2020 and you are eligible for the EU Settlement Scheme, your eligible family members will need either to apply for a family permit to come to the UK and then apply to the EU Settlement Scheme. In certain circumstances, they may be able to apply direct to the EU Settlement Scheme from overseas. This will secure their entitlement to free healthcare in the UK.

Any family member with whom you have a new relationship, formed after 1 January 2021, must apply for a visa. They may be eligible to do so under the family rules -however, most family visas do not entitle the holder access to public funds or free healthcare.

If you were not living in the UK before 1 January 2021, and do not have status under the EU Settlement Scheme, both you and your family members need to apply for an appropriate visa.

See more information about family visas and permits.

Family members of people of Northern Ireland

If you have a family member who is an eligible person of Northern Ireland, and who lives in the UK, you may be able to join that person in the UK without paying the immigration health surcharge.

See the definition of an eligible person of Northern Ireland.

Instead, you may be eligible to apply for pre-settled or settled status under the EU Settlement Scheme on the basis of that relationship.

Once you have either pre-settled or settled status, you will not be charged for your healthcare, as long as you continue to be ordinarily resident in the UK.

See more information about applying to join family living permanently in the UK.

Children born in the UK to those here lawfully for more than 6 months

If you give birth to a child in the UK, your child will be entitled to free NHS hospital treatment in England on the same basis as someone who is ordinarily resident.

Your child is covered until 3 months of age, but only if they do not leave the UK during that period.

You will also need to have either:

  • a valid visa of more than 6 months and have paid the immigration health surcharge for that visa
  • a valid visa of more than 6 months but were exempt from paying the immigration health surcharge
  • a valid visa of more than 6 months, which you applied for prior to 6 April 2015

You should apply for a visa for your child during the 3-month period after your child’s birth. You may have to pay the immigration health surcharge for your child. Failure to do so means you may be charged for NHS services provided for your child after the 3-month period.

When your healthcare costs in the UK are covered by an EU country, Norway, Iceland, Liechtenstein or Switzerland

S1 holders

You may be entitled to healthcare in the UK paid for by an EU country, Norway, Iceland, Liechtenstein or Switzerland if you:

  • live in the UK and receive either a State Pension or certain ‘exportable’ benefits from that country
  • live in the UK and work in an EU country, Norway, Iceland, Liechtenstein or Switzerland (frontier worker)
  • are posted to work in the UK by an employer in an EU country, Norway, Iceland, Liechtenstein or Switzerland
  • are an eligible family member or dependent of one of the above

You should be issued with an S1 certificate by the relevant country, which shows that you are entitled to healthcare in the UK paid for by that country. If you do not know whether you are eligible, you will need to check with the relevant national health insurance authority to see if they are responsible for your health costs in the UK.

You must register your S1 in the UK by sending it directly to the Overseas Healthcare team:

Overseas Healthcare Services
NHS Business Services Authority
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

Email: ohsfaregistrations@nhsbsa.nhs.uk

Phone: 0191 218 1999, or +44 191 218 1999 from outside the UK

Immigration health surcharge reimbursement for S1 holders

If your UK visa started on or after 1 January 2021 and you’ve registered an S1 document issued to you by an EU country or Norway, you may be eligible for a full or partial refund of your immigration health surcharge payment.

You can also apply for a full or partial refund of your immigration health surcharge payment if your visa started on or after 1 January 2021 and you’ve registered an S1 document issued to you by Switzerland, Iceland or Lichtenstein. However, you will only be able to backdate that refund to 1 November 2021 for S1 entitlement documents from Switzerland, and 1 January 2024 for those from Iceland and Liechtenstein.

To apply, contact the Overseas Healthcare Services team (details above).

If your S1 only covers part of your stay in the UK, you will receive a partial reimbursement. To get a full reimbursement, make sure that your S1 is valid for the length of your visa.

You can apply for a refund for any dependants who have registered an EU, Norway, Iceland, Liechtenstein or Switzerland-issued S1, where you have paid the immigration health surcharge on their behalf.

If they paid the immigration health surcharge themselves, they should apply for the refund.

If an employer or third party has paid the immigration health surcharge for you, you must begin the application on their behalf. The Overseas Healthcare Services team will then contact them for more information to process the application.

Students studying for more than 6 months

If you begin a course of study in the UK that is longer than 6 months, you need to pay the immigration health surcharge as part of your visa application.

You may be eligible for a full or partial reimbursement if all of the following are true:

  • you’re a full-time student in UK higher education
  • your visa started on or after 1 January 2021
  • you have an EHIC issued in an EU country, Norway, Iceland, Liechtenstein or Switzerland
  • you do not work in the UK

For more information, see Immigration health surcharge for EU students in the UK.

Students studying for less than 6 months

If your stay in the UK is 6 months or less, you do not need to pay the immigration health surcharge. ‘If you have a valid EHIC issued by an EU country, Norway, Iceland, Liechtenstein or Switzerland, you can access medically necessary treatment during your stay.

You should also buy insurance to cover your healthcare as you would if visiting another non-EU country.

Getting healthcare in Scotland, Wales and Northern Ireland

This guidance is about NHS entitlements in England. For more information about accessing healthcare in Scotland, Wales and Northern Ireland, visit the websites for health services in each country:

Published 19 March 2019
Last updated 22 February 2024 + show all updates
  1. Various changes to the text to reflect EEA and EFTA changes that came into force on 1 January 2024.

  2. Updated email address to contact the overseas healthcare team.

  3. Added a call out box to reflect partial and full immigration health surcharge reimbursements for S1 holders.

  4. Updated to reflect the UK-Switzerland Convention on Social Security Coordination coming into effect. From 1 November 2021, eligible visitors from Switzerland can access free, state-provided, necessary NHS healthcare through an EHIC. Eligible people living in the UK from Switzerland will be able to have their healthcare in the UK funded by Switzerland, such as those exporting their state pension from Switzerland and certain cross-border workers.

  5. In the section 'When your healthcare costs in the UK are covered by an EU country', updated information about immigration health surcharge reimbursements for S1 holders and students.

  6. Updated information in 'When your healthcare costs in the UK are covered by an EU country'. This includes details about immigration health surcharge refunds. New telephone numbers were also added.

  7. Updated with information on living in or moving to the UK now the Brexit transition period has ended, reflecting the terms of the UK–EU Trade and Co-operation Agreement on reciprocal healthcare arrangements.

  8. Added no-deal Brexit arrangement for Spanish citizens.

  9. Increased visibility of calls to action. Highlighted the different guidance for living in England, Scotland, Wales and Northern Ireland if there is a no-deal Brexit. Highlighted guidance for EU and EFTA (Iceland, Liechtenstein, Norway, and Switzerland) citizens about agreements with EFTA states and studying in the UK.

  10. First published.