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 at least eight weeks before you travel, especially if you're going abroad. Your GP 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 2.
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 holiday period. 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 to live 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 letter from your GP or a personal health record card giving details
about the medicines may be useful.
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 ask your GP for 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 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.
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If you are travelling abroad with your prescribed medicines, you should always ensure that they 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 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.
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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 preplanned 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 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.
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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.
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Title
Document
reference
Updated by
Reference:
Approved by
Date
approved
Next review
date
Policy on medicine supply for British Nationals going abroad and eligibility for NHS Services
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Judith Croot, Pharmacy Technician, Mid Essex CCG
Natalie Leong, Pharmacist, Mid Essex CCG
1
http://www.nhs.uk/nhsengland/Healthcareabroad/pages/Healthcareabroad.aspx
2
http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH
_07437
Mid Essex Medicines Management Committee
April 2015
April 2017
Previous version
Key Changes
January 2013
Updated format
Management document added
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