Who pays for the NHS — an honest breakdown
The biggest mistake is to think that "all healthcare in Britain is free". It is not. But there is no need to be scared: for refugees and asylum seekers a lot is covered. Let us break down what is free for everyone, what requires an HC2 certificate, and where a bill may come — and what to do then.
What is free and what may be chargeable
| Service | Free for everyone | With HC2 / benefit | May be chargeable |
|---|---|---|---|
| GP appointment | ✅ | ||
| Ambulance 999, 111, A&E | ✅ | ||
| HIV, STIs, infections | ✅ | ||
| Emergency / immediately necessary care | ✅ | ||
| Sexual health, contraception | ✅ | ||
| Treatment after torture / FGM / violence | ✅ | ||
| Prescriptions (England) | ✅ HC2 / benefit | £9.90 each | |
| Dental, glasses | ✅ HC2 / benefit | by band | |
| Childbirth | not refused due to money | ✅ refugees / asylum seekers | bill without exemption |
| Planned hospital treatment | ✅ exempt persons | chargeable for "non-residents" |
Who is exempt from hospital charges
What to show: asylum seeker — ARC card; Section 95 — letter + HC2; refugee — status letter; trafficking victim — NRM decision. Not sure — show any Home Office documents, the hospital will check your status themselves.
Pregnancy and childbirth
If you receive a bill
- Do not ignore it and do not pay silentlyAsk for a written explanation of why the bill was issued.
- Contact the hospital's Overseas Visitors teamGather evidence of your status/exemption.
- Get helpMaternity Action (for maternity) 0808 802 0029 or an IAA solicitor. Bills are cancelled and refunded if you are later recognised as a refugee/victim of human trafficking.
£500+ debt and the Home Office
This concerns money (debt), not treatment or diagnosis — the fact that you received treatment is not passed to the Home Office. More about confidentiality — will the Home Office find out. If you are worried about your asylum case — this is a question for an IAA solicitor.
Where to go next
Frequently asked questions
Frequently asked questions
Is it true that all healthcare in the UK is free?
No, not all — but for refugees a lot is covered. Free for everyone: GP, ambulance 999/111, A&E, HIV and infection treatment, emergency care, care after torture/abuse, sexual health. Prescriptions, dental, glasses — with HC2 certificate or for benefit recipients. Planned hospital treatment may be chargeable for those who are not exempt.
Is childbirth chargeable?
Childbirth and pregnancy cannot be postponed or refused because of money — it is "immediately necessary" care. If you are an asylum seeker, refugee, on Section 95 or Section 4 — free, you are exempt. If you have no status and no exemption — care will be given, but a bill may be sent later. Do not abandon care out of fear of a bill — it is dangerous. For advice call Maternity Action 0808 802 0029.
Who is exempt from hospital charges?
Among others: asylum seekers (and their family), refugees and those granted protection, people on Section 95 / Section 4, victims of torture, FGM, domestic and sexual violence, victims of human trafficking, children in care. Their hospital treatment is free, like for citizens.
What should I show at the hospital to prove exemption?
Asylum seeker — ARC card. Section 95 — support letter + HC2. Refugee — status letter. Victim of human trafficking — NRM decision. Not sure of your category — show any Home Office documents, the hospital will check your status through their system.
I received a bill but I think I should not have to pay.
Do not ignore the bill, but do not pay silently. Ask for a written explanation of why the bill was issued, contact the hospital's Overseas Visitors team, gather evidence of your status/exemption, and urgently seek help — Maternity Action (for maternity) or an IAA solicitor. Bills are cancelled and refunded if the person is later recognised as a refugee or victim of human trafficking.
Can an unpaid bill harm my case?
Yes, and it is important to know this in advance: an unpaid hospital debt of £500 or more, outstanding for 2+ months, the NHS is obliged to report to the Home Office, and this can become grounds for refusal of a future immigration application. This does NOT happen if you are disputing the bill or following an agreed repayment plan. So — do not ignore it, seek help.