Within the EEA,EFTA,Switzerland

Reciprocal Healthcare Arrangements with European Economic Area (EEA) European Free Trade Association (EFTA) States – Norway, Iceland, Liechtenstein 

If you are a resident of Norway, Iceland or Liechtenstein and your visit to the UK was before 31 December 2020, you can continue to use your EHIC for emergency or necessary healthcare until the end of your visit. Those who receive treatment in the UK and hold an EHIC, S1 or S2 certificate will have those costs paid to the UK Government by that country.

If you are a UK national who has moved to Norway, Iceland or Liechtenstein and on or before 31 December 2020, you can receive NHS care using your EHIC.

Since 1 January 2021, EHICs are no longer valid in Norway, Iceland or Liechtenstein and short term visitors may have to pay for healthcare unless a specific charging exemption applies.

An agreement is in place between the UK and Norway, which enables UK citizens and Norwegian citizens to access medically necessary healthcare in either the UK or Norway with a UK or Norwegian passport.

The UK is currently negotiating new reciprocal healthcare agreements with these three countries.

As with EU countries, under certain circumstances you may be eligible to receive a UK EHIC for emergency or necessary medical treatment in the EU: Healthcare Cover Abroad - EHIC and GHIC.  

Ensure you have adequate health insurance when you travel as the UK EHIC may not cover all of your healthcare costs.

You may also be able to obtain an S1 certificate to receive stated healthcare paid for by the UK.

You can receive planned treatment in Norway, Iceland, or Liechtenstein, with an S2 certificate provided your application was approved by the health authority on or before 31 December 2020.

EEA EFTA Citizens’ Rights Agreement (Norway, Iceland and Liechtenstein) on GOV.UK

UK-Switzerland Social Security Convention from 1 November 2021

The arrangements within this Convention are similar to those reached with the EU and Trade and Cooperation Agreement. These include: 

  • Medically necessary healthcare when visiting either UK or Switzerland. Swiss residents can use their EHIC or PRC to receive care in the UK at the same cost as a UK resident.
  • Comprehensive state healthcare via the S1 certificate for individuals exporting their state pension, maternity allowance to the other State, or for frontier workers, posted workers and other cross border workers.
  • Access to planned treatment via S2 certificate for eligible residents of either State to receive treatment from the other State if it cannot be accessed within a medically justifiable timeframe from your Local Health Board or Trust.
  • Equal treatment so that individuals covered under this Convention will have the same healthcare entitlements and obligations as nationals of the other State in the same position, regardless of whether they hold an EHIC, S1 or S2 certificate. 
  • Reimbursement of the Immigration Health Surcharge for those that have a valid S1 or students in full time higher education.

 There are some differences:

  • The Convention covers UK nationals, Swiss nationals, UK citizens, refugees, stateless persons, and dependents of these regardless of nationality. It is not necessary to check the nationality of people presenting their Swiss EHIC in the UK because in Switzerland only eligible individuals are given the Swiss EHIC thus everyone who has the EHIC will be covered.
  • Individuals who fall outside of the categories above are unable to claim equal treatment in UK or Switzerland and will therefore be chargeable. There is no change for Swiss resident non-EU third country nationals who receive care in the UK.




Long Term Healthcare Coverage – S1 Certificate

From 1 January 2021, if you move to an EU country (or move from an EU country to the UK), you and your family can still access healthcare whilst in that country via an S1 certificate if eligible. This applies to individuals who are frontier workers, other cross-border workers such as mariners and some posted workers.

If you have moved from UK to Norway, Iceland, Liechtenstein or Switzerland before 1 January 2020, you also may be entitled to healthcare whilst in that country.

You entitlement depends on whether you want to live abroad permanently or work outside the UK for a set period and whether you have worked or paid contributions or  whether you receive certain benefits, such as a pension.

If you are citizen of Norway, Iceland, Liechtenstein or Switzerland and were living in the UK on or before 31 December 2020, your S1 is still valid because of the Citizen's Rights Agreement with those countries.

