Policy on medicine supply for British Nationals going abroad and
eligibility for NHS services
Plan Ahead
If you're taking medicines for a health condition, and you're planning on being away from home
for a while, it's good to be prepared.
Visit your GP Surgery and see the Nurse at least eight weeks before you travel, especially if you're
going abroad. Your Practice Nurse will be able to recommend that you have certain vaccinations
which may consist of several doses. They will also be able to advise you about any other
precautions you should take when visiting specific countries.
Going abroad for less than three months
If you are away from the UK for less than three months you may be able to get free or reduced
healthcare if you are visiting another country.
In EEA countries and Switzerland, this will be covered if you have an EHIC (European Health
Insurance Card). However, many popular destinations outside the EEA don't have an agreement
with the UK to provide healthcare, and not all costs such as transport back to the UK will be
covered if there is an agreement. That's why it's advisable to get your own travel insurance. A
list of countries that have agreements with the UK to provide healthcare can be found on page 6.
If you take a particular medicine, you should check that it is available in the country that you plan
to live in. Local policy allows your GP in the UK to prescribe 28 days supply of your medication
after which you will need to register with a local doctor in the country in which you are staying (or
alternative arrangements depending on individual countries policy) to ensure continued supply.
Some medicines may have a different brand name in other countries.
Can my GP prescribe extra medication to cover my trip?
It depends on several things, including:
how long your GP thinks you need medication for your condition
how often your treatment needs to be reviewed
how long you‟ll be away
The majority of people will find that their normal repeat prescription supply period will be sufficient
to cover their period away. If your normal repeat prescription is due whilst you are away, your GP
may be able to give you an early repeat prescription to ensure that you do not run out whilst you
are away. However, this will depend on, for example:
how long your GP thinks you‟ll continue to need your medication
how often your treatment needs to be reviewed
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In exceptional cases e.g. where you are constantly travelling and will be unable to register with a
local doctor, your GP may prescribe up to a maximum of 3 months‟ supply. Please be aware that
this is at the discretion of the GP and will be applicable in a minority of cases. Also where
medication requires frequent monitoring for example warfarin, it may not be appropriate for the
GP to prescribe for such an extended period.
Going abroad for more than three months1
If you are no longer resident in the UK and are living abroad, the NHS normally won't pay for any
treatment or services. This includes people who are in receipt of UK state retirement pensions.
No longer resident, means that you have left the country for more than three months. Therefore,
you will have to obtain healthcare cover in the country you are in, or get private medical
insurance.
If you are going abroad for more than 3 months then all you are entitled to at NHS expense is a
sufficient supply of your regular medication to get to the destination and find an alternative supply
of that medication.1 It may be worthwhile having your prescription translated into the language of
the country or countries that you're visiting. Also, a prescription list from your GP or a personal
health record card giving details about the medicines may be useful. Reception can print this list
on request.
Some people who live abroad may be eligible to receive free or reduced cost healthcare in other
European Economic Area (EEA) countries and Switzerland. For example, if you are working for a
UK employer, are in the armed forces or you are in education. To see if you are eligible, see the
Department of Health website: Other circumstances affecting eligibility.
Travelling with your medication
If you are travelling outside the EU, you should seek advice about obtaining your medicines in
the countries that you will be travelling to and you can also contact the relevant country's
embassy or high commission for advice before you go.
You will also need to find out whether there are any restrictions on taking your medicines in and
out of the UK or the country you are visiting, as some medicines that are available over the
counter in the UK may be controlled in other countries and vice versa. If you're in any doubt, you
should declare them at customs when you return.
For example, some prescribed medicines, such as Temazepam, contain controlled drugs, so the
amount you can take abroad is limited. If you need to take more than the maximum allowance
with you, you'll need a special license from the Home Office. See the HM Customs and Excise
website to check the permitted allowances on various drugs. You can also contact the Home
Office Drugs Branch on 020 7035 4848, or visit the Home Office website for advice.
