NHS visitor and migrant cost recovery programme

Information and resources for NHS organisations, frontline staff and the public.

Migrants, visitors and former residents of the UK must pay for their care when they’re in England. In April 2015, changes were made to the way the NHS charges overseas visitors for healthcare. This is so that the NHS does not lose out on income for services these people receive.

This collection includes guidance and a range of resources, including template letters and posters, to help NHS organisations manage overseas visitors and recover the costs of healthcare where appropriate.

There are also resources available from e-Learning for Healthcare.

No charges for COVID-19 testing, treatment and vaccination for inpatients in secondary care

Overseas visitors who are admitted and receiving secondary care in England, including anyone living in the UK without permission, will not be charged for:

  • testing for COVID-19 (even if the test shows they do not have COVID-19)
  • treatment for COVID-19, including for a related problem called multisystem inflammatory syndrome that affects some children
  • vaccination against COVID-19, including boosters

No immigration checks are needed for overseas visitors if they are only tested, treated or vaccinated for COVID-19.

Overseas visitors are still expected to pay for certain charges that the resident population pay (for example, dental or prescription charges), unless exempt from those charges.

Charges for hospital treatment of secondary and subsequent illness

While COVID-19 testing and treatment is exempt from charges for those admitted to secondary care in England, this exemption is not intended to cover hospital treatment of any secondary or subsequent illness. Secondary or subsequent illness refers to:

  • conditions or complications which arise from the initial COVID-19 infection, including long COVID
  • any co-existing conditions a patient may have

These conditions remain chargeable, unless the individual is exempt. Under the charging regulations, the duty is on NHS trusts to assess, based on the views of clinicians, what treatment for COVID-19 is exempt or chargeable.


Charging regulations: impact and equality analyses

Guidance for NHS organisations

Resources for health professionals

Guidance for the public

Updates to this page

Published 15 October 2015
Last updated 27 July 2023 + show all updates
  1. Updated to reflect that the COVID-19 testing and treatment charging exemption now applies to inpatients in secondary care, and to add a section 'Guidance for the public'.

  2. Updated text about diagnosis and treatment of COVID-19 for overseas visitors.

  3. Updated text about diagnosis and treatment of COVID-19 for overseas visitors.

  4. Added link to subtitled version of video 'Introduction to overseas visitor and migrant cost recovery'.

  5. Added video introducing overseas visitor and migrant cost recovery.

  6. Added links to 'Healthcare when leaving an immigration removal centre: guidance for detainees' and 'Healthcare for people leaving an immigration removal centre: guidance for NHS providers', under 'Guidance for NHS organisations' section.

  7. Added guidance on NHS patient debts and immigration status checks to the 'Guidance for NHS organisations' section.

  8. Existing forms and letters to doctors and patients have been published on their own pages and added to the 'Resources for health professionals' section.

  9. Added 'Windrush generation guidance for NHS staff and NHS care providers' to the collection, in the 'Guidance for NHS organisations' section.

  10. Added new group: 'Charging regulations: impact and equality analyses'.

  11. The page has been completely overhauled: 'Independent reports' section has been removed, 'Migrant access to the NHS' consultation has been removed, 'Recovering costs of NHS healthcare from visitors and migrants' guidance has been removed from the 'Resources for health professionals' section, and 'Guidance on overseas visitors hospital charging regulations' has been removed from the 'Guidance for NHS organisations'. The following new pages have been added to the 'Guidance for NHS organisations' section: 'Overseas NHS visitors: framework to support identification and upfront charging', 'Overseas NHS visitors: non-NHS bodies implementing the charging regulations', 'Ways in which people can be lawfully resident in the UK', 'How the NHS charges overseas visitors for NHS hospital care', 'Overseas chargeable patients: NHS debt and immigration rules', 'Providing healthcare for overseas visitors from the EEA: information for primary care staff', 'EHIC incentive scheme' and 'EU cross-border healthcare directive: information for NHS providers'.

  12. Added link to 'Evaluation of overseas visitor and migrant NHS cost recovery' independent report.

  13. Added links to an E-Learning for Healthcare resources, including an overseas visitors cost recovery video.

  14. Link to consultation added

  15. First published.