If you lived in Wales on 31 December 2020, your S1 is still valid.

Further details including how to apply for an S1 can be found here: Healthcare Cover.




Planned Medical Treatment in the EU and Switzerland – S2 Funding Route

You may be entitled to NHS funding for planned healthcare treatment within the EU and Switzerland with an S2 certificate. Certain eligibility criteria need to be met before this funding is approved.

The criteria for Wales include:

  • You must be ordinarily resident in Wales.
  • Treatment “Provider” must be in the EU or Switzerland (but does not include Northern Ireland, Scotland and England and Wales). The EU countries are; Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain and Sweden.

Note this scheme does not necessarily cover planned treatment in Norway, Liechtenstein or Iceland. Please contact your Local Health Board before you apply.

  • The treatment provider may be either private or state providers. The treatment must however be available under the providing country’s state healthcare scheme (i.e. could be provided by a private or state provider, but it must be available within the state healthcare system). 
  • Applications must be authorised before treatment is received.
  • The NHS must confirm that it cannot provide the treatments or equivalent, in a medically accepted timeframe, for the patient’s condition / diagnosis (referred to as Undue Delay)
  • There must be written support from a UK, EU or Switzerland clinician which, following their full medical assessment, supports the diagnosis, treatment and medical timeframe necessary for the treatment that the patient is seeking funding for.
  • There must be written support from an EU or Switzerland clinician / provider of the planned treatment dates and estimated costs.
  • The patient / applicant must check with the EU or Switzerland provider that they will accept an S2 form to fund the treatment(s).
  • S2 cannot be considered for the clinical trial or experimental part of any treatment package.
  • The patient does not pay for eligible treatment costs (apart from any required co-payment cost which would be charged to a person insured within that system, which the patient must pay).
  • S2 cannot be issued / approved if any of the treatment costs have already been paid for (unless the payment relates to the co-payment charge).

Welsh residents should contact their Local Health Board (LHB) in their area of Wales to make an application. LHBs are the first port of call for assessing S2 applications for Wales:

Aneurin Bevan UHB 
Telephone: 01633 623432
email: abb.ipfr@wales.nhs.uk 

Betsi Cadwaladr UHB 
Telephone: 03000 855145 (Phone calls are diverted to an answering machine, which is checked twice a day)
Email: BCU.IPFR@wales.nhs.uk

Cardiff and Vale UHB                              
Cardiff and Vale IPFR (Individual Patient Funding Requests) Commissioning Team 02921 836535
Email: CAV.IPFR@wales.nhs.co.uk 

Cwm Taf Morgannwg UHB 
Commissioning Team: 01443 744800
Email: Cwmtaf.IPFR@wales.nhs.uk 

Hywel Dda UHB 
Telephone: 01437 834485
Email: hdd.ipfr@wales.nhs.uk  

Powys Teaching HB 
Telephone: 01874 712694
Email: Monitoring@powyslhb@nhs.net 

Swansea Bay UHB                              
Planning Office - S2 Route 01639 683615 or 01639 683389 

The NHS Business Services Authority assess applications for standard and maternity S2 certificates and are responsible for issuing to UK residents.  

If your application under the S2 route is approved, you will be issued with an S2 guarantee form, which you will need to present to the relevant healthcare provider abroad.  Your treatment will be provided under the same conditions of care and payment that would apply to residents of the country you will be treated in. You may need to pay a percentage of the costs personally, known as co-payment charge although you may be able to claim some or all of this when you return to the UK. You will not be reimbursed for travel and accommodation costs under S2.

You may be able to request an S2 if you are an EU national and have been living in the UK prior to1 January 2021.

Since 1 January 2021, EU citizens who move to the UK for more than six months need to pay the Immigration Health Surcharge as part of their visa application. This may be reimbursed in certain circumstances i.e. a Member State covers their healthcare costs in full. See Travelling to the UK from other RoW countries below.

Last Updated: 13/04/2022 07:49:21