When you need to seek medical care the last thing you want to worry about is the cost. However this can be a real concern for many people, particularly when it comes to accessing healthcare overseas.
Many Americans are used to covering their own healthcare costs or having health insurance. The healthcare system in the UK is a little different, and you may have heard that the UK's National Health Service (NHS) is free at the point of use.
But is the NHS really free for all? If you move to the UK to work or to study, do you have to pay for healthcare?
Here's a brief look at the healthcare system in the UK and what costs are attached for immigrants and short-term visitors.
The NHS Is (Technically) Free to Use
The NHS is the public healthcare provider in the UK and has three core areas:
- Primary care is largely delivered by General Practitioners (GPs), who are the main point of contact for most people when they need medical advice.
- You can also be referred to a specialist or receive treatment in hospital for more serious conditions.
- For emergencies many hospitals, but not all, have Accident & Emergency (A&E) departments.
Access to the NHS for UK residents is free although certain exclusions apply. However immigrants and short-term visitors, such as tourists, will likely need to pay a fee or surcharge when using the NHS.
Having said that, there are certain services and treatments carried out by the NHS that will always be free, no matter what your immigration status.
These free services include:
- Accident and emergency services, excluding follow-up treatment or admission to hospital as an In-Patient
- Family planning services, excluding abortions or infertility treatment
- Treatment for most infectious diseases
- Treatment required for a physical or mental condition caused by torture, FGM, domestic or sexual violence, unless you are in the UK solely for the purpose of receiving treatment
What NHS Care Has to be Paid for?
There are some NHS services that do need to be paid for, regardless of whether you are a UK permanent resident or not. The payment required will often depend on your personal circumstances, such as your income, whether you have a disability, and the treatment you need.
In general, UK residents typically have to pay for the following NHS treatments:
- Prescriptions - the current charge is £9
- Dental care - there are three bands of charges ranging from basic check ups to more complicated procedures such as dentures
- Eye tests
- Travel costs to or from NHS facilities (although you may be able to claim back these costs in certain circumstances)
You can find out more about these healthcare costs on the NHS website here.
The Cost of Healthcare When Visiting the UK Temporarily
If you are visiting the UK for less than six months you will have to pay a fee for using NHS services. If you need NHS hospital treatment during your stay, you will be charged 150% of the standard NHS rate, although this charge may vary if an exemption category applies to you or the treatment.
You should therefore ensure you have appropriate health insurance to cover the costs of any treatment you need during your visit to the UK. Some insurance providers may ask you to pay the cost of care upfront and then claim back the expenses later on. Make sure you understand how this process works and what treatment would be covered when shopping around for your cover.
Remember that any existing domestic health insurance plan you have will likely not cover you for the cost of treatment abroad in the UK, so you may need to purchase a local UK health plan or an international plan.
The Cost of Healthcare When Moving to the UK
If you are planning on staying in the UK for more than six months then you'll have to pay an immigration health surcharge (IHS) as part of your visa application process.
The standard surcharge fee is currently:
- £300 per year per person for students and each of their dependents; or
- £400 per year per person for everyone else.
The full amount should be paid upfront to cover you for the duration of your visa. For example, if your visa is for two years then you would have to pay £800.
After you've paid the IHS this will cover your healthcare costs with the NHS. You'll be able to access the service in the same way as permanent UK residents and receive free treatment (except for those excluded services noted above).
Be aware that you will not be able to claim back the surcharge even if you leave the UK before your visa expires, or you never use the NHS during your stay.
There are certain exemptions to the IHS. For example, you do not have to pay if you are the dependent of a member of the armed forces and they are not subject to immigration control. You also don't have to pay the surcharge if you're applying for infinite leave to remain in the UK.
You can find out more about the surcharge and exemptions here.
Even if you do pay the IHS, you may also wish to consider taking out your own private health insurance. This will cover you for treatment at private medical providers in addition to NHS facilities, which may help you to access treatment more quickly. If you're living in the UK as an expatriate, you may wish to consider an international health insurance plan which will cover you for treatment both in the UK and when you travel home.
What Should You Do if You Need Treatment?
How you access the NHS will depend on whether you're visiting the UK or moving more permanently.
Seeking Treatment When Visiting the UK
Prior to travelling to the UK, make sure you have adequate health insurance to cover the duration of your stay. Keep details of your health insurance with you in case of emergencies.
If you need medical treatment that is not urgent, you can call a free helpline by dialling 111. They will advise you on how to proceed and where to seek care. The UK also has walk-in centers that can deal with minor problems. You can find your nearest walk-in centre on the NHS website.
You could also talk to a pharmacist, as you might be able to buy over-the-counter medication to treat your issue.
If you need urgent care, you can find the nearest A&E online here. You can also dial 999, but please note this emergency number should only be used in situations where you or someone else is seriously ill or injured and their life is at risk.
Seeking Treatment When Moving to the UK
Before moving to the UK you will have to pay the health surcharge when applying for your visa. As noted above you could consider buying additional health insurance.
When you arrive in the UK you should register with your local GP. You can find a list of GP clinics on the NHS website.
When you register with a GP you will need to fill out a registration form and prove your immigration status. Please note that every GP surgery has the right to decide whether they can accept new patients or not. If your closest GP surgery is not accepting new patients, you can usually find another surgery nearby.
If you require treatment you can then call your GP surgery and book an appointment. Otherwise you can use the free helpline on 111 or visit one of the walk-in centres noted above.
In emergency situations, you should visit your nearest A&E or dial 999.