Types of fraud related to this category
- NHS staff facilitation: This relates to an NHS staff member who has abused their position to facilitate access to NHS care without charge.
- Fraudulent application: This relates to someone who has intentionally made a fraudulent application to receive cover under a reciprocal healthcare agreement to which they are not entitled.
- False use: This relates to an individual falsely claiming to be entitled to care under a reciprocal healthcare agreement who has no entitlement to do so.
- Reciprocal healthcare fraud: Fraudulent use of European Health Insurance Cards (EHICs), Global Health Insurance Cards (GHICs), Provisional Replacement Certificates (PRCs) and various other reciprocal healthcare arrangements. Also, false representation during the application stage.
Exemptions related to these categories
- Primary care (including GP, dental and ophthalmic) is free at the point of delivery whether you are ordinarily resident in the UK or not, as well as some other services under regulation 9 of the National Health Services (Charges to Overseas Visitors) Regulations 2015 for example A&E, palliative care and treatment for sexually transmitted infections. Also, services under 117 of the Mental health Act 1983 are exempt.
- Secondary care: Access to secondary care without charge is determined by an individual being ordinarily resident in the UK under the National Health Services (Charges to Overseas Visitors) Regulations 2015. It has been a legal requirement since 2017 for relevant bodies to secure an advance payment for the care / service provided to those who not ordinarily resident in the UK. However, if a clinician has determined that care is urgent or immediately necessary, then care must not be refused, but charges should be recovered immediately following treatment or in parallel to it.
- Immigration Health Surcharge (IHS): Individuals with visas valid for 6 months or more will have paid on application (unless exempt or waived) the IHS fee and be entitled to care without charge, but payment will still be required for some services including prescriptions and assisted conception.