# Medical treatment question on Fiance Visa



## signifi (Jul 30, 2013)

On the VAF4A form, 6.17 it asks "have you ever received medical treatment in the UK?

When my Fiance was visiting me here in the UK from Russia she had a very sore throat and she went to the Minor Injuries unit of a local NHS hospital where she saw a doctor for a consultation about her throat and was prescribed some anti-biotics. She paid for the anti-biotics at the local pharmacy and was fine in a couple of days?

Does this mean she puts YES to question 6.17 on the form?

And then at Q 6.18 asks if she paid for treatment?

Does "treatment" mean the doctor's consultation?...or...does treatment mean antibiotics?
In my mind "treatment" means the medicine to treat. Therefore she would put YES to question 6.18.

These questions seem to be poorly worded in my opinion.
Could anyone clarify what we should be putting for this please?


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## AmyD (Jan 12, 2013)

The spirit of the question is: has she used the NHS. She has, since she consulted with a doctor. Say yes.


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## nyclon (Apr 3, 2011)

signifi said:


> On the VAF4A form, 6.17 it asks "have you ever received medical treatment in the UK?
> 
> When my Fiance was visiting me here in the UK from Russia she had a very sore throat and she went to the Minor Injuries unit of a local NHS hospital where she saw a doctor for a consultation about her throat and was prescribed some anti-biotics. She paid for the anti-biotics at the local pharmacy and was fine in a couple of days?
> 
> Does this mean she puts YES to question 6.17 on the form?


Yes.



> And then at Q 6.18 asks if she paid for treatment?
> 
> Does "treatment" mean the doctor's consultation?...or...does treatment mean antibiotics?
> In my mind "treatment" means the medicine to treat. Therefore she would put YES to question 6.18.


Yes she will need to arrange to pay for the services other than the prescription. Everyone pays for prescriptions. Treatment means being seen by the doctor. Seeing an NHS doctor is not free for someone on a visit visa. A tourist can only receive emergency treatment administered in an A & E without charge. Other than that, a tourist has to pay for any treatment received from the NHS. She will need to contact the hospital and ask to be billed and pay the bill. It's her responsibility and she needs to insist that she be billed. They are not setup for billing which is why she wasn't asked for payment when treated. 

It is really important that she gets this sorted. Not paying for NHS services could cause the visa to be refused.


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## signifi (Jul 30, 2013)

Okay, thank you Nyclon. Can I go to the hospital and ask to pay the bill in person?


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## nyclon (Apr 3, 2011)

signifi said:


> Okay, thank you Nyclon. Can I go to the hospital and ask to pay the bill in person?


It's a start. You may have to push and you may have to request speaking to someone higher up.


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## signifi (Jul 30, 2013)

I spoke to NHS direct on the phone, and the lady was shocked at how honest I was. I will receive a phone call with advice about this within 24 hours she said. Will post info up for anyone else that this may apply to.


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## nyclon (Apr 3, 2011)

You may have to be persistent. This is something the UKBA is cracking down on namely tourists using the NHS without paying. Don't let them brush you off.


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## signifi (Jul 30, 2013)

Spoke to NHS Direct. They could not help directly but said I need to speak to someone at the hospital's cash office. They said normally if you are eligible for payment that billing would be discussed. I distinctly remember mentioning to the doctor that she was a Russian citizen but nothing was said at the time. 
Nothing is ever easy. :-(


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## signifi (Jul 30, 2013)

The latest...
Just got another phone call back from NHS Direct (very efficient) Complex Health Information and Medicines Enquiry Service at 10pm and was told that this type of consultation is free of charge because it was at a Minor Injuries Unit of an NHS hospital.
She went on to say that in this instance the only time billing would occur would be if this overseas visitor was actually admitted (overnight stay) and then discharged.

This may affect others so I will provide a link where this info is clarified:
Advice for overseas visitors - The NHS in England - NHS Choices

And I have pasted text here which answers the same...

