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SECTION 3 SERVICES/TREATMENT EXEMPT FROM NHS CHARGES
GENERAL INFORMATION:
52. Some healthcare services and treatments are "exempt from charges" regardless of the patient's background, country of origin, medical history, residency or even legality of entry to the UK. This is to ensure that everyone is given access to emergency healthcare and to help prevent the spread of infectious diseases.
53. A person who is being treated for an infectious disease is only entitled to free treatment for that disease, and should be charged for any other treatment which may become necessary, unless it is for another infectious disease.
SPECIFIC EXEMPTIONS
Hospital Departments
54. All treatment given in A&E departments and casualty departments is "exempt from NHS charges". This includes treatment in an observation ward. The exemption ceases to apply when the patient is formally admitted as an in-patient or as a registered out-patient, unless the patient falls into one of the categories of exemption ( section 2).
55. Referral from a GP is not in itself evidence that a patient is entitled to "exemption from NHS charges." Hospitals should always seek independent evidence of an overseas visitor's entitlement in terms of residency and legality before formally admitting him/her as an in-patient or registered out-patient.
Ambulance Services
56. Emergency Ambulance Services are "exempt from NHS charges" for ALL overseas visitors.
Family Planning Services
57. Family Planning Services provided in an NHS clinic are "exempt from NHS charges" for ALL overseas visitors.
Infectious Diseases
58. Treatment for any of the diseases listed below is " exempt from charges", whether the disease is already diagnosed or not, for ALL overseas visitors.
Anthrax
Bacillary dysentery
Chickenpox
Cholera
Diphtheria
Erysipelas
Food poisoning
Severe Acute Respiratory Syndrome ( SARS)
Legionellosis
Leptospirosis
Lyme disease
Malaria
Measles
Membranous croup
Meningococcal infection
Mumps
Paratyphoid fever
Plague
Poliomyelitis
Puerperal fever
Rabies
Relapsing fever
Rubella
Scarlet fever
Smallpox
Tetanus
Toxoplasmosis
Tuberculosis
Typhoid fever
Typhus fever
Viral haemorrhagic fevers*
Viral hepatitis
Whooping cough
* Viral haemorrhagic fever covers, amongst others, Argentine haemorrhagic fever (Junin), Bolivian haemorrhagic fever (Machupo), Chickungunya haemorrhagic fever, Congo/Crimean haemorrhagic fever, Dengue fever, Ebola virus disease, haemorrhagic fever with renal syndrome (Hantaan), Kyasanur forest disease, Lassa fever, Marburg disease, Omsk haemorrhagic fever, Rift Valley disease and Yellow fever.
Sexually Transmitted Diseases
59. Treatment provided for sexually transmitted diseases at a specialised STD clinic and treatment of a sexually transmitted disease resulting from a related referral is "exempt from NHS charges" for ALL overseas visitors.
HIV/ AIDS
60. Exemption from charges for HIV/ AIDS is limited to a diagnostic test and counselling associated with the test and its results
61. ALL overseas visitors who are not "exempt from NHS charges" are to be treated as private patients after diagnosis and counselling and must pay the prescription costs for any drugs used to treat HIV (unless the overseas visitor qualifies under one of the specific categories of exemption in section 2).
Involuntary Psychiatric Treatment
ALL overseas visitors who are compulsorily detained in hospital, or received into guardianship under Mental Health Legislation are "exempt from NHS charges".
LIMITS OF EXEMPTION FROM NHS CHARGES:
62. "Exemption form NHS charges" is LIMITED to the NHS care and services for which a UK national ordinarily resident in Scotland would not pay. That is, if a person is deemed to be "exempt from NHS charges" then they are entitled healthcare and services on exactly the same basis as a UK resident, i.e. they will not pay for medical treatment but may pay for, e.g. dental treatment unless they fall within the categories of patients who would be exempt from charges. Those on low income may apply on form HC1 for help with NHS costs.
Prescriptions
63. Overseas visitor who do not qualify as "exempt from NHS charges" should be charged for the full costs of any prescribed medication.
Known Pre-conditions
64. No overseas visitor is "exempt from NHS charges" for a known precondition unless:
64.1 they fall into one of the relevant categories in section 2; or
64.2 they fall into one of the specific exemptions (see directly above); or
64.3 they are EEA/Swiss nationals in possession of an EHIC; or
64.4 they are Australians receiving renal dialysis treatment (see Reciprocal Agreements, section 4)
NHS Eye and Dental Examinations
65. Eligibility to free NHS eye and dental examinations is restricted to those ordinarily resident in the UK or those who fall within the categories of "exemption from NHS charges" as described in section 2 of this guidance. In ALL other cases the charges will not be met by the Government and dentists, optometrists and ophthalmic medical practitioners should see the patient privately and make appropriate charges.
Dental Treatment
66. Overseas visitor who do not qualify as "exempt from NHS charges" should be charged for dental treatment. Therefore, when providing dental treatment the dentist should treat the patient as a private patient.
Glasses/Contact Lenses
67. Overseas visitor who do not qualify as "exempt from NHS charges" should be charged for glasses/contact lenses. They will not be entitled to an NHS optical voucher towards the cost. Overseas visitors who do qualify as "exempt from NHS charges" will only be entitled to a voucher towards the cost of glasses/contact lenses if they fall within one of the "normal" eligibility categories, e.g. in receipt of Income Support. They are entitled to apply for help with NHS costs on form HC1 in the same way as permanent residents on low income.
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