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SECTION 4 RECIPROCAL HEALTH AGREEMENTS
EEA Nationals
68. Nationals of ALLEEA countries and Switzerland are entitled to any necessary NHS treatment while visiting the UK on the same basis as residents, upon production of an EHIC. This covers everything, including existing conditions so long as the patient's visit to the UKis not expressly for the purpose of receiving treatment. For Oxygen Therapy or Renal Treatment contact must be made prior to treatment.
EEA Nationals Electively in the UK for Treatment (E112 System)
69. When a national of another EEA member state (or Switzerland) comes to the UK expressly to receive NHS treatment (e.g. planned operations, treatment or therapy) then they must have an E112 form signed by their healthcare provider/insurer. This means that their healthcare provider in the country of residence has agreed to pay the UK Government for the cost of the treatment. Such patients should not be charged.
70. Patients seeking to exercise their rights under Article 49 of the Treaty of European Union, in the limited circumstances as detailed in the case law of the European Court of Justice, should be required to pay for treatment and provided with receipts which will enable them to reclaim costs from their health care providers in their countries of residence. The onus will be on the patient to claim reimbursement from their healthcare provider in the country of residence.
71. In any other circumstances any EEA or Swiss national coming for the purpose of receiving treatment should be treated as a private patient.
Non- EEA Reciprocal Health Agreements
72. The UK has reciprocal healthcare agreements with some non EEA countries (see Annex 2, list 1). Persons from these countries are entitled to partial exemptions from NHS charges. This includes:
- emergency treatment at an A&E/ casualty department/ GP surgery as available to everyone in the UK regardless of residency or legality of entry.
- treatment the need for which arose during the visit (see pg. 9 for definition)
- Quota Territories (see below)
List 1 and List 2 Countries:
73. There are differences between the 'List 1' countries and the 'List 2' countries (see annex 2)
- List 1 countries cover nationals who are resident in the country concerned.
- List 2 countries cover residents of the country concerned, irrespective of their nationality.
Examples of Evidence
List 1 countries:
Evidence of nationality will be required. Such evidence would be Passports of National ID cards. Evidence of residency will also be required. Such evidence could be a national insurance card equivalent, a driving licence, home health of benefits documentation.
List 2 countries:
Evidence of residency will be required. Such evidence could be a national insurance card equivalent, a driving licence, home health of benefits documentation.
Quota Territories:
74. Quota arrangements apply to a number of patients who can be referred for treatment to the UK from the islands noted below. Patients accepted by the UK under these arrangements are "exempt from NHS charges". NHS hospitals will be notified in advance of patients authorised to come for treatment under these arrangements. The quota arrangements are monitored by the Department of Health.
- the UK dependent territories of Anguilla, British Virgin Islands, Montserrat, St. Helena, and the Turks and Caicos Islands
- Gibraltar*
- Caribbean Islands**
*Note: Patients from Gibraltar must produce a letter from their home health or benefits authority confirming that they have either:
- been referred as part of the agreed quota arrangements with the UK, or
- are being referred by the home health or benefits authority who will be paying for the treatment.
If neither document can be presented, the patient should be considered as a self-referral and therefore informed that they can only be treated as a private patient and will be charged the cost of the procedure.
**Note: Patients of Caribbean Islands are limited to 4 patients from each island per year.
Channel Islands:
75. Patients from the Channel Islands can be referred to the UK for treatment. The arrangements must be made in advance with the relevant NHS hospital and the patient must have the appropriate documentation and have been referred by their home health authority.
Australia:
76. There is a specific agreement between the UK and Australia to the effect that residents of Australia may receive Renal Dialysis NHS treatment free of charge, subject to prior arrangement and spare capacity at a renal unit.
Turkey and Turkish controlled North Cyprus:
77. A resident of Turkey or the Turkish controlled area of North Cyprus, currently in the UK and requiring treatment 'the need for which arose during the visit', should be informed that they can only be treated privately unless he or she can prove that they are without sufficient funds or medical insurance to meet the cost of the treatment.
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