Access to Healthcare

Access to publicly funded healthcare

The National Health Service (NHS) is a residency-based healthcare system that works on the concept of ordinary residence regardless of nationality, holding a British/Irish passport, owning a property in the UK, having an NHS number, being registered with a GP or having paid or paying taxes in the UK.

In order to be eligible to receive publicly-funded health care in Northern Ireland an individual must be classed as ordinarily resident.

An individual will be considered to be ordinarily resident when that residence is:

lawful,
voluntary; and
Properly settled here for the time being.

Anyone who is ordinarily resident in Northern Ireland is entitled to access publicly-funded health services. However, some Individuals who are not ordinarily resident in Northern Ireland may be entitled to access health services on the same basis as a person who is ordinarily resident, e.g., Frontier/Cross border Workers.

The South Eastern Trust Access to Healthcare Team are obliged by law to find out if people using our services are eligible for free care, or whether we need to charge for the treatment received. The individual is primarily responsible for providing documentation to prove eligibility however, the Access to Healthcare Team are here to assist the individual to gather this information.

All individuals apart from those receiving treatment that is exempt (as per the Persons Not Ordinarily Resident Regulations 2015) are required to complete a questionnaire and asked to provide documents to support their Ordinary Residence in NI or their exemption as an eligible

Visitors from the EEA (European Economic Area)

Any visitor from a European Economic Area (EEA) member state must show their European Health Insurance Card to access free healthcare. A valid EHIC entitles the patients to free treatment for conditions that arose during the visit, which cannot wait until they return home.

If you cannot show either an EHIC or Provisional Replacement Card (PRC), you will be liable to pay for treatment.

To get a provisional replacement certificate (PRC) that will cover until the Full EHIC arrives, follow the link below:

Apply outside of Ireland

European Health Insurance Card – Employment, Social Affairs & Inclusion – European Commission (europa.eu)

Only for Irish applicants:

Apply for an EHIC in Ireland – HSE.ie

Any visitors from countries with whom the UK has a Reciprocal Healthcare Agreement will need to show proof that they are a national/resident (as appropriate) of the country, e.g. a passport, a residence permit, etc., in order to be exempt from charges according to the agreement in place.

Pre-existing conditions that acutely exacerbate while in the UK or, in the opinion of a clinician, need prompt treatment to prevent them from acutely exacerbating, e.g., dialysis, are also included.

Further information on Reciprocal Healthcare Agreements

Countries with bilateral healthcare agreements

Pre-existing conditions that acutely exacerbate while in the UK or, in the opinion of a clinician, need prompt treatment to prevent them from acutely exacerbating, e.g., dialysis, are also included.

Further information on Reciprocal Healthcare Agreements

Emergency Treatment

The accident and emergency department is the only department that is exempt from charges up to the point of admission as an inpatient to a ward, or if referred to a clinic for an outpatient appointment. Please note this exemption does not apply to emergency treatment provided after admission to a ward, CCU, ITU / HD

Outpatient Appointments

All clinic and outpatient appointments including x-rays, maternity, physiotherapy are chargeable unless you meet an exemption.

Maternity Services

Overseas patients who require maternity treatment during the course of their visit to NI

If you are not ordinarily resident meaning someone who is living lawfully in Northern Ireland, and you do not meet an exemption, you will be charged for your maternity care.

If you are coming from England/Scotland/Wales for the purpose of receiving maternity care you must seek prior approval from your GP and provide written confirmation to the Access to Healthcare Team.

You are required to show evidence to support your exemption, examples include:

A valid European Health Insurance Card (EHIC) or S2 certificate issued in your European country of residence – Please note an EHIC card may not be used if the sole purpose for your visit to NI is to deliver your baby. There may be some instances where the EHIC may be accepted for planned delivery eg for migrant mothers wishing to return home to be with family for support, however this is assessed on a case by case basis and you MUST seek prior approval from your competent state before travelling and advise the maternity unit of your intention to deliver whilst on your visit.
A valid visa of more than 6 months issued with a BRP having paid the Health Surcharge.
A guarantee of payment issued by your insurance company covering maternity services, must be provided if possible prior to treatment.
A valid passport or identity card if you are resident of a bilateral agreement country.

