What Benofits Does Passport Provide for Pregnant Wemon and Babies

This information canvas outlines the entitlement to free NHS maternity care in England for women from abroad (or Uk citizens returning to England afterwards living abroad).

• The ordinary residence test
• EEA nationals
• Exemptions from charges
• the health surcharge
• Access to maternity care
• How to bargain with NHS charges and debt
• How to challenge charging decisions.
• Where to go for more help.

New regulations are existence introduced in the Fall 2017. This information sheet contains details of those changes.

If y'all live in Scotland, Wales or Northern Ireland, we have produced a split information sheet.

Am I entitled to free NHS motherhood care?

NHS motherhood intendance is provided free of charge to women who are;

• considered to exist 'ordinarily resident' in the Britain, or
• EEA nationals who are insured by another European state, or
• exempt from charges (including people who have paid the clearing health surcharge).

If you lot exercise not fall into any of these groups you may be asked to pay for your care, but you cannot be refused care if you cannot pay at the time you receive care.  Information technology is very important for your health and your babe's health that you attend for maternity care fifty-fifty if y'all are unable to pay.

Motherhood care includes all antenatal, nativity and post-natal intendance.

The NHS charging regulations outlined in this information canvas currently merely apply to NHS infirmary care. If you lot are using community motherhood services, you should bank check whether these services are provided (and funded) by a hospital. If they are, the charging regulations volition still apply.

If you are uncertain nigh your clearing status, you should seek specialist immigration advice – run into organisations listed at the end of this data sheet.

Who will determine if I am going to be charged for my maternity care?

All NHS hospitals must make reasonable enquiries to determine who is not ordinarily resident and accuse overseas visitors for their NHS care. This volition normally be carried out by Overseas Visitors Managers (OVM) at the infirmary. Authorities guidance on charging for NHS care states that hospitals should follow these steps:

1. Patients should exist asked if they are insured by another state,
2. "All patients must exist assessed against the test for ordinary residence in the U.k.…If the patient is commonly resident in the UK they must not exist charged".
3. Patients who are non normally resident in the United kingdom of great britain and northern ireland, and are non insured by some other EEA country must exist assessed against the exemptions.
4. Patients who are bailiwick to charges must be charged. Maternity care must not be withheld or delayed if y'all are unable to pay in advance.

Do I accept to pay the charges upfront?

Upfront charging for NHS care is being introduced from 23 Oct 2017. This volition permit hospitals to ask for accelerate payment for an estimated amount of charges providing they have:

• fabricated reasonable enquiries as to whether you have to pay for NHS intendance or y'all fall inside i of the exemptions, and
• securing advance payment will not foreclose or delay an 'immediately necessary service' or an 'urgent service'.

An 'immediately necessary service' specifically includes antenatal intendance, care in childbirth and postnatal care of mother and baby. This means that your maternity care must never be refused or delayed if you cannot pay for treatment in advance.

An urgent service includes intendance that is necessary to salve a person'southward life or foreclose a status becoming life-threatening or to prevent serious damage.

Is there any information on my NHS records about whether I have to pay for intendance?

From 21^stAugust 2017 hospitals have a new duty to put a 'flag' on a patient's record to state whether the patient is chargeable or exempt and the date that they made that decision. However, the NHS has a duty to carry out 'reasonable enquiries' earlier charging a patient. This duty applies every time that the NHS applies charges to your handling. If your immigration status or residence status changes you should provide new evidence to the NHS.

If you are wrongly charged for treatment you should get specialist advice from the organisations listed below.

The ordinary residence examination

Who is 'ordinarily resident' in the UK?

Individuals who are considered to be 'ordinarily resident' in the UK are entitled to gratuitous NHS intendance. In law, a person is ordinarily resident here if they are:

"living lawfully in the United Kingdom voluntarily and for settled purposes as function of the regular club of their life for the fourth dimension existence, whether of short or long duration."

Yous must first institute whether you lot are living lawfully in the UK.

Am I living lawfully in the UK?

You are considered to be living lawfully in the Uk if you have permission from the UK Government to live here, for example, if yous are a British Denizen, accept leave to remain or are exercising your EU Treaty rights.  The post-obit may exist living here lawfully:

• Non-EEA Citizens with get out to remain in the UK.
• EEA/Swiss nationals who are working, studying or self-sufficient and their family members,
• Not-EEA carers of British and EEA nationals,
• Some Commonwealth citizens with a right of abode,
• Refugees and people with humanitarian protection, and
• Some temporary residents under the clearing rules.

There is a detailed Department of Wellness guide to ways in which you lot tin can be lawfully resident in the UK. If y'all are uncertain you should get advice from a registered immigration adviser: www.gov.u.k./government/uploads/organization/uploads/attachment_data/file/496967/lawfully-resident-u.k..pdf

Am I commonly resident in the Britain?

If you have established that you are lawfully resident in the United kingdom of great britain and northern ireland, you lot must then establish whether you are normally resident.

The post-obit people are considered ordinarily resident:-

• "Qualified" EEA Citizens (i.e. EEA Citizens who are exercising treaty rights [working, work-seeking, self-employed, cocky-sufficient]) in the UK.
• Family members of qualified EEA Citizens, whether or not they themselves are EEA Citizens.
• UK Citizens who are in the Great britain for settled purposes as role of the regular lodge of their life for the time being.
• People with indefinite leave to remain (ILR) and who are in the UK for settled purposes equally part of the regular lodge of their life for the time-being.

