The National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989

• (1) Where an overseas visitor who has been granted leave to enter the United Kingdom for a course of treatment applies, or someone applies on behalf of that person, for exemption from charges for services forming part of the health service, the Scottish Ministers may determine where they consider that exceptional humanitarian reasons justify it, that no charge shall be made or recovered in respect of that person and that course of treatment.

• (2) Such a determination may only be made by the Scottish Ministers if they are satisfied in the case of that person that–

• (a) the treatment specified is not available in that person’s home country;

• (b) the necessary arrangements have been made for temporary accommodation for that person, the authorised companion (if any) and any authorised child for the duration of the course of treatment; and

• (c) the necessary arrangements have been made for the return of that person, the authorised companion (if any) and any authorised child to their home country when the course of treatment is completed.

Liability for payment of charges

Repayments

Revocations

Reciprocal arrangements with EEA States on or after IP completion day

4B

No charge may be made or recovered in respect of any services forming part of the health service to an overseas visitor where those services are provided in circumstances covered by a reciprocal agreement with an EEA State where that agreement comes into force on or after IP completion day.

Exemption from charges for treatment the need for which arose during the visit

Overseas visitors from the Republic of Ireland: treatment the need for which arose during the visit

5A

No charge may be made or recovered for services forming part of the health service provided only for the purpose of giving treatment the need for which arose during the visit in respect of an overseas visitor who is ordinarily resident in the Republic of Ireland and who is—

• (a) an Irish citizen, or

• (b) a British citizen.

Frontier workers: treatment the need for which arose during the visit

5B

• (1) No charge may be made or recovered for services forming part of the health service provided only for the purpose of giving treatment the need for which arose during the visit in respect of an overseas visitor who is a relevant frontier worker.

• (2) In paragraph (1) “a relevant frontier worker” means a person who—

• (a) is pursuing in the United Kingdom an activity as an employed or self-employed person which the person began to pursue there before IP completion day,

• (b) resides in an EEA State or Switzerland, and

• (c) returns to their residence in that EEA State or Switzerland (as the case may be) at least once a week.

Overseas visitors from EEA States where no reciprocal agreement: treatment the need for which arose during the visit

5C

• (1) This regulation applies only where regulation 4B (reciprocal arrangements with EEA States) does not apply.

• (2) No charge may be made or recovered for services forming part of the health service provided only for the purpose of giving treatment, the need for which arose during the visit, in respect of an overseas visitor described in paragraph (3).

• (3) For the purposes of paragraph (2) an overseas visitor is a person who is resident in an EEA State and, at the time that the treatment which constitutes the service is provided—

• (a) holds a European Health Insurance card issued by the competent institution of an EEA State or Switzerland,

• (b) holds a Provisional Replacement Certificate issued by the competent institution of an EEA State or Switzerland, or

• (c) would have been eligible to be issued with a European Health Insurance Card by the United Kingdom if IP completion day had not occurred.

Exemption from charges for treatment provided to a member of the forces of the North Atlantic Treaty Organisation

Exemption from charges for exceptional humanitarian reasons

Exemption from charges for overseas visitors with UK reciprocal healthcare entitlements before IP completion day

6B

• (1) No charge may be made or recovered in respect of any services forming part of the health service provided on or after IP completion day to an overseas visitor who is ordinarily resident in an EEA State or Switzerland, was ordinarily resident there immediately before IP completion day, and either—

• (a) immediately before IP completion day held a valid UK reciprocal healthcare document, or

• (b) at the time that the treatment which constitutes the services was provided, would have been eligible to be issued with a UK reciprocal healthcare document if IP completion day had not occurred.

• (2) In paragraph (1) “UK reciprocal healthcare document” means an S1 certificate, A1 healthcare certificate, European Health Insurance Card or equivalent document issued by a competent institution of the United Kingdom.

EU Exit: transitional arrangements

6C

• (1) No charge may be made or recovered in respect of any services forming part of the health service provided on or after IP completion day to an overseas visitor who is ordinarily resident in an EEA State or Switzerland, as part of a course of treatment which was authorised before IP completion day in accordance with Regulation (EC) No 883/2004 or Regulation (EEC) No 1408/71.

• (2) No charge may be made or recovered in respect of any services forming part of the health service provided before 31 December 2020 to a person who is an overseas visitor by virtue of section 39 of the Immigration Act 2014[^f00005] and who may be granted leave to remain in the United Kingdom by virtue of Appendix EU to the immigration rules[^f00006] (EU citizens and family members). This applies whether or not the person has applied for or has been granted leave to remain under Appendix EU to the immigration rules.

Liability for payment of charges

Repayments

Revocations

Exemption from charges for overseas visitors from Ukraine

4C

• (1) No charge may be made or recovered in respect of any overseas visitor, being a person or the spouse, civil partner or child of a person who—

• (a) is lawfully present in the United Kingdom, and

• (b) is ordinarily resident in Ukraine,

for services forming part of the health service which the overseas visitor receives during the period the overseas visitor is lawfully present in the United Kingdom.

• (2) This paragraph applies to an overseas visitor who, during the relevant period, received services forming part of the health service and is exempt from charges for those services by virtue of paragraph (1).

• (3) An overseas visitor to whom paragraph (2) applies is to be treated for the purposes of these Regulations as if, at the time that the services forming part of the health service were provided, the overseas visitor was an overseas visitor in respect of whom no charge may be made or recovered for services forming part of the health service.