Immediately necessary treatment

Immediately necessary treatment is that which a patient needs:

to save their life, or
to prevent a condition from becoming immediately life-threatening, or
promptly to prevent permanent serious damage from occurring.

This treatment will always be provided irrespective of whether a patient has been informed of, or agreed to pay, charges. Also it will not be delayed or withheld to establish the patient’s chargeable status or to seek payment.

All maternity services, including routine antenatal treatment, are treated as being immediately necessary

Non-urgent Treatment

Non-urgent treatment is routine elective treatment that could wait until the patient can return home

Contact Details

If you have any further questions or have any queries surrounding the evidence you will need to submit, please contact:

SET Access to Healthcare Team

Email: Accesshealthcare@setrust.hscni.net

Phone: 028 90564725

Frequently Asked Questions

Why have I received this questionnaire?	HSC Trusts have a duty to check evidence of a patient’s entitlement and as a consequence you may receive a letter asking you to complete a questionnaire or be asked by a member of staff to provide proof of your circumstances.
What is Ordinarily Resident in NI?	In order to be considered “ordinarily resident” in Northern Ireland, you must be living here lawfully and on a settled basis. Being born in NI or holding a UK passport and living elsewhere, paying UK taxes or receiving a UK pension does not mean you are automatically entitled.
If I have a HCN am I entitled to access publically funded health care in NI?	Everyone who is or has been registered with a GP or receives health care in a hospital will have a Health & Care Number. This number is your unique identifier for your medical records. It is not confirmation that you have entitlement to access publically funded health care in Northern Ireland.
I was born in Northern Ireland, am I entitled to access publically funded health care in NI?	Only if you reside in NI for a Settled Purpose. If you leave NI to live elsewhere, your entitlement ends.
I am not a UK or Irish national, but I am married to a person from NI/UK, am I entitled to access publically funded health care in NI?	Only if you have regularised your stay in the UK with the Home Office, i.e. obtained a VISA or Permit which allows you to reside in the UK and you are residing in NI.
I hold a British Passport am I entitled to access publically funded health care in NI?	Only if you reside in NI for a Settled Purpose.
I hold an Irish Passport am I entitled to access publically funded health care in NI?	Only if you reside in NI for a Settled Purpose.
I was born and raised in NI and now live elsewhere, but return home every year to visit family. Am I entitled to access publically funded health care in NI?	Not unless you satisfy an exemption under the Health and Social Care Provision of Health Care to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015
Am I entitled to get my healthcare treatment anywhere in the UK?	Only immediately necessary treatment.
Is Proof of identity the same as proof of lawfulness in the UK?	No. Not all documents that prove your identity also prove your lawfulness for example, a driving licence, an Electoral ID Card or a Translink pass will only confirm your identity.
I am a UK/Irish national and I own property in Northern Ireland, does that make me entitled to access publically funded health care in NI?	No. You must reside in Northern Ireland for a Settled Purpose. Owning property or paying rates does not entitle you to access publically funded health care in NI.
I work in NI and pay my taxes here, but do not live here. Am I entitled to access free health services?	If you travel from another EEA Member State to Northern Ireland to work on a regular basis and are registered with HMRC as a worker, you are considered to be a “cross border” or “frontier” worker and you are entitled to access health services in Northern Ireland on the same basis as a person who is “ordinarily resident” here.
I am a family member of a Cross Border Worker, am I entitled to access treatment free of charge in Northern Ireland?	Cross Border Worker family members are not entitled to the full range of HSC services free of charge.
I have been a Frontier Worker for years, do I continue to have the same entitlements as I had before BREXIT?	Frontier workers working in the UK immediately before 31 December 2020 will have protected rights under the EU Withdrawal Agreement and be able to access healthcare according to the same rules as before the UK left the EU, for as long as they continue to be frontier workers.
