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The short answer
Under the NHS charging rules in England, overseas visitors who are not ordinarily resident are charged 150% of the cost of NHS hospital treatment unless an exemption applies. Some services are free to everyone, including GP and nurse consultations, A&E (until admission), NHS 111, family planning and treatment for certain infectious diseases. Non-urgent care must be paid for in full and in advance.
When a parent or relative comes from Nigeria to see a new grandchild or spend the summer, health is often the thing families plan for least. The migrant health guide says people on visitor visas, or visas of under six months, pay for chargeable care at the point of use rather than being covered as residents are. The rules are set out in the Department of Health's migrant health guide on GOV.UK, and they are more specific than most people realise.
What is free for every visitor
The migrant health guide (updated 2 October 2023) lists services that are free to everyone, whatever their immigration status:
- GP and practice nurse consultations; a visitor staying more than 24 hours and under three months can be seen as a temporary patient
- A&E, walk-in centres and urgent treatment centres, up to the point of admission
- NHS 111
- Diagnosis and treatment of certain infectious diseases, including TB and HIV
- Family planning and treatment of sexually transmitted infections (not termination of pregnancy or IVF)
- Treatment for conditions caused by FGM, torture or domestic violence
- Palliative care provided by registered charities
Note what "free A&E" means: the emergency department visit is free, but if the visitor is admitted to a ward, or sent to a follow-up outpatient clinic, that care is chargeable. GP consultations are free, but anything the GP refers on to hospital is likely to be charged.
What is charged, and at what rate
The guide says chargeable overseas visitors pay 150% of the cost of NHS treatment. That covers most hospital care: admissions, operations, scans and outpatient appointments.
| Type of care | How it is handled under the guide |
|---|---|
| Non-urgent, planned treatment | Must be paid in full and in advance, against an estimate |
| Urgent or immediately necessary treatment | Given without waiting for payment; billed afterwards |
| Maternity care | Treated as immediately necessary, so provided, but still charged (East Sussex Healthcare NHS Trust states this on its overseas visitors page) |
| A&E visit without admission | Free |
Being treated first does not mean being treated free. A hospital will still send the bill, and the overseas visitors team will usually ask for passport and visa details at registration.
Worked example (illustrative)
Example: a visiting father has chest pain and goes to A&E. The A&E assessment is free. He is kept in for two nights for tests. If the hospital's cost for that stay were £4,000, the visitor charge at 150% would be £6,000 (4,000 × 1.5). Because the care was urgent, he is treated first and invoiced afterwards. The figures are invented to show the arithmetic; real costs vary by hospital and treatment.
Questions to ask at the hospital
Overseas visitors teams deal with this every day, and a clear conversation early avoids a surprise later. Useful questions:
- Is this treatment classed as urgent or immediately necessary, or as non-urgent?
- What is the written estimate, and does it already include the 150% charge?
- Will you bill the travel insurer directly, and what letter do you need from them?
- If we cannot pay in one go, can we agree a payment plan in writing?
- Who do we contact if the final bill differs from the estimate?
Keep copies of every estimate, invoice and receipt. If the insurer later refunds you, it will usually want the original hospital documents.
Unpaid bills and future visas
The guide says NHS debts of £500 or more left unpaid for two months (for services from 6 April 2016) are reported to the Home Office and may affect a person's future immigration application. For a parent who visits every year, an unpaid hospital bill can therefore cost far more than the bill itself. If a bill arrives, contact the trust's overseas visitors office promptly and ask about a payment plan.
How to plan before the trip
- Buy travel health insurance in Nigeria or the UK that covers the whole stay and pre-existing conditions, and check it pays UK hospitals directly. ESHT notes that insurers may need to give a letter of guarantee for the full cost, or the patient pays.
- Bring a written list of medicines and diagnoses, and enough medication for the stay.
- Register the visitor as a temporary patient with your GP if they will stay more than 24 hours.
- Keep passport and visa copies handy for any hospital visit.
- Agree in the family who will deal with any bill, and in which currency the money will come.
Also read the visa terms: GOV.UK says a Standard Visitor can stay up to six months.
Where Pryme fits
If a hospital bill lands, families often pool money from Lagos and London. A Pryme account holds naira and pounds, and Swap shows the rate and the fee before you approve a conversion. To understand which UK services a resident can and cannot claim, see what no recourse to public funds means and registering with a GP. Outside Nigeria, Pryme's activities are carried out through regulated partners.
Questions people ask
Is A&E free for visitors from Nigeria?
Yes, the A&E visit itself is free to everyone. Care after admission to a ward, or follow-up outpatient appointments, is charged at 150% of the NHS cost.
Can my visiting mother see my GP for free?
Yes. GP and nurse consultations are free to all; a visitor staying over 24 hours and under three months can be seen as a temporary patient. Hospital referrals are usually charged.
Will the hospital refuse treatment if she cannot pay?
Urgent and immediately necessary care is given without payment first and billed afterwards. Non-urgent care must be paid in full in advance.
Can an NHS debt affect a UK visa?
The guide says unpaid NHS debts of £500 or more, outstanding for two months, are shared with the Home Office and may affect future applications.
Sources
- GOV.UK: NHS entitlements, migrant health guide (updated 2 Oct 2023) · accessed Oct 2026
- East Sussex Healthcare NHS Trust: Visiting from overseas · accessed Oct 2026
- GOV.UK: Standard Visitor visa · accessed Oct 2026
This article is general information, not financial, legal or tax advice. Products described are provided under the terms on this site and are subject to regulation and eligibility.