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I am an EU citizen who is living in the UK on a visa and plans to stay there for several years. On applying for the visa I payed the NHS surchage for the duration of the stay.

Question: Am I now entitled to free NHS services (e.g. GP visits, hospital treatment, cancer treatment, ... ) in the same way as an ordinarily resident person?

I ask, because it seems to me that the online information provided by the NHS tries really hard to avoid stating this in clear terms.

Apparently, being "ordinarily resident" is the measure of things: the website states clearly and repeatedly that only ordinarily resident people are entitles to certain services being free of charge (so-called secondary care services). I, who have just entered the UK and have no "indefinite leave to remain", am not ordinarily resident in this sense.

I expected that paying the NHS surcharge makes me somehow "equal" to such a resident for the duration of my visa. But the few times this situation is discussed on the website, it is not without a potential catch.

Here it sounds more like it is an exception for me not to be charged for something:

People who are covered by reciprocal healthcare agreements, who hold an EHIC or who have paid the immigration health surcharge may also be exempt from payment for certain services. [...]

Here and here I am kind of similar to an ordinary resident (in which way?), but also not the same (how?):

People who have paid the surcharge (or who are exempt from having to pay it or have had the requirement waived) can use the NHS in a similar same way to an ordinarily resident person while their visa remains valid. They will still need to pay for certain NHS services, including prescriptions, dental treatment and assisted conception services.

If you've paid the surcharge or are exempt from paying it, and your visa allows you to be here for more than 6 months, you'll 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'll have to pay some charges, such as prescription or dental charges.

I have a hard time finding anything about what these differences between me and an ordinarily resident person should be? I am aware that some services are not free for me, e.g. certain prescriptions and dental treatment. But they aren't free for residents either, are they?

So, I am now in the unpleasant situation that whenever I read something about what the NHS can do for its people, I am utterly clueless whether this applies to me as well.

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It appears the only difference between an ordinary resident and and someone who paid / are exempted from the Immigration Health Surcharge (IHS) seeking NHS services is the access to free assisted conception services.

In the guidance provided by Department of Health & Social Care to individuals on How charges for NHS healthcare apply to overseas visitors, dated 31 Dec 2020, they used a more concrete language (text emphasis mine):

Payment of the immigration health surcharge entitles the payer to NHS-funded healthcare on the same basis as someone who is ordinarily resident, from the date their visa is granted and for as long as it remains valid. They are entitled to free NHS services, including NHS hospital care, except for services for which a UK ordinary resident must also pay, such as dentistry and prescriptions in England, and assisted conception services.

The guide from the NHS on Moving to England from EU countries or Norway, Iceland, Liechtenstein or Switzerland, last updated on 12 Mar 2021, also have similar concrete language (text emphasis mine):

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

The legal basis of this exception is in SI 2015/238, reg. 10(2A), which took effect in Summer 2017. A NHS Clinical Commission Group provided a human readable explanation:

Immigration health surcharge - removal of assisted conception services

Amendments to the NHS (Charges to Overseas Visitors) Regulations 2015 were introduced into Parliament on 19 July 2017.

As a result, from 21 August 2017, assisted conception services will no longer be included in the scope of services available for free for those who pay the immigration health surcharge.


I am aware that some services are not free for me, e.g. certain prescriptions and dental treatment. But they aren't free for residents either, are they?

You are correct - see this page for when an ordinary resident is required to pay for their treatment.

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  • Thank you for the great detail in your answer :)
    – M. Rumpy
    Oct 31 '21 at 15:47

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