Hospital services

Hospital treatment is free to ‘ordinary residents’ of the UK. But if you are visiting the UK – to stay with family, on business, as a tourist, or if you are living here without proper permission – then you are likely to be charged by an NHS hospital for the treatment it gives you. Not paying this charge may have an effect on any future immigration application you make and you risk being turned down.
Some services or treatments carried out in an NHS hospital are exempt from charges, so that they are free to all overseas visitors.
UK hospitals will treat you for most infectious diseases, including sexually transmitted infections (STIs) free of charge, to limit the spread of those diseases. Also read the common health questions about infections.
If you are taken to A&E (accident and emergency department), a minor injuries unit or walk-in centre for emergency treatment then this is free of charge. However, if you are admitted to hospital for any other emergency treatment a charge may be incurred. You should not go to A&E for non-emergencies, but see a GP instead.
Compulsory psychiatric treatment, treatment imposed by a court order and family planning services are also free of charge. Note that neither maternity treatment, nor terminations of pregnancies are classed as family planning services.

Hope this helps someone else.


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## nyclon (Apr 3, 2011)

I would strongly suggest that you get that in writing as the answers to questions remain yes you have received medical treatment and no you didn't pay for it.


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## signifi (Jul 30, 2013)

Thanks Nyclon. I went to the hospital this morning before work and the lady at the cash office said she can confirm that the treatment was indeed free, but said she could not write a letter. Instead she gave me an NHS Cambridgeshire number to contact. I rang them and spoke briefly and explained the complex situation; they said that they would call me back soon to discuss the matter further with someone who could actually help. Still waiting to hear back. I'm wondering if my fiance explains the situation in the blank box which proceeds this medical question on the form, and also showing the name/type of NHS medical centre it is will suffice?


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## oluwanifemi (May 15, 2013)

Hello,
you need to get a writing note from the NHS to support your spouse application because similar thing happened to me before my spouse visa was issued in june 2013. the ECO requested for more additional information from me....'EVIDENCE OF PAYMENT OF NHS TREATMENT IN THE UK".
my spouse spoke with the NHS office and a letter was issued to us and i posted the letter to sheffield the following day and my spouse visa was issued.
please, make sure you have a writing letter from the NHS as a proof before supporting your application....
all the bst.


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## signifi (Jul 30, 2013)

Spoke to NHS department called Patient Advice and Liasion Service, and they assured me that (also via a secondary discussion with their finance dept.) that there is nothing to worry about and they confirmed that this hospital unit we visited was a no charge service. They also assured me that a written letter (with NHS letterhead) will be sent to my fiance via email to confirm this. They were actually very helpful when I spoke to the right person. She also said that if my fiance did not receive this letter by Monday, to call her direct number and she will attend to it. That level of service is rare these days.


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## oluwanifemi (May 15, 2013)

Hello Signifi,
great to hear about the latest development.......all the best


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## signifi (Jul 30, 2013)

oluwanifemi said:


> Hello Signifi,
> great to hear about the latest development.......all the best


Thank you kindly. My fiance plans to apply this week, so I may put up a list of our docs to make sure we have everything in order, just to be sure? I notice this is a great place to do this as it seems to give good peace of mind.


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## signifi (Jul 30, 2013)

After 3 days of waiting still nothing from the NHS. Was told the letter would be done Friday and it's now Tuesday. Apparently the person who needs to write the letter is also treating patients!!! Don't know what to do! Have rang same lady twice a day every day and she cannot get this person to do it for us! Very frustrating.


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## signifi (Jul 30, 2013)

Update: Was assured today that a new NHS manager (one not so busy and who will not be treating patients) had been assigned to write this letter and we will receive tomorrow. I would have thought that for this question in the VAF4A forms that the UKBA would have a list of NHS hospitals and Minor Injuries Units which offer treatment free of charge to visitors? Seems very strange?


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## Styxman (Feb 6, 2013)

Signifi - A similar question: during my first visit to the UK (2008) I was treated at a hospital for strep throat. There was an ATM in the hospital, so I withdrew GBP and paid cash for the treatment and antibiotic. Therefore the answers to the VAF4 questions 6.17 and 6.18 would be "yes". I will state that I paid in cash for the treatment on the application, however since it was 5 years ago, I cannot find the receipt from the hospital. From your interaction with the Patient Advice and Liasion Service, is this who I would contact to substantiate what I've said on the application is true? Thanks.


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## signifi (Jul 30, 2013)

NHS nightmare continues. Now found out need two letters from two different departments and I have spent so much money on mobile phone calls to speak to the correct people in various departments. If we had any idea how much trouble this would cause I'm sure she would have chosen to never seek treatment. This has been almost a week now of phone calls back and forth to the NHS and different departments, and still no letters of support. Crazy system.


