Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Overview
The UK's National Health Service (NHS) provides comprehensive healthcare that's free at the point of use for eligible residents. For expats, understanding NHS eligibility is key—most visa holders gain access by paying the Immigration Health Surcharge (IHS) upfront.
Private health insurance in the UK is optional but popular. While the NHS provides excellent care, private insurance offers faster access to specialists, private hospital rooms, and flexibility in choosing consultants. Many expats use a combination of NHS for emergencies and routine care, with private insurance for elective procedures.
Moving to the UK?
Understand your NHS eligibility and explore private insurance options for faster access.
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NHS Access for Expats
The NHS is one of the world's largest publicly funded healthcare systems. Whether you can access it depends on your immigration status and whether you're considered "ordinarily resident."
Who Gets NHS Access
- Visa holders who paid IHS: Full NHS access for visa duration
- Settled/Pre-settled status (EU citizens): Full NHS access
- Indefinite Leave to Remain: Full NHS access
- British citizens: Full NHS access
- Refugees and asylum seekers: Full NHS access
NHS Services
Once eligible, you can access:
- GP (General Practitioner): Register with a local surgery for primary care
- Hospital care: Emergency and planned treatments
- Mental health services: Through GP referral
- Prescriptions: £9.90 per item in England (free in Scotland, Wales, NI)
- Dental and optical: Subsidized but not free for most adults
NHS Limitations
The NHS is excellent but has some challenges:
- Wait times: Non-urgent specialist referrals can take weeks to months
- GP access: Appointments can be difficult to get quickly
- Choice: Limited ability to choose specific consultants
- Dental: NHS dentists are scarce in many areas
Immigration Health Surcharge (IHS)
Most visa applicants must pay the IHS to access NHS services. This is paid upfront as part of your visa application.
Current IHS Rates (2024)
- Standard rate: £1,035 per year
- Student/Youth Mobility: £776 per year
- Dependents: Same rate as main applicant
Example Costs
- 3-year Skilled Worker visa: £3,105 (£1,035 × 3)
- 5-year visa: £5,175
- Family of 3 (5-year visa): £15,525
IHS Is Usually Good Value
Despite the upfront cost, IHS provides excellent value compared to private insurance. Full NHS access for £1,035/year is significantly cheaper than comprehensive private coverage, which typically costs £2,000-4,000/year.
IHS Exemptions
Some visa categories don't pay IHS:
- Health and Care Worker visa holders
- Domestic workers in private households
- Certain diplomatic visas
- Some EU Settlement Scheme applicants
Visa Requirements
Health insurance requirements depend on your visa type. Most work visas don't require private insurance—the IHS provides NHS access.
Skilled Worker Visa
- Pay