Uk nationals, who have been living/working away, may also have to testify their ordinary residence.  If you have emigrated, you lot are likely to exist charged for NHS care on visits to the United kingdom but you are non chargeable if you tin show that you are still usually resident here.

EEA nationals living in the Great britain will demand to demonstrate that they are exercising EU treaty rights in the UK (eastward.g. are employed, cocky-employed, a educatee or a family unit fellow member of someone exercising their EU treaty rights) or accept permanent residence in the UK.

I am not a UK Citizen, EEA Denizen or the family member of an EEA.   Am I ordinarily resident?

Under the 2015 charging regulations, people who require go out to remain in the UK, must take indefinite go out to remain (ILR) , in club to exist considered unremarkably resident.

If you have ILR yous must still exist able to demonstrate that yous are ordinarily resident here and not just visiting.

If you lot are in the Uk on a curt term visa (e.g. a spouse or student visa), you cannot be classed equally usually residenteven if y'all have been in the Britain for more than than half dozen months and tin can prove that y'all are settled here.  You may not have to pay for NHS maternity care if you are covered by one of the exemptions below or you pay the health surcharge when renewing your visa.

Non-EEA nationals without ILR can only be considered ordinarily resident if they are not subject area to clearing command, for example, a family member of an EEA national who is resident hither.

You lot are not considered to be living lawfully in the Uk if you have overstayed your Visa or your claim for asylum and any subsequent appeals have been refused just y'all may non take to pay for NHS maternity intendance if yous are covered by one of the exemptions below.

You are entitled to some NHS intendance if y'all are from a non-EEA country that has a reciprocal healthcare understanding. For more than information, see the Government guidance.

I have been here for less than 6 months can I nonetheless be considered to exist commonly resident hither?

Y'all tin be considered to be ordinarily resident in the U.k. if you have lived here for less than six months just can prove that y'all are in the UK for settled purposes.  For instance, you have taken a job here, your children have started school here, or y'all accept taken out a lease on your accommodation.  It is possible to be ordinarily resident from solar day ane.

What sort of show can I requite to show that I am ordinarily resident here?

It is important to provide as much information as you can to show that you lot are resident here, for instance:-

• Your tenancy agreement.
• Utility and Council Taxation bills.
• Employment contract
• Letter from college, confirming course duration.
• Letter of the alphabet from children'south school, confirming enrolment.

If you have recently returned from working or studying abroad it is a good idea to provide show to show that your chore or course was for a temporary period and provide details of where you lived and why you were not settled in that location, for example, how often you lot returned to the UK and what you are intending to do now.

You can ask friends and family unit to provide evidence for you, for case, if y'all are living with relatives. If y'all are unable to provide evidence immediately yous may exist charged just if y'all afterward provide satisfactory testify charges can exist cancelled. Come across below for how to claiming charging decisions.

EEA/EU nationals

I am from an EU/EEA country.  Am I entitled to gratuitous NHS care?

Countries in the EEA are:Austria,Kingdom of belgium,Bulgaria, Croatia, Republic ofCyprus, Czech Democracy,Denmark,Estonia, Finland,France, Deutschland, Greece, Hungary, Iceland, Ireland,Italy,Latvia, Liechtenstein, Lithuania,Luxembourg, Malta,Netherlands, Kingdom of norway, Poland, Portugal, Romania,Slovakia, Slovenia, Espana, Sweden

EEA and Swiss nationals and their family members are subject field to the aforementioned rules every bit other nationals for entitlement to gratuitous NHS healthcare which means they must be ordinarily resident in the UK.

For more than data most motherhood rights and benefits for EEA nationals see Maternity rights and benefits: European union, EEA and Swiss nationals.

I accept a (European Health Insurance Bill of fare) EHIC.  What am I entitled to?

EEA or Swiss nationals or their family members, who take a valid European Health Insurance Card (EHIC), are entitled to some treatment without charge, even if they are not ordinarily resident, considering the UK can merits back the costs of handling. The EHIC covers 'all treatment that is medically necessary before their planned engagement of return'. The EHIC covers maternity intendance, including antenatal and postnatal care, provided the reason for the woman'south visit was not specifically to requite nascence or receive maternity treatment and the treatment is necessary before her return.

EHICs are issued by the country where you work or are settled.  If you don't take an EHIC or have lost it, you can asking a Provisional Replacement Document (Prc) from the EEA country responsible for providing the EHIC.  This will requite you access to the same free treatment as an EHIC.

An EHIC/Red china volition merely cover the cost of your NHS care if you are hither temporarily and accept not settled here. You can exist here temporarily and use an EHIC, fifty-fifty if you are planning to be here for a while and exercise not yet have a appointment of return.

EEA nationals who program to take their babe whilst they are in the UK volition exist asked to provide an S2 form issued by the EEA land in which they are resident.  However, the NHS guidance states that:

 'since not all EEA states automatically issue the S2 (formerly E112) for maternity, discretion tin can exist applied if a valid EHIC is presented instead. If no valid entitlement document is presented, so payment will be required from the patient (unless a unlike exemption applies)'.

If you lot accept been charged yous may exist entitled to reimbursement from your abode state or if yous provide an EHIC valid for the menstruation of your handling yous may exist able to claim a refund from the NHS.