• (4) A Health Board which, in respect of an overseas visitor to whom paragraph (2) applies, has—

• (a) yet to make charges under regulation 2 (making and recovery of charges), must not make the charges,

• (b) made charges under regulation 2 but has yet to recover the charges, must not recover the charges,

• (c) made charges under regulation 2 and received payment in respect of the charges, must repay any sum paid in respect of the charges in accordance with regulation 8 (repayments).

• (5) This paragraph applies to a dental practitioner, ophthalmic medical practitioner or ophthalmic optician (as the case may be) who, during the relevant period, provided an oral health assessment, dental examination, eye examination or sight test to an overseas visitor to whom paragraph (2) applies.

• (6) A dental practitioner, ophthalmic medical practitioner or ophthalmic optician (as the case may be) to whom paragraph (5) applies, who has—

• (a) yet to make charges under regulation 2, must not make charges under that regulation,

• (b) made charges under regulation 2 but has yet to recover the charges, must not recover the charges under that regulation,

• (c) made charges under regulation 2 and received payment in respect of the charges, must repay any sum paid in respect of the charges in accordance with regulation 8.

• (7) In this regulation, “the relevant period” means the period from 24 February 2022 to the coming into force of these Regulations.

Exemption from charges for treatment the need for which arose during the visit

Overseas visitors from the Republic of Ireland: treatment the need for which arose during the visit

Frontier workers: treatment the need for which arose during the visit

Overseas visitors from EEA States where no reciprocal agreement: treatment the need for which arose during the visit

Exemption from charges for treatment provided to a member of the forces of the North Atlantic Treaty Organisation

Exemption from charges for exceptional humanitarian reasons

Exemption from charges for overseas visitors with UK reciprocal healthcare entitlements before IP completion day

EU Exit: transitional arrangements

Liability for payment of charges

Repayments

Revocations

Exemption from charges for overseas visitors under the Gaza medical evacuations

4D

• (1) No charge may be made or recovered in respect of any overseas visitor, being a person who—

• (a) has been granted leave to enter the United Kingdom outside the immigration rules (made under section 3(2) of the Immigration Act 1971), and

• (b) is lawfully present in the United Kingdom after being evacuated from Gaza for the purposes of undergoing treatment in the United Kingdom under the “Gaza medical evacuations”,

for services forming part of the health service which the overseas visitor receives during the period the overseas visitor is lawfully present in the United Kingdom.

• (2) No charge may be made or recovered in respect of any overseas visitor, being a person who—

• (a) has been granted leave to enter the United Kingdom outside the immigration rules (made under section 3(2) of the Immigration Act 1971), and

• (b) is lawfully present in the United Kingdom after being evacuated from Gaza for the purposes of accompanying an overseas visitor to whom paragraph (1) applies,

for services forming part of the health service, provided only for the purpose of giving treatment the need for which arose during the visit.

• (3) For the purposes of paragraph (1), the “Gaza medical evacuations” means the evacuations described in a statement to Parliament by the Secretary of State for Health and Social Care on 1 September 2025.

• (4) This paragraph applies to an overseas visitor who, during the relevant period, received services forming part of the health service and is exempt from charges for those services by virtue of paragraphs (1) or (2).

• (5) An overseas visitor to whom paragraph (4) applies is to be treated for the purposes of these Regulations as if, at the time that the services forming part of the health service were provided, the overseas visitor was an overseas visitor in respect of whom no charge may be made or recovered for services forming part of the health service.

• (6) A Health Board which, in respect of an overseas visitor to whom paragraph (4) applies, has—

• (a) yet to make charges under regulation 2 (making and recovery of charges), must not make the charges,

• (b) made charges under regulation 2 but has yet to recover the charges, must not recover the charges,

• (c) made charges under regulation 2 and received payment in respect of the charges, must repay any sum paid in respect of the charges in accordance with regulation 8 (repayments).

• (7) This paragraph applies to a dental practitioner, ophthalmic medical practitioner or ophthalmic optician (as the case may be) who, during the relevant period, provided an oral health assessment, dental examination, eye examination or sight test to an overseas visitor to whom paragraph (4) applies.

• (8) A dental practitioner, ophthalmic medical practitioner or ophthalmic optician (as the case may be) to whom paragraph (7) applies, who has—

• (a) yet to make charges under regulation 2, must not make charges under that regulation,

• (b) made charges under regulation 2 but has yet to recover the charges, must not recover the charges under that regulation,

• (c) made charges under regulation 2 and received payment in respect of the charges, must repay any sum paid in respect of the charges in accordance with regulation 8.

• (9) In this regulation, “the relevant period” means the period beginning with 15 September 2025 to the coming into force of these Regulations.

Exemption from charges for treatment the need for which arose during the visit

Overseas visitors from the Republic of Ireland: treatment the need for which arose during the visit

Frontier workers: treatment the need for which arose during the visit

Overseas visitors from EEA States where no reciprocal agreement: treatment the need for which arose during the visit

Exemption from charges for treatment provided to a member of the forces of the North Atlantic Treaty Organisation

Exemption from charges for exceptional humanitarian reasons

Exemption from charges for overseas visitors with UK reciprocal healthcare entitlements before IP completion day

EU Exit: transitional arrangements

Liability for payment of charges

Repayments

Revocations