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## KHP (Oct 25, 2012)

I've just read this and now I'm panicking! My husband was visiting me and had to go to A&E because of an irregular heart beat which was related to a separate condition. He was not admitted and just checked by the doctor on duty. Is heart rate stabilised and we left just with the advice to come back if anything else occurred. He informed them that he was here a visitor and was not asked to pay a fee.

Will I need a letter for this? How will we get it in time before he applies?

thanks,
KHP


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## signifi (Jul 30, 2013)

It's okay nyclon my fiance now has both letters already. Second department responded to her email within 2 hours! She now has a letter on official letterhead which was emailed to her explaining everything and both stating that no money is owed for both treatments from her in April and July this year. First department took 4 days to get her the letter, the other one only took 3 hours.
I think we now have everything for applying.
Thank you for your prompt responses and help in this. I had no idea this could be a potential issue so thanks again for flagging it up.


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## nyclon (Apr 3, 2011)

signifi said:


> It's okay nyclon my fiance now has both letters already. Second department responded to her email within 2 hours! She now has a letter on official letterhead which was emailed to her explaining everything and both stating that no money is owed for both treatments from her in April and July this year. First department took 4 days to get her the letter, the other one only took 3 hours.
> I think we now have everything for applying.
> Thank you for your prompt responses and help in this. I had no idea this could be a potential issue so thanks again for flagging it up.


Glad to hear it worked out.


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## nyclon (Apr 3, 2011)

KHP said:


> I've just read this and now I'm panicking! My husband was visiting me and had to go to A&E because of an irregular heart beat which was related to a separate condition. He was not admitted and just checked by the doctor on duty. Is heart rate stabilised and we left just with the advice to come back if anything else occurred. He informed them that he was here a visitor and was not asked to pay a fee.
> 
> Will I need a letter for this? How will we get it in time before he applies?
> 
> ...


If you read the whole thread than you would know that emergency treatment administered in an A&E is free to visitors. If that's what he got, then it should be fine. Also, the NHS aren't trained in immigration rules so they wouldn't necessarily know whether to ask for payment.

Am I entitled to NHS treatment when I visit England? - Health questions - NHS Choices


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## signifi (Jul 30, 2013)

Thanks nyclon. If anyone else has this issue, they need to speak to the exact department of the hospital or medical centre, preferably the cash office, and they will give you the relevant admin person who can arrange this. NHS actually has many other companies which fall under it's huge organisation, so being treated in a hospital may mean contacting different departments.


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## tomuk (Jan 13, 2014)

Hello everyone, 

Just joined up to this very informative site. We are are going to apply for the fiance visa very soon and we have also been concerned about this same question.
My fiance visited the doctors surgery during her visit to the UK last year for some contraceptive pills. She was not charged for this service. Will this have any affect on our application?

I found a link on the UKBA website that states:

"Some health services are free of charge to everyone. These are:

treatment given in an accident and emergency (A&E) department or in an NHS walk-in centre that provides services similar to those of an A&E department;
treatment for certain infectious diseases (but for HIV/AIDS, only the first diagnosis and counselling that follows it are free);
compulsory psychiatric treatment; and
family planning services."

I can't post the URL link because this is my first post on this forum and it says I need to have made at least 4 posts to able to do this.

thanks


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## Crawford (Jan 23, 2011)

tomuk said:


> Hello everyone,
> 
> Just joined up to this very informative site. We are are going to apply for the fiance visa very soon and we have also been concerned about this same question.
> My fiance visited the doctors surgery during her visit to the UK last year for some contraceptive pills. She was not charged for this service. Will this have any affect on our application?
> ...


Why family planning services should be free to visitors to the UK is beyond me, but I have looked at the UKBA site and found the paragraph the OP posted and it does appear that family planning services is included in treatment which is available to anyone.

Did your fiancee not bring enough contraceptive pills to cover her visit?


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## tomuk (Jan 13, 2014)

She was here for over 4 months, so she did not bring enough for the total duration of her visit so we had to get some.
As someone who has paid into the system and has never used the NHS in my adult life I think I am entitled to some pills on her behalf. 
I think giving free pills is more cost effective than pregnancy hence why they are free to everyone!