I am an EEA national and I've come to England to live and piece of work. Am I entitled to free NHS care?

Yous are entitled to costless NHS care if you are exercising Treaty rights to piece of work or study in the UK and you are commonly resident here. You will demand to provide evidence to the NHS, every bit outlined in a higher place, to evidence that yous are at present settled here.

Even if yous are entitled to free NHS intendance because you are ordinarily resident hither, you lot can even so be asked to provide an EHIC/PRC to enable the NHS to claim back the costs of your handling.

A spouse, civil partner, dependent child or parent of an EEA national who is usually resident here is as well entitled to be treated every bit ordinarily resident.

A student who is here for a long catamenia of study may exist asked to provide an EHIC/PRC. If the student does non accept a valid EHIC and is intending to study in the UK for a long flow, the NHS should consider if they are unremarkably resident every bit the pupil may be settled here for the time existence.

Exemption from charges

Am I exempt from charges for NHS care?

Some people are not "usually resident" in the U.k. but are "exempt" from NHS charges.

You volition be entitled to complimentary NHS motherhood intendance if you are in one of the following exempt groups:-

• You have claimed aviary or Article iii leave (including humanitarian or temporary protection) and are waiting for a decision or, following a refusal, yous await the outcome of an appeal,
• Y'all have been granted refugee condition or Article 3 leave, (including humanitarian or temporary protection),
• You are a Britain Regime employee (including members of the armed forces). This exemption also covers the employee'due south spouse/civil partner and children aged under xviii,
• You are covered past reciprocal health care agreements
• Yous have been detained for mental health handling or are subject to courtroom ordered treatment,
• You are in prison or clearing detention,
• You are a refused asylum seeker who receives back up nether Department 4(2) or Section 95 of the Immigration and Asylum Deed 1999 or Local Say-so support under section 21 of the National Help Human activity 1948 or Part one of the Intendance Act 2014,
• You are a woman who has been recognised as or suspected of being a victim of trafficking or modernistic slavery (her spouse/ceremonious partner and children are also exempt),
• You are a kid in the care of the Local Say-so.

Yous should seek advice if yous are uncertain nearly your immigration status or whether y'all are covered by an exemption (meet list of advice agencies below).

What happens if I was exempt from charging and I was receiving free treatment simply my awarding has now been refused?

Many of the exempt groups listed above tin go on to receive free handling if they had already started a class of treatment earlier their application is refused.

The following people can continue to receive free existing handling:

• Asylum seekers whose applications and appeals have been refused,
• Refused aviary seekers who stop receiving s.4(2) back up, southward.21 or Role 1 support,
• People no longer in prison house, clearing detention, looked later on by the local say-so or detained for mental health handling, and
• Suspected victims of mod slavery who is institute non to take been a victim.

Any new treatment would be chargeable, unless yous fall within an exempt group. The authorities guidance says that immediately necessary treatment (which includes maternity care) must not be refused to this vulnerable group if they cannot pay in advance.

I received NHS maternity care in the UK before I became exempt from charging; do I withal have to pay the charges for the maternity care I received?

You must be treated as existence exempt from charges for any maternity care you received before you were granted aviary or temporary or humanitarian protection or were identified as a victim of modern slavery if you:

• Came to the UK to utilize for asylum or temporary or humanitarian protection, or as a victim of modern slavery, and
• Accessed NHS maternity services earlier you had practical for asylum or temporary or humanitarian protection or before y'all had been identified as a victim of modern slavery, and
• Have after been granted asylum, temporary or humanitarian protection or identified as a victim of modern slavery.

This means that any charges made for the services you received will be cancelled and must non be pursued by the NHS. If you accept already paid the charges, they must be refunded to you.

Which services are exempt from charges for NHS intendance?

The following services are exempt from charges for anybody that needs them, whatsoever your immigration or residence condition is.  If you are an EEA national, the NHS tin inquire for your EHIC/People's republic of china in order to claim reimbursement from another EEA country but y'all cannot exist charged.

No charges may be made for the following services:

• Accident and emergency (A&E) services up until the point that the person is accepted as an inpatient. A&E services provided at an outpatient appointment are chargeable.
• Services provided exterior of an NHS hospital, unless the staff providing the services are employed by or working under the direction of an NHS hospital
• Family planning services (not including pregnancy termination). Temporary EEA nationals can apply an EHIC for termination of a pregnancy equally long equally it is necessary before you return to your ain country.
• Diagnosis and handling of certain contagious diseases e.g. TB or HIV,
• Diagnosis and handling of sexually transmitted infections
• Treatment of a physical or mental condition acquired past torture, female genital mutilation (FGM), domestic violence or sexual violence when the patient has not travelled to the U.k. in order to seek treatment, run across beneath for more details.

Which services are free of accuse for victims of violence or FGM?

You are entitled to treatment for any status, including chronic conditions that are a direct result of the torture, female genital mutilation, domestic violence or sexual violence that y'all accept suffered. Torture includes cruel, inhuman and degrading handling or penalization.

This ways that you are not entitled to allNHS services complimentary of charge only you lot are entitled to those services that are needed as a direct result of the torture, violence or FGM. NHS treatment includes psychological handling and it covers the initial treatment and ongoing treatment. Authorities guidance says that 'Handling will include mental wellness services and maternity services needed as a consequence of sexual violence.'  You are also entitled to any antenatal, perinatal and postpartum treatment that is needed as a upshot of FGM.

