Guidance
Healthcare for EU citizens living in or moving to the UK from 1 January 2021
Information on accessing healthcare for citizens from EU countries, Norway, Iceland, Liechtenstein and Switzerland living in or moving to the UK from 1 January 2021.
New rules for January 2021
The UK has left the EU, and the transition period after Brexit comes to an end this year.
This page tells you what you’ll need to do from 1 January 2021. It will be updated if anything changes.
For current information, read: Healthcare for EU citizens living in the UK
You can also read about the transition period.
What you need to do
If you are living in the UK on or before 31 December 2020, you should:
- apply to the EU Settlement Scheme by 30 June 2021, if you are eligible
- apply for a frontier worker permit by 1 July 2021, if you are eligible
- apply for an S1 certificate if you are eligible and do not have one
- register your S1 certificate
If you are moving to the UK from 1 January 2021, 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
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 GOV.UK guidance.
Living in the UK before 31 December 2020
If you are a citizen of an EU country, Norway, Iceland, Liechtenstein or Switzerland, and living lawfully in the UK on or before 31 December 2020, you will be able to use the NHS in England, as you do now, after that date.
To maintain your entitlement to free NHS healthcare, you must apply to the EU Settlement Scheme by 30 June 2021. Once you are granted either pre-settled or settled status, or while your application is pending, you will not be charged for your healthcare as long as you continue to be ordinarily resident in the UK. You may be asked to show that you hold pre-settled or settled status when seeking healthcare.
If you don’t apply by 30 June 2021, you could lose your right to access free healthcare.
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 England 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 are living lawfully in the UK on or before 31 December 2020, and 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).
You must register your S1 certificate in the UK in order to maintain your entitlement. You should send it directly to the Overseas Healthcare Team for it to be processed:
Overseas Healthcare Services
NHS Business Services Authority
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN
Email nhsbsa.ovmqueries@nhs.net
If you do not have an S1 certificate, you can apply for one when you reach state pension age, as long as you remain living in the UK. You can apply for one from the relevant EU, Norway, Iceland, Liechtenstein or Switzerland health insurance authority.
Workers from an EU country, Norway, Iceland, Liechtenstein or Switzerland in the UK before 31 December 2020
If you are a frontier worker (someone who lives in an EU country, Norway, Iceland, Liechtenstein or Switzerland, but works in the UK) on or before 31 December 2020, you can continue to access NHS healthcare as you do now.
You will need to apply for a frontier worker permit if you wish to continue to enter the UK for work as a frontier worker after 1 July 2021.
For more information on the frontier worker permit scheme, see Home Office guidance.
If you are a posted worker (someone employed or self-employed in an EU country, Norway, Iceland, Liechtenstein or Switzerland, but temporarily sent to work in the UK), you can continue to access healthcare in England as you do now for the duration of your current posting. Your entitlement to free healthcare will end when your posting ends.
Some countries however have determined that their EHICs will not be valid for use in the UK after 31 December 2020. Visitors from those countries will be able to request a Provisional Replacement Certificate (PRC) instead. You should check before travelling to the UK whether you can use your EHIC or require a PRC.
Moving to the UK from 1 January 2021
From 1 January 2021, 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 in order 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 stays of 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.
Find full details about the Immigration Health Surcharge, including exemptions.
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 were required to, you’ll be charged for certain NHS services unless an exemption applies.
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 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, as long as they live in the UK on a properly settled basis for the time being.
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 to access public funds or free healthcare.
If you were not living in the UK on or before 31 December 2020, and do not have status under the EU settlement scheme, you and your family members will all need to apply for an appropriate visa.
Visit GOV.UK for 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.
Find 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 live in the UK on a properly settled basis for the time being.
Find 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 until 3 months of age on the same basis as someone who is ordinarily resident, but only if they do not leave the UK during that period.
You will also need to have:
- 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.
Studying in England
If you are studying in the UK on or before 31 December 2020 you may use your EHIC for medically necessary healthcare until the end of your course in the UK. You must apply to the EU Settlement Scheme if your course extends beyond 30 June 2021.
From 1 January 2021, if you begin a course of study in the UK which lasts longer than 6 months, you will need to pay the Immigration Health Surcharge as a part of your Student Route visa application.
If your course of study in the UK is less than 6 months in duration, you will not need to pay the Immigration Health Surcharge. You may have to pay for any NHS healthcare you receive. Any treatment that you need to pay for will be charged at 150% of the national NHS rate. You should 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:
Healthcare for visitors to the UK from the EU from 1 January 2021
Information on accessing healthcare from 1 January for visitors to the UK from EU countries, Norway, Iceland, Liechtenstein and Switzerland.
New rules for January 2021
The UK has left the EU, and the transition period after Brexit comes to an end this year.
This page tells you what you’ll need to do from 1 January 2021. It will be updated if anything changes.
For current information, read: Healthcare for EU citizens visiting the UK
You can also read about the transition period.
Coronavirus (COVID-19) testing and treatment
Overseas visitors to England, including anyone living in the UK without permission, will not be charged for:
- testing for coronavirus (even if the test shows you do not have coronavirus)
- treatment for coronavirus
What you need to do
If you are visiting the UK from the EU, Norway, Iceland, Liechtenstein or Switzerland, you should:
- have travel or health insurance that covers the duration of your trip
- bring your European Health Insurance Card (EHIC) if you are eligible to continue using it in the UK
- bring your S1 form if you are eligible to continue using it in the UK
- bring your S2 form if you are eligible for one
- check if you need to apply for an S2 Healthcare Visa
Getting healthcare in England
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. This means all visitors to England may have to pay for NHS healthcare, depending on their circumstances.
