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INTRODUCTION
Purpose
1. The purpose of this guidance is to explain the circumstances under which overseas visitors are "exempt from NHS charges". "Exempt from NHS charges" does not mean they are exempt from all healthcare charges, but that they are entitled to receive NHS care and services on exactly the same basis as those ordinarily resident in the UK.
2. For example, those ordinarily resident in the UKdo not pay for NHS services such as medical treatment or NHS eye/dental examinations in Scotland. They do pay for "chargeable" services, such as NHS dental treatment and NHS prescriptions/wigs/fabric supports, unless they fall within the categories of people who are exempt from patient charges eg categories based on age or income.
3. An overseas resident who does not fall into any of the categories for "exemption from charges" and who is not receiving a service which is exempt from charges (see Section 3) must be charged for any care provided by the NHS, where it is permitted by the National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989 as amended, or else advised to seek private treatment.
4. The Regulations permit charging for NHS dental treatment, NHS eye examinations and NHS hospital services. Charges may also be made for private treatment. It is for the body which is providing the service, whether hospital or family health service practitioner or clinic or in some cases NHS Boards, to determine an appropriate charge.
Dental Charges
5. Although the National Health Service (Charges to Overseas Visitors) (Scotland) (Amendment) Regulations 2006 provide that dentists shall charge an overseas resident who does not fall into any of the categories for "exemption from charges" for NHS dental examinations and treatment, the charge in question must be determined by NHS Boards and the maximum patient charge does not apply. It is open to an NHS Board to decide on a charge on a commercial basis for the dentist to levy from the patient for such dental examinations. As the normal NHS charging and payment claim/reimbursement regime does not apply in such cases it is recommended that private treatment/examinations should be given to these patients.
Eye examinations
6. Similarly, these Regulations provide for a charge, which must be determined by NHS Boards, to be levied by the optometrist or ophthalmic medical practitioner where an NHS eye examination is given to an overseas resident who does not fall into any of the categories for "exemption from charges". Similar issues arise here, and it is therefore again recommended that private eye examinations are given to these patients. It should also be noted that overseas residents who do not fall into any of the categories for "exemption from charges" should not be issued with NHS optical vouchers
Primary medical services
7. The Regulations do not permit charging for NHS primary medical services i.e. GP services 1. Where an individual is registered with a GP practice and receives NHS primary medical services they should not be charged for such services. However, an individual can register with a GP practice privately and be charged for those private GP services. GP practices are asked to consider whether it would be more appropriate to register a person who would not be eligible in the terms of the Regulations and this guidance for NHS hospital treatment as a private patient.
8. Hospitals are advised to check the residency status of all overseas nationals seeking treatment. Referral from a GP is not in itself proof that an individual is "exempt from NHS charges".
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