If you have been a victim of violence or FGM it is of import that you effort to speak to your medical professionals so that they tin help you to access these services free of charge. Some of the organisations listed beneath may be able to assistance you lot. The NHS should have prove of torture, violence or FGM from your GP or other organisations such every bit Freedom from Torture. If you are refused gratuitous treatment you lot can become gratis, confidential advice from the Maternity Activeness Maternity Care Access Advice Service, meet contact details beneath.

More information on the exemption for NHS services for victims of violence can exist found in chapter seven of the Government Guidance: www.gov.uk/government/uploads/system/uploads/attachment_data/file/496951/Overseas_visitor_hospital_charging_accs.pdf

Am I entitled to exist refunded charges for my maternity care if I am now exempt as a issue of new regulations for supported refused asylum seekers and victims of FGM?

If you received NHS care and were charged for information technology but have later on get exempt from charges, as a result of amendments to the regulations in February 2016 for failed asylum seekers supported under Function 1 of the Care Act and victims of FGM performed outside the UK, any charges should be cancelled.  If you have paid for NHS services, yous can use to the Section of Health for consideration of a refund.

The Immigration Health Surcharge (IHS)

What is the immigration health surcharge?

The Immigration Health Surcharge (IHS) was introduced in April 2015 for people who are applying for leave to enter or to remain in the UK for more than 6 months.

People who have paid the IHS volition be entitled to NHS healthcare free of charge, as soon every bit their get out to remain begins.

The IHS is £200 per year per person (with a discounted rate of £150 per year per person for students). Information technology must exist paid in respect of the applicant and all their dependents.The IHS is payable in total with the clearing application fee and must include the charge for every year or part-twelvemonth of residence in the Britain covered past the visa.  For example, a visa for two and a half years will include a surcharge of £500 to encompass that period for the applicant and each dependant.

Failure to pay the IHS could outcome in an immigration application being refused or exit to remain in the Britain being cancelled.

If you are exempt from paying the IHS, come across below, or you lot came to the UK earlier the IHS was introduced, and you make an in-time application for exit to remain (before your existing visa expires) and your leave is extended while your application is considered, you remain exempt from NHS charges until your extended leave expires.

Once your leave expires or while yous are an overstayer, yous are chargeable for your NHS care, including whatsoever treatment that has already begun.

Am I exempt from the health surcharge?

The Immigration Health Surcharge (IHS) cannot be paid if the visa is for 6 months or less (e.g. visit and fiancée visa).  People with those visas are chargeable for their NHS maternity care.

Some people are exempt from paying the health surcharge including:

• People (and their dependents) who apply for go out to remain in the UK for asylum/humanitarian protection or as a victim of mod slavery or under the Abode Office Destitution Domestic Violence Concession
• Dependents of a member of the HM forces.

If yous are exempt from paying the HIS, yous should non be charged for NHS maternity intendance.

If y'all accept paid the IHS, your babe will too be exempt from charges until south/he is three months' old.  After this time, your infant will be assessed in his/her own right for exemption or liability for NHS healthcare charges.  For more information about healthcare charges for children, see the organisations listed below,

I came to the U.k. earlier the Immigration Health Surcharge was introduced; am I entitled to free NHS maternity care?

Regulation eleven of the 2015 Charging Regulations gives transitional protection to people who fabricated an application for leave to remain in the United kingdom for more than than six months before April 2015.  This regulation says that you are non liable to pay the IHS retrospectively and should exist exempt from charges until the stop of your current visa (including any extension to your current visa). If you utilise for further leave to remain, yous will be assessed for liability to pay the surcharge as part of this application.

Is there whatsoever discretion to waive the Immigration Wellness Surcharge for women who are destitute?

The IHS must exist paid at the time you lot make your clearing awarding unless you are in one of the exempt groups (see above).  Women who tin can prove they are destitute at the time of applying for an extension to their immigration exit can inquire to take the application fees waived. It is as well possible to ask to accept the immigration health surcharge waived, reduced or refunded although this is rarely granted.  You volition demand to be able to prove that yous are destitute to the Home Office. You can get communication from the Maternity Activity Maternity Intendance Access Advice Line, see contact details below.

Entitlement to NHS wellness care

Practice NHS maternity services have the discretion to refuse to provide maternity care?

No.  All maternity care is classed equally " immediately necessary" , and must not be refused for any reason.  Maternity care includes all antenatal, nascency and post-natal intendance.

Even if you are unable to pay for services at the time of handling, you must receive motherhood care.  You should ask to speak to the Overseas Visitors Manager at the hospital to explain your circumstances and discuss your options (eastward.g. whether you might be exempt or to agree a repayment plan [see beneath]).

If you are refused maternity care you should contact the Patient Advice and Liaison Service (PALS) at your hospital, Healthwatch or seek farther advice from the organisations listed below. Y'all can make a complaint to the NHS, see below. You lot can also contact the Maternity Intendance Access Advice Service (details below) who tin can advise you and refer you for emergency legal activity if necessary.

Do I have to testify my passport to get NHS maternity intendance?

NHS maternity care must exist provided, whatever your nationality and regardless of whether you have go out to remain in the United kingdom.