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## Whatshouldwedo (Sep 29, 2013)

This thread has given me more concerns! My husband, my non EU spouse, was treated as a private patient in 2003 so, of course, we will answer yes to the two questions regarding medical treatment on the application form for a spousal visa. His medical insurance cover paid the bill and he paid the balance. I have the name of the hospital, the consultants name, my husband's private patient number, a telephone number for the private patients section of the hospital and an email from the credit control department to confirm there were no outstanding invoices. Will this be sufficient and should we include the email in our supporting documents, please?


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## nyclon (Apr 3, 2011)

If he didn't seek treatment from the NHS it's not an issue. They want to make sure that treatment received from the NHS was payed for if you weren't on a visa which entitled you to free treatment. If he received and paid for private treatment you have nothing to worry about.


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## Whatshouldwedo (Sep 29, 2013)

Thank you Nyclon!


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## Whatshouldwedo (Sep 29, 2013)

Oh goodness, I had forgotten that my husband would have received NHS treatment at times between the years 1961-1969 when he lwas resident in the UK. But, of course, we would have no details about that period of time. He also visited the GP on a couple of occasions when he was on a spousal visa from 1998-2000. There is no room to put all that in so do we put that in the extra information area and just enter private treatment information where it asks about treatment?


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## KHP (Oct 25, 2012)

tomuk said:


> She was here for over 4 months, so she did not bring enough for the total duration of her visit so we had to get some.
> As someone who has paid into the system and has never used the NHS in my adult life I think I am entitled to some pills on her behalf.
> I think giving free pills is more cost effective than pregnancy hence why they are free to everyone!


Hi Tomuk,

That's fine. Just put the date of the GP visit and treatment provided and why it was free i.e. Family planning. 

Good luck,
KHP


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## canadianfiancee (Jan 14, 2013)

*6.17 / 6.18*

Hello everyone,

Thanks to this site, I managed to get my marriage visitor visa over the summer and promptly got married in London. However, when I was in London I started urinating blood and was severely infected three days before my wedding. Consequently, I went to a private practice to pay for medical service. The doctor there was sufficiently alarmed by my state and recommended I go to the A&E ASAP. Upon reaching A&E at St. Thomas', I was promptly sent to the most extreme of emergencies wing. I was treated accordingly, given the severity of my case. I was given intravenous antibiotics and oral antibiotics and blood tests were taken. 

When it was time for me to leave, I asked to settle my bill but the doctor told me it is free of charge. He wrote me a letter to forward to my family doctor about the whole situation, but no mention of treatment being free of charge. Please note that this whole event happened at the A&E. I stayed at the hospital ER for about two hours.

I am getting concerned as this is definitely a question on the spousal visa application, specifically, 6.17 and 6.18. I am just worried that I have no documentation to prove that my treatment was free or charge at the A&E - however, I have receipt from my treatment at the private clinic. Will this affect my application? Should I try to get a letter from St. Thomas'?

Thanks so much and I appreciate all your responses.

With kind regards,
Canadian fiancée


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## Crawford (Jan 23, 2011)

canadianfiancee said:


> Hello everyone,
> 
> Thanks to this site, I managed to get my marriage visitor visa over the summer and promptly got married in London. However, when I was in London I started urinating blood and was severely infected three days before my wedding. Consequently, I went to a private practice to pay for medical service. The doctor there was sufficiently alarmed by my state and recommended I go to the A&E ASAP. Upon reaching A&E at St. Thomas', I was promptly sent to the most extreme of emergencies wing. I was treated accordingly, given the severity of my case. I was given intravenous antibiotics and oral antibiotics and blood tests were taken.
> 
> ...


You have nothing to worry about - yours was a genuine emergency and such treatment is provided free of charge within the NHS.

If you want to get a letter from St. Thomas' to allay your fears then do so, but there is no need to do so. 

Your explanation of your symptoms and treatment will suffice.


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## canadianfiancee (Jan 14, 2013)

Thank you so much for your prompt response Crawford, it is very much appreciated. I have the St. Thomas' doctor's report on my case (the one he asked me to forward to my Canadian GO upon my return here). It is written on official letterhead. I also have receipt from the private doctors. I will include these in the application. Do you think they are sufficient enough to explain the situation and how genuine the emergency is? 

Thanks so much again.


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