Medically necessary treatment
If you are visiting the UK from an EU country, Norway, Iceland, Liechtenstein or Switzerland and you fall ill or have an accident during your temporary stay in England, you may have to pay for NHS healthcare. Any treatment you have to pay for will be charged at 150% of the national NHS rate.
Some services, such as Accident & Emergency (A&E) and visits to a GP, are free to everyone. Urgent treatment, or treatment which cannot safely wait until you leave the country and return home will always be provided, and the matter of payment dealt with later. Only a clinician can decide if your treatment is urgent or immediately necessary.
There are some visitors from EU countries, Norway, Iceland, Liechtenstein or Switzerland who can continue to access medically necessary treatment in the UK. This includes UK nationals living and working in EU countries, Norway, Iceland, Liechtenstein or Switzerland on or before 31 December 2020, and their family members. You may be asked to provide evidence of your residency in an EU country, Norway, Iceland, Liechtenstein or Switzerland. Please check with the authorities in the Member State in which you reside for further information.
If you began a temporary visit to the UK on or before 31 December 2020, you will be able to access medically necessary treatment while your current visit lasts, even if it extends into 2021. You will not be covered for any subsequent visits.
For visitors from EU countries, Norway, Iceland, Liechtenstein or Switzerland who can continue to access medically necessary treatment in the UK, you will need to provide an EHIC issued by your EU country of residence when accessing that treatment. Some countries however have determined that their EHICs will not be valid for use in the UK after 31 December 2020. Visitors from those countries will be able to request a Provisional Replacement Certificate (PRC) instead. You should check before travelling to the UK whether you can use your EHIC or require a PRC.
If you are studying at an accredited higher education institute in the UK on or before 31 December 2020 you may use your EHIC or PRC for medically necessary healthcare until the end of your course. You must apply to the EU Settlement Scheme if your course extends beyond 30 June 2021.
If your course of study in the UK begins after 1 January 2021 and lasts for more than 6 months, you will need to pay the Immigration Health Surcharge as a part of your Student Visa application.
If you are a family member of a frontier worker (someone who lives in an EU country, Norway, Iceland, Liechtenstein or Switzerland and was working in the UK in that capacity on or before 31 December 2020) , you can receive NHS treatment for free if it becomes medically necessary during a temporary visit to England. However, you need to be able to present a copy of your S1 form.
The EHIC and PRC are not alternatives to travel insurance. It will not cover any private medical healthcare, being flown back home, or lost or stolen property.
If your EHIC has been lost or stolen during your visit to England and you need a replacement, then you should contact the relevant organisation in your home country to request a Provisional Replacement Certificate (PRC).
If you do not have an EHIC and cannot obtain a PRC, or are seeking treatment which is not covered by your EHIC, you may have to pay for treatment. The treatment you receive will be charged at 150% of the national NHS rate.
Seeking planned treatment in England
If you are coming to the UK from an EU country, Norway, Iceland, Liechtenstein or Switzerland and have requested authorisation from the relevant organisation in your home country for planned treatment under the S2 route on or before 31 December 2020, you will be able to complete that treatment in England, even if that treatment happens after that date. You will need to make all the necessary arrangements yourself in advance. If you are not a citizen of an EU country, Norway, Iceland, Liechtenstein or Switzerland, you may need to apply for an S2 Healthcare Visa.
The S2 only covers state-provided treatment and you will not be required to pay anything yourself, except any mandatory patient contributions that patients in England would have to pay, such as prescription costs. You may have to pay for any treatment which is not covered by your S2 form.
From 1 January 2021, some visitors may continue to use the S2 route for planned treatment in the UK. Please check with the authorities in the Member State in which you reside for further information.
If you are not eligible for an S2, you will be charged for that treatment at 150% of the national NHS rate.
UK nationals who no longer live in the UK
Because the NHS is a residency-based system, under NHS rules UK nationals who move abroad on a permanent basis generally lose their entitlement to free NHS healthcare.
If you are a UK national and move to an EU country, Norway, Iceland, Liechtenstein or Switzerland on or after 1 January 2021, you should not expect to be able to use NHS services for free when visiting the UK. You should take out appropriate travel insurance when visiting the UK, as you would when visiting any other country. Any treatment you may have to pay for will be charged at 150% of the national NHS rate.
Some former UK residents do not have to pay for NHS treatment when visiting England. This includes UK war pensioners, UK government employees, and UK nationals living in EU countries, Norway, Iceland, Liechtenstein or Switzerlandon or before 31 December 2020 who will be able to use a UK S1 or an EHIC, PRC or S2 issued by the country where they live.
You should check before travelling to the UK whether you qualify for an exemption from charging or will be required to pay for your treatment.
If you return to the UK permanently and you are ordinarily resident, you will be able to access NHS care without charge.
Travel insurance
The government always advises visitors to the UK to take out travel or health insurance in order to be able to reclaim healthcare costs you are required to pay from your insurer.
Check your insurance has the necessary healthcare coverage to make sure you can get the treatment you need during your visit.
Insurance is particularly important for those with a pre-existing health condition. You must tell your insurance company about any health conditions you have to make sure you can get the cover you need.
Speak to your doctor for advice before you travel and make plans for how to care for your condition when you are in the UK. You should also bring your health condition identification or a letter saying what medication you are taking.
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:
How charges for NHS hospital care will apply to overseas visitors from 1 January 2021
Published 17 December 2020
New rules for January 2021
The UK has left the EU, and the transition period after Brexit comes to an end this year.
This page tells you what you’ll need to do from 1 January 2021. It will be updated if anything changes.
For current information, read: Overseas NHS visitors: implementing the charging regulations
You can also read about the transition period.