Nether the 2015 Charging Regulations, NHS hospitals are entitled to make reasonable enquiries to determine who is ordinarily resident and accuse overseas visitors for their NHS care.  This volition normally be carried out past Overseas Visitors Managers (OVM) at the hospital.  In order to prove that you are entitled to gratis NHS care, you have to prove that y'all are usually resident in the U.k. by showing that y'all are here lawfully and you are settled for the fourth dimension being.  You may likewise exist entitled to free NHS care if you are in one of the categories of people who are exempt e.1000. aviary seekers or you lot are seeking treatment that is exempt from charging due east.g. emergency intendance.  See higher up on exemptions from charging for more than data.

Ordinary residence is explained in affiliate three of the Department of Health 'Guidance on implementing the Overseas Hospital Regulations 2015' and explicitly states on page 29:

'A person is not ordinarily resident in the Britain simply considering they take British nationality; concur a British passport; are registered with a GP; have an NHS number; own property in the UK; or have paid (or are currently paying) National Insurance contributions and taxes in the U.k..'

For more information on what documentation might exist needed to prove ordinary residence, encounter above on the ordinary residence test. In some circumstances you may demand to prove your passport to bear witness your residence status but it volition not be necessary in all cases.

Where can I observe the Government guidance on access to maternity intendance?

Department of Health guidance for England is independent in 'Guidance on implementing the overseas company hospital charging regulations'.  Chapter 8 of the Guidance says:

'Due to the severe health risks associated with conditions such as eclampsia and pre-eclampsia, and in society to protect the lives of both female parent and unborn baby, all motherhood services, including routine antenatal treatment, must exist treated as being immediately necessary. No adult female must e'er be denied, or have delayed, maternity services due to charging issues. Although she must exist informed if charges employ to her handling, in doing and then she should not be discouraged from receiving the remainder of her motherhood treatment. Overseas Company Managers (OVMs) and clinicians should be especially careful to inform meaning patients that farther maternity healthcare volition not be withheld, regardless of their power to pay.'

The latest version was updated in February 2016 and is available at

https://www.gov.united kingdom of great britain and northern ireland/government/uploads/system/uploads/attachment_data/file/496951/Overseas_visitor_hospital_charging_accs.pdf

I am a refused aviary seeker.  Tin I access NHS motherhood care?

In England, if you lot accept been refused aviary, humanitarian or temporary protection and you are in receipt of Section 4(two) or Section 95 support or local authority adaptation back up under south.21 NAA or Role i of the Intendance Act you are entitled to free NHS care.

If you are not receiving support y'all cannot exist refused NHS maternity care only you lot will be asked to pay unless you are entitled to gratis care nether any of the other exemptions.

I am not 'usually resident' or covered by an EHIC or exemption.  Can I obtain NHS motherhood care?

If you are non 'ordinarily resident' in the United kingdom and are not exempt, you may exist asked for pay for motherhood care.  Maternity care is classed as 'immediately necessary treatment'and cannot be refused for whatever reason.  If yous cannot pay, you must not be refused care.

If yous have overstayed a visa or are uncertain most your clearing status, you should seek specialist immigration advice – see organisations listed at the finish of this information canvas.

I am non ordinarily resident or exempt from charges; will I exist charged if I have an abortion?

Yeah, you will exist charged if you have an abortion at an NHS hospital. If you are an EEA national and y'all have an EHIC/Red china, yous are entitled to a termination free of charge providing it is necessary before you lot can return to your state.

If you are thinking of having an ballgame, seek further advice from the ballgame charities listed. In some cases, charities may be able to waive or reduce charges if you can show that you are unable to pay.

I am not 'normally resident' in the United kingdom.  Am I entitled to GP care?

There is no police preventing GPs from treating anyone.  GPs have the discretion whether or not to register patients, and so long as they do not discriminate confronting anyone. GPs may only refuse registration if the local Health commissioner has agreed that they can close their lists to new patients or you live exterior the GP's catchment surface area or for other reasonable grounds. GPs have a duty to provide free of charge treatment which they consider to be immediately necessary or an emergency, regardless of whether that person is an overseas company or registered with that practice.

NHS England has produced guidance for registering with a GP practice. A GP do is entitled to ask you to testify that y'all alive within their practice area but in that location are no regulations that say you must provide proof of identity, accost or residence in guild to be registered with a GP and you must not have registration or appointments refused because you are unable to provide these documents.

world wide web.nhs.uk/NHSEngland/AboutNHSservices/doctors/Documents/how-to-register-with-a-gp-leaflet.pdf

NHS healthcare charges

Am I entitled to proof of payment if I pay for my maternity intendance?

Yes, you are entitled to a receipt for whatever payments made for NHS care. It is of import to keep a record of whatsoever payments you lot brand and go on all receipts as proof of payment.

How much will motherhood care price?

The amount you lot will be asked to pay will depend on the intendance that you and your baby need. Charges can exist based on a local price organisation or the National Tariff Payment System and overseas visitors are charged 150% of the cost.

The National Tariff Payment Organization provides prices and rules for NHS providers; you lot can detect more information about how charges are broken downward in Chapter xiii of the NHS Charging guidance.