Countries such as India, Pakistan and Turkey and the Middle East have very specific rules about
medications that you can, or cannot, bring into the country. If you're unsure about taking your
medication into a certain country, contact the appropriate embassy or high commission. The UK
Foreign and Commonwealth Office (FCO) website provides the relevant contact details for every
country.
If you are travelling abroad with your prescribed medicines, you should always ensure that they
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are in a correctly labelled container. If you are carrying needles or syringes in your luggage, it is
a good idea to have a letter from your GP with you, so that, if required, you can prove that the
drugs are for medical use. This may help you avoid any problems at customs. Your GP is
entitled to charge you for this service, but it could be worth it.
European Economic Area countries (EEA)1: Austria, Belgium, Bulgaria, Cyprus (Southern),
Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia,
Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Republic of Ireland, Romania,
Slovakia, Slovenia, Spain, Sweden, UK, plus Iceland, Liechtenstein Norway and Switzerland.
Remember, each country‟s health system is different and might not include all the things
you would expect to get free of charge from the NHS. This may mean that you have to
make a patient contribution to the cost of your care. You may be able to seek
reimbursement for this cost when you are back in the UK.
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Regulations Relating to Entitlement to NHS services2
Entitlement to Primary Care NHS Services
Practices may accept onto their list of patients anyone who applies. They may also refuse to
accept people as patients but only if there are reasonable and non-discriminatory grounds for
doing so that do not relate to the applicant‟s race, gender, social class, age, religion, sexual
orientation, appearance, disability or medical condition.
So in practice, GPs discretion to refuse a patient is limited. Examples of where a GP can refuse
to register a patient would be if the patient was violent, lived outside the practice area or if the
practice was closed to any new patient registration.
Overseas visitors, whether lawfully in the UK or not, are eligible to register with a GP practice
even if those visitors are not eligible for secondary care services.
Entitlement to Secondary Care („Hospital‟) NHS Services
Anyone who is deemed to be „ordinarily resident‟ in the UK is entitled to free NHS hospital
treatment in England. “Ordinarily resident” is a common law concept interpreted by the House of
Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled
purposes as part of the regular order of their life for the time being, with an identifiable purpose for
their residence here which has a sufficient degree of continuity to be properly described as settled.
It is unlikely that anyone coming to live in the UK, intending to stay for less than 6 months,
will fulfill these criteria.
Anyone who is not ordinarily resident is subject to the National Health Service (Charges to
Overseas Visitors) Regulations 1989, as amended. These regulations place a responsibility on
NHS hospitals to establish whether a person is ordinarily resident; or exempt from charges under
one of a number of exemption categories; or liable for charges.
British Nationals living abroad
Under the current regulations issued by the Department of Health (DoH), anyone who is spending
more than 3 months living outside the UK is no longer automatically entitled to free NHS hospital
treatment in England. Whether you remain entitled depends on the nature of your residence
abroad. Details from the DoH as follows:
Extended holidays
If you are going abroad for a one-off extended holiday for a few months, then you will continue to
be fully exempt from charges for NHS hospital treatment when you return to resume your
permanent residence in the UK. The same will apply to your spouse, civil partner and children
(under the age of 16, or 19 if in further education) if they are living with you in the UK on a
permanent basis.
Once you are living here permanently you will become ordinarily resident and the Regulations will
cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily
resident if they are living permanently in the UK with you. If they are not living permanently in the
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UK then the Regulations will apply and in order to be entitled to free hospital treatment they will
have to meet one of the categories of exemption in their own right.
In common with those ordinarily resident in the UK, anyone who is exempt from charges for
hospital treatment will have to pay statutory NHS charges, eg prescription charges, unless they
also qualify for exemption from these, and will have to go onto waiting lists for treatment where
appropriate.
Living as an “insured” resident of a European Economic Area (EEA) country?
If you go to live permanently (or for more than 3 months each year) in another EEA member state
and become an “insured” resident of that member state (ie become insured for the purposes of
state healthcare in that country) then, under European Community Social Security Regulations,
you will be entitled to “all necessary treatment” free of charge when you are visiting the UK. This
means treatment the need for which arises whilst in the UK, including pre-existing conditions
which acutely exacerbate unexpectedly, or, in the opinion of a clinician, would be likely to acutely
exacerbate without treatment. It also covers the treatment of chronic conditions, including routine
monitoring. It does not cover elective treatment such as pre-planned operations without special
arrangement.
