Travel from Jersey to the UK for medical treatment could become means-tested.
Health department papers have revealed proposals which would force wealthy patients to pay for flights and accommodation.
Currently all public patients needing treatment in the UK have their travel and hotel stays paid for. Around 2,500 people were referred off-island last year.
Means-testing - which was in place until 2017 - could be brought back so that the richest 30% of patients would pay all or part of the cost.
Treatment would remain free.
The proposal is part of suggestions to tackle rising healthcare costs.
A Health Advisory Board report warns: Healthcare costs are rising and Health and Care Jersey must ensure that finite public funding is used fairly and directed to the Islanders who need care.”
The document also reveals an intention to charge patients who are fit to be discharged from the General Hospital, but choose to remain.
Charges for emergency treatment could be applied to patients who 'have not made a social or economic contribution to the island' - this would include non-working residents who have lived in Jersey for less than 12 consecutive months.
It would not apply to staff on temporary work permits, and visitors from the UK would continue to be covered by the reciprocal healthcare agreement.
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