Maternity care is divided into antenatal care, birth and postnatal care; gauge charges for these services are:

• Antenatal care £1590-£4233,
• Birth £2244-£3282 (plus boosted payments if you demand a long stay in infirmary),
• Postnatal care £355.50-£1207.50

The amount you are charged could exist more or less than these amounts. For more than information, the latest National Tariff tin can be found at world wide web.gov.uk/government/publications/nhs-national-tariff-payment-system-201617

If you are in the UK in the early stages of pregnancy but are planning on having your baby abroad, you should only be charged for the care that yous actually receive.  Hospitals have three charging options: they can charge for a whole package, a proportion of a parcel and per appointment.

If you lot are asked to pay, you should ask for an itemised beak so you can see what you have been charged for. If you disagree with the amount y'all accept been charged you should talk to the hospital's Overseas Visitors Manager.  You can as well speak to the OVM virtually repayment options (for case, whether you can fix a repayment programme) and, if necessary, y'all should get advice.

I have been told that I will be charged for NHS motherhood care; what if I decide to take the baby at dwelling?

If you conform a abode birth with NHS maternity services, you will be charged as above.

Whilst it is not illegal to give birth to your baby at domicile without midwife/medical support (i.e. on your own or with the support of friends or family), if you lot are considering this it is very important for the safety and well-beingness of you and your babe that you lot get medical advice before the nascency to make sure you understand any potential risks to you or your baby and to hash out your birth options.

If you accept a home nascency without midwife/medical support you volition not be charged. Yet, if you have any complications and need medical treatment during or post-obit the birth, y'all could exist charged.

If you need emergency treatment considering your or your baby'due south life is at risk, any handling you receive from a hospital's accident and emergency service will exist gratis of charge merely if you are and then admitted to hospital for further treatment, yous will be charged for all medical care you receive as an inpatient (fifty-fifty if it arises from an emergency).

What should I do if I am asked to pay and I am unable to do so?

If you are unable to pay for your maternity care, then you should inform the hospital.  Ideally, this should be done in writing.  Citizens Communication Bureaux and local community organizations may be able to assist with this.

You lot tin enquire to repay the debt through regular monthly payments.  The corporeality y'all pay should be based on your income and expenses and so even a small monthly repayment (e.m. £5) should be accepted if that is all you can afford.

Hospital trusts accept a duty to recover charges, just should not get across what is reasonable when pursuing charges.  If the trust or a debt collector is aggressively pursuing payment, then yous tin can brand a formal complaint to the trust.  Your local PALS service or Healthwatch may be able to help you negotiate with the trust.

Yous can as well become specialist debt communication, including communication well-nigh debt drove, from the organisations listed below.

The NHS can write off debt if:

• the patient has died and the debt is not recoverable from their estate,
• the patient is not traceable,
• it is not toll-effective to go on to pursue the debt considering of the patient'due south fiscal circumstances, for example, the patient is destitute or genuinely has no means to pay it, or
• reasonable steps accept been taken and there are no further ways to recover the debt.

The debt must be written off if information technology is afterwards establish that the charges should not accept practical. Yous should proceed to attend for maternity care fifty-fifty if you are unable to pay the charges.

It is very important to go along a record of all payments and y'all are entitled to a receipt for any payments fabricated.

My husband has been asked to sign a grade to say that he will human action every bit a guarantor to pay my debts. Does he have to sign it?

Only the patient is liable to pay a debt for their NHS care. Debts for healthcare are simply linked to the person who owes the money and debts are not 'registered' against a detail address. If the NHS asks y'all and your husband (or anyone else, including family, friends or relatives) to sign a joint agreement to repay the debt then they will also be liable to repay the debt. In some circumstances you may both be required to repay the debt if you accept joint belongings or a joint bank business relationship. You should get communication before signing a joint agreement from a specialist debt adviser. You tin get free debt communication from the organisations listed below.

A guarantor is someone who agrees to pay a debt if the person named on the agreement falls backside with payments. A guarantor should have the ways to repay the debt, if necessary, and should get advice on the consequences if they are unable to pay. You do non have to provide a guarantor and if you and/or your husband/partner or anyone else are pressurised into signing a joint repayment agreement or a guarantee grade you lot should seek legal advice.

Recall: maternity care is regarded as immediately necessary handling and must not be delayed or refused considering of charging bug or inability to pay. Maternity care must not be delayed or refused whilst a repayment plan is negotiated or considering you practice not have a guarantor.

Anyone asked to deed as guarantor should seek communication from a specialist debt adviser before signing a guarantee agreement and should check the agreement carefully. You tin can get free debt communication from the organisations listed beneath.

Tin the NHS tell the Home Office near the debt?

Yes, the NHS can tell the Home Office if a non-EEA patient has unpaid debts:

• over £1000 (that are more than than 3 months old) from 1/11/11 to 5/4/16 or 23/11/16 (depending of type of leave).
• over £500 (that are more than two months old) from 6/4/sixteen and from 24/11/16 (depending on type of leave).

The Home Office is able to take this into business relationship when considering future clearing applications for leave to enter or remain in the land.

The NHS cannot notify the Home Role of outstanding debts in whatsoever of the following circumstances:

• The NHS must not tell the Home Office about a debt owed by an EEA national, her/his family member or a not-EEA national who has derived residence rights in the U.k. because they are the carer of a British or Eu citizen (known as Zambranocarers).
• The NHS must nottell the Home Role of outstanding debts if you are challenging the determination to charge yous, for example, where there is a dispute nearly your immigration status or whether y'all are ordinarily resident.
• The NHS must non tell the Dwelling house Part if you lot accept an agreed payment plan in place and you are sticking to information technology.
• The NHS must not inform the Home Office of outstanding debts where the debt has been cancelled.
• In Northern Ireland, the guidance states that the NHS must not inform the Home Office of a debt, if it has been written off. The England guidance is silent on this point.