I am a retired Frontier Worker am I still entitled to access free health services in NI?	Retired Frontier workers who were employed in NI on or before 31 December 2020, who reside in a member state are no longer entitled to access the full range of publicly-funded health services in Northern Ireland. However, they are entitled to access continuing treatment which began before they retired if they are in receipt of a UK state pension.
I have recently become a Frontier Worker, I work in NI and live in the ROI. When I retire, am I entitled to receive health care in NI?	There is no access to publicly funded healthcare in Northern Ireland for a retired frontier worker that started frontier working in the UK on or after 01 January 2021.
I live in NI, but I receive my pension from another country, am I entitled to access publically funded health care in NI?	Yes, but only if you are lawfully in the UK for a Settled Purpose and can demonstrate that you reside in NI.
I lived all my life in NI but moved to ROI on retirement. Am I still entitled to receive free healthcare in NI?	No, you will no longer be entitled to receive free healthcare in NI as you are no longer resident in NI. However, you should apply to HMRC for an S1 Certificate and if provided you can provide this to the Health Service Executive, who will assess your entitlement to access publically funded health care in ROI. As access to publically funded health care in ROI is means tested, holding an S1 does not guarantee automatic entitlement.
I live in NI, but work in another country, am I entitled to access publically funded health care in NI?	Yes. If NI is your centre of your family life. For example your main residence is here, your family live here and you regularly return home.
I live in the Republic of Ireland and work in England/Scotland/Wales. Am I entitled to access publically funded health care in Northern Ireland?	No. You must work in NI.
I am from NI, but studying in England/Scotland or Wales and I am home on a visit. Am I entitled to access publically funded health care in NI?	Yes, during your course of study, provided NI remains your centre of family life. You should not be registered with a GP in NI when you are not in NI, but you may be entitled when you are home on a visit. Once your course of study ends, if you do not return to NI within 3 months, you will no longer be entitled as a resident.
I am a student from an EEA country coming to NI to study. Will I be entitled to free healthcare while I am there?	Students who come from the EU, EEA country or Switzerland to the UK to study (for courses lasting more than six months) whose student visas start on or after 1 January 2021 will pay the immigration health surcharge as part of their student visa application and will be entitled during their stay to health care on the same basis as someone who is ordinarily resident here.
I was born in NI; I now live in another country and pay National Insurance Contributions to the UK. Does this entitle me to access publically funded health care in NI?	No. You must either be Ordinarily resident or an eligible visitor. Paying voluntary National Insurance contributions does not provide you with entitlement to access publically funded health care in Northern Ireland
I am visiting Northern Ireland from an EEA Member State. Am I entitled to free treatment?	As a visitor from an EEAA Member State you must pay for your treatment unless you provide a valid European Health Insurance Care (EHIC) . A visitor is someone who is in the UK for a period of less than 6 months. EU Nationals wishing to live and work in the UK must have an immigration status. BRP, Pre-settled or Settled status.
I am visiting Northern Ireland from a Non-EEA Member State. Am entitled to free treatment?	If you are a visitor from a Non-EEA Member State, you must pay for your treatment unless: ● You qualify under a Bi-lateral Agreement between your home country of residence and the UK – www.gov.uk/guidance/uk-reciprocal-healthcare-agreements-with-non-eu-countries ● OR If you fall under an exemption as set out in the Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015.
I will be moving to NI from an EEA country soon, will I be entitled to free healthcare?	From 1 January 2021, people moving to NI from the EU, EEA or Switzerland must pay the immigration health surcharge when applying for a visa to enter and remain in the UK for more than 6 months. Payment of the immigration health surcharge entitles the payer to access publicly 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.
I will be moving to NI from a Non-EEA country. Will I be entitled to free healthcare?	In order for a Non-EEA national to be entitled to access publicly funded healthcare they need to hold: ● A standard visa and have paid the immigration health surcharge ● A EUSS status ● Indefinite leave to remain