`The hospital says they can’t treat me because I’ve overstayed my visa'

The bottom line: you can’t be refused essential treatment for HIV.

The rules about who can and who can’t get NHS treatment are complex, and often change. It sometimes happens that NHS officials make mistakes and wrongly tell people that they can’t get treatment.

If you’ve been told that you can’t get HIV treatment or are worried about being asked to pay for it, you can get advice from THT Direct or the Refugee Council.

An important rule is that a hospital cannot refuse to give you essential treatment for a condition that is “life threatening.”  The doctor has to decide what is essential, but this usually includes HIV treatment if your CD4 count is below 350.

The hospital may still ask you to pay later, but they should first give you the medicines that you need.

You cannot be refused essential treatment for either of these reasons:

• because the hospital doesn’t think you are entitled to free NHS treatment
• because the hospital doesn’t think you will pay the bill

What can you do if you get a bill?

It can be extremely alarming to receive a bill for thousands of pounds of hospital treatment. But it may be possible to negotiate a realistic solution with the hospital. Here's some things you can do:

• Continue to take your treatment.
• Contact the hospital’s Overseas Payments Officer as soon as possible to talk about whether you can pay the bill.
• If you have no income at all, many hospitals will decide to cancel the debt.
• If you have a very low income, many hospitals will accept a token payment of a few pounds a month.
• But if you ignore the bills and don’t contact the hospital, they may ask debt collectors to get involved, and this will be more difficult to deal with.

Mistakes are sometimes made – you may be entitled to free treatment, but are still sent a bill. Contact THT Direct or the Refugee Council for confidential advice.

More about NHS rules

Most NHS treatment (except prescription charges etc.) will be free if you are in one of the following categories:

• You have been lawfully living in the UK for the last 12 months before treatment.
• You are working legally for a UK employer.
• You are now living legally in the UK as a permanent resident.
• You are a refugee, you are in the process of applying for asylum, or you are appealing against an asylum decision.
• You are in prison, or in immigration detention.
• You are from one of the countries with a bilateral healthcare agreement with the UK, and you started to need treatment after you arrived here. Broadly speaking, this includes the countries of the European Economic Area, most East European countries, the ex-Soviet Union states, some British dependencies and a few Commonwealth countries.

But you may be charged for treatment if:

• You are undocumented (entered the country without proper papers or permission).
• Your asylum appeal has had a final refusal and you are awaiting deportation.
• You are here on a visitor visa.
• You have overstayed any kind of visa.
• You have a British passport but do not usually live in the UK.

However all treatment at an Accident & Emergency centre should be free for everyone. In addition maternity services are usually considered essential treatment that cannot be refused (even if a bill is sent later). 

These lists are not complete, and you can get more information from THT Direct or the Refugee Council.

If you need advice and information about immigration.

You can find out how we can help you access information and advice about asylum and immigration here.