At that place are clear guidelines that the NHS must follow before informing the Home Office of unpaid bills. The guidelines can be found at:   www.gov.uk/government/uploads/system/uploads/attachment_data/file/507694/Overseas_chargeable_patients_2016.pdf

The NHS does not take to tell you that they are going to notify the Habitation Office or that they have already notified the Home Part about an unpaid debt simply information technology is good exercise to tell you and to explicate why. All the same, the NHS must tell you lot that they are able to contact the Dwelling house Office if you lot practice not repay the debt or exercise not stick to a repayment program. If the NHS does not follow the guidelines and notifies the Home Office of your debt, you should seek advice.

Information technology is important to talk to the NHS to agree a payment program and try to stick to the plan. You can ask to repay in small instalments e.g. £5 per month instalments if you lot can bear witness that this is all you can afford to pay. The guidelines say that information almost debt may simply exist passed to the Home Role where no reasonable arrangements have been fabricated, or kept to, for repaying the debt.

If yous pay the debt after the Home Office has been informed or you agree a payment plan, the NHS must inform the Home Role immediately. The NHS may be liable for any consequences of failing to tell the Home Office near any changes, for example, if a visa application is wrongly refused.

The NHS can enquire the Home Part to verify your nationality or immigration status (such as asking for confirmation that you have practical for asylum), just the NHS must non share whatsoever clinical information about you with the Abode Office. These are strict rules. If you recall that the NHS has passed on other information about you, y'all should get legal communication.

How do I brand a complaint about a decision to charge me for my NHS intendance?

Regime guidance on charging (see above) says that NHS staff must non discriminate when implementing the charging rules, for case, they must non target particular racial groups. You lot also have a right not to be treated in an intimidating, hostile, degrading or offensive way. This means that enquiries about your residence condition and payment should be made privately and discreetly. If yous have been treated unfairly or discriminated confronting y'all can make a complaint.

If y'all are unhappy virtually the hospital'south decision to charge you, for example, they have rejected prove that you are usually resident or they have refused to provide maternity services until yous pay for treatment you can make a complaint. If it is later found that the charges should not have been applied, the debts can be cancelled (see section 13.lxx of the Authorities guidance on charging).

1. Firstly, y'all should try to resolve complaints informally past speaking to the hospital and showing them the relevant section of the Government guidance: gov.uk/government/uploads/system/uploads/attachment_data/file/496951/Overseas_visitor_hospital_charging_accs.pdf
2. If you have not been able to resolve it with the infirmary you lot can make a complaint using the NHS England Complaints procedure. england.nhs.great britain/contact-the states/complaint/#unhappy
3. If y'all are all the same unhappy you can heighten the matter with the Parliamentary and Health Service Ombudsman. Run across beneath for contact details.
4. Y'all can also become specialist legal advice most challenging charging decisions or refusal of treatment. Judicial review claims must be brought promptly and inside 3 months of the decision you are complaining about. Yous must accept completed all complaints and appeals available.

Some of the organisations listed below may be able to suggest you and help you to make a complaint.

If yours or your babe'south health is afflicted by delays to your treatment because of charging decisions or because you were deterred from seeking handling considering of fear of charges, you should go legal advice. You can get gratis, confidential advice from the Maternity Activity Maternity Care Access Advice Line, see contact details below.

If you are uncertain virtually your immigration status or y'all need help with regularising your status yous should seek help from a registered immigration specialist.

This factsheet was produced past Maternity Action in July 2017. Information technology is always of import to go up-to-appointment advice.

Support our work with a donation.

Where to get for more help

NHS motherhood care and charges

Maternity Action
www.maternityaction.org.great britain

Maternity Care Admission Advice Service: for advice on NHS charges and access to NHS maternity care – 0808 800 0041. Th 10 – 12 midday.  Email enquiries: maternitycareaccess@maternityaction.org.uk

For more than information on NHS motherhood care charging meet:

www.maternityaction.org.uk/advice-2/maternitycareaccess/

Migrant Women's Rights Service: Second tier advice on financial back up and housing options for migrant women and access to NHS maternity care. – 020 7251 6189 Electronic mail enquiries: migrantwomensrights@maternityaction.org.uk

This is a 2nd tier advice service for midwives and directorate

Debt advice/repayment plans/write-offs

Debt Advice Foundation

Gratuitous debt communication and assistance with debts.

Tel no. 0800 043 xl 50

world wide web.debtadvicefoundation.org

StepChange

world wide web.stepchange.org

Free debt advice and assistance with debts. Callers must exist resident in the UK.

www.stepchange.org/Contactus.aspx

Citizen'southward Communication Bureau

www.citizensadvice.org.united kingdom of great britain and northern ireland/debt-and-money/

Free advice on dealing with debts.