Living in a bilateral healthcare agreement country?
If you have at some point lived lawfully in the UK for 10 continuous years and subsequently
choose to go and live permanently (or for more than 3 months each year) in a country with which
the UK has a bilateral health agreement, then, when you are visiting the UK, you will be exempt
from charges for treatment for a condition which arises after your arrival here. Routine treatment
of a pre-existing condition, or pre-planned operations etc, will be chargeable. This partial
exemption will also apply to your spouse, civil partner and children (under the age of 16, or 19 if in
further education) if they are living with you in the UK for the duration of your visit. NB – This
level of exemption will also apply if you live in an EEA member state but do not become an
“insured” resident there.
You will only be fully exempt from charges if you meet one of the other exemption criteria, for
example because you are working abroad and have been doing so for less than 5 years.
Living in a non-bilateral healthcare agreement country?
If you choose to go and live permanently (or for more than 3 months each year) in a country with
which the UK does not have a bilateral health agreement, then you will not normally be eligible for
free NHS hospital treatment during a visit to the UK, no matter how long you may have lived here
in the past. You may, however, be exempt from charges if you meet one of the other exemption
criteria, for example because you are working abroad and have been doing so for less than 5
years.
Living in both the UK and another country?
If you spend more than 3 months living in another country on a regular basis each year, for
example because you spend four months living in a second home during the winter but return to
the UK for the rest of the year, then you may not be eligible for free hospital treatment while you
live here. If the other country is one with which the UK has a bilateral health agreement then the
partial exemptions described above will apply to you. If the other country is not one with which
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there is a bilateral health agreement, then you will not be entitled to free NHS hospital treatment
during the time you live here, unless you meet one of the other exemption criteria.
Returning to the UK after a period of time living away?
If you go anywhere abroad for more than three months, either for a one-off extended holiday for a
few months or to live permanently for several years, but then return to the UK to take up
permanent residence here again, then you will be entitled to receive free NHS hospital treatment
from the day you return. So will your spouse, civil partner and children (under the age of 16, or
19 if in further education) if they are also living with you permanently in the UK again.
Once you are living here permanently you will become ordinarily resident and the Regulations will
cease to apply to you. Your spouse, civil partner and child will also be considered ordinarily
resident if they are living permanently in the UK with you. If they are not living permanently in the
UK then the Regulations will apply and in order to be entitled to free hospital treatment they will
have to meet one of the categories of exemption in their own right.
In common with those ordinarily resident in the UK, anyone who is exempt from charges for
hospital treatment will have to pay statutory NHS charges, eg prescription charges, unless they
also qualify for exemption from these, and will have to go onto waiting lists for treatment where
appropriate.
Bilateral healthcare agreement countries
European Economic Area countries (EEA): Austria, Belgium, Bulgaria, Cyprus (Southern),
Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia,
Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Republic of Ireland, Romania,
Slovakia, Slovenia, Spain, Sweden, UK, plus Iceland, Liechtenstein and Norway. Switzerland by
special arrangement.
Nationals of, and UK nationals in, the following countries: Armenia, Azerbaijan, Belarus,
Bosnia, Croatia, Georgia, Gibraltar, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, Montenegro,
New Zealand, Russia, Serbia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan.
Residents irrespective of nationality of the following countries: Anguilla, Australia,
Barbados, British Virgin Islands, Falkland Islands, Iceland, Isle of Man, Jersey, Montserrat, St.
Helena, Turks and Caicos Islands..
Other NHS Services
In practice, where the information relates to free NHS treatment, it also covers all NHS treatment,
i.e. access to GPs and NHS prescriptions.
References
1. http://www.nhs.uk/nhsengland/Healthcareabroad/pages/Healthcareabroad.aspx
2. http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/D
H_074374
November 2012
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