To detect your nearest CAB: www.citizensadvice.org.uk/almost-u.s./how-we-provide-advice/communication/search-for-your-local-citizens-advice/

National Debt line

Free online debt advice and tools. Tel no. 0808 808 4000.www.nationaldebtline.org

Trafficking and the National Referral Mechanism

Salvation Army

If yous think you are a victim of trafficking or modern slavery and would like advice and support y'all can call the Salvation Ground forces 24-hour confidential Referral Helpline

0300 303 8151

Open 24 hours, seven days a week

Healthcare and access to healthcare

Children's Legal Centre

world wide web.childrenslegalcentre.com/?sfid=132&_sft_resource_topic=healthcare

Freedom from Torture

Intendance and treatment for victims of torture

London Heart Tel: 020 7697 7777

West Midlands Centre Tel: 0121 314 6825

N East Centre Tel: 0191 261 5825

North Westward Centre Tel: 0161 236 5744

Scottish Centre Tel:0141 420 3161

Helen Bamber Foundation

Care and treatment for survivors of torture and violence

www.helenbamber.org

Tel No 020 3058 2020

Healthwatch England

A consumer organisation that can help with complaints against health care providers.

03000 68 3000

enquiries@healthwatch.co.uk

world wide web.healthwatch.co.uk/about-us

Parliamentary and Health Service Ombudsman

If you are unable to resolve a complaint with an NHS body you can make a complaint to the Ombudsman:

Helpline 0345 015 4033 Mon to Friday viii.30 – 5.30

www.ombudsman.org.united kingdom of great britain and northern ireland/brand-a-complaint

Patient Communication and Liaison Service (PALS)
Help in resolving bug with the NHS.  You can find your local PALS through the website.www.nhs.uk/service-search/patient-communication-and-liaison-services-(pals)/locationsearch/363

Doctors of the Earth
Free healthcare for vulnerable and excluded people.

Clinic advice line: 020 7515 7534. This line is open from 10am to 12 midday, Monday to Friday
www.doctorsoftheworld.org.uk/projectlondon

Marie Stopes International

Charity who offer a range of reproductive healthcare and advice, including abortions.
www.mariestopes.org.u.k.

0345 300 8090

Immigration advice

You can search for accredited immigration advisers in your expanse at:
https://www.gov.united kingdom of great britain and northern ireland/notice-an-immigration-adviser

Rights of Women world wide web.rightsofwomen.org.uk
Free legal communication on sexual violence, clearing and asylum police.
Helpline 020 7490 7689.

Civil Legal Advice
If you lot are eligible for legal help you tin get free legal communication on 0345 345 4 345 (offers translation service). To check your eligibility encounterwww.gov.uk/ceremonious-legal-advice

To search for specialist legal advisers or solicitors in your area seediscover-legal-advice.justice.gov.uk

More than Motherhood Action information sheets

Maternity rights and benefits

EU, EEA and Swiss nationals (including A8 and A2) – maternity rights and benefits

No recourse to public funds – motherhood rights and benefits

Undocumented migrants – maternity rights and benefits

Indefinite go out to remain, right of abode and UK citizenship – maternity rights and benefits

Victims of trafficking or modern slavery – maternity rights and benefits

Asylum seekers – maternity rights and benefits

Refugees – motherhood rights and benefits

Refused aviary seekers – maternity rights and benefits

Financial support and housing

Asylum seekers – financial support and housing

Refused aviary seekers – financial support and housing

No recourse to public funds – financial support and housing

Charging for NHS maternity care

NHS intendance for women from abroad (England)

NHS care for women from abroad (Scotland, Wales and Northern Ireland)

Asylum-seekers and Article three claimants – entitlement to NHS maternity  care

Refused aviary-seekers and Article 3 claimants – entitlement to NHS maternity  intendance

Refugees, Humanitarian Protection, Article three or temporary protection – entitlement to NHS maternity  care

Victims of trafficking or modern slavery – entitlement to NHS maternity care

EEA and Swiss Citizens and their family members – entitlement to NHS motherhood  care

Non-EEA national family members of EEA and Swiss citizens – entitlement to NHS maternity  care

No recourse to public funds or limited go out – entitlement to NHS maternity  care

Undocumented migrants – entitlement to NHS maternity  care

Indefinite leave to remain, correct of abode and UK citizens – entitlement to NHS maternity  intendance

Information-sharing betwixt the Home Office and the NHS

Dealing with debts owed to the NHS for motherhood care

Polish language guides to motherhood and parental rights

Ciaza i uprawnienia macierzynskie dla pracownic z Polski

Pregnancy and motherhood rights at piece of work for Polish workers (in English)

Karmienie piersia w miejscach publicznych

Breastfeeding in public places (in English language)

Uprawnienia w pracy dla ojcow i partnerow polscy pracownicy

Rights at piece of work for Polish fathers and partners' (in English)

Spanish linguistic communication guides to maternity rights and benefits

Derechos por embarazo y maternidad de las mujeres trabajadoras de habla hispana

Pregnancy and maternity rights for Spanish speaking workers' (in English)

Información para mujeres de habla hispana sobre ayudas económicas para progenitores y bebés

Money for parents and babies for Spanish speakers (in English language)

Portuguese language guides to maternity rights and benefits

Gravidez e direitos de maternidade para trabalhadoras que falam portugues

Pregnancy and maternity rights for Portuguese speaking workers' (in English)

Auxílio financier para país e bebês que falam português

Money for parents and babies for Portuguese speakers (in English)

fanninussighboult.blogspot.com

Source: https://maternityaction.org.uk/advice/nhs-maternity-care-for-women-from-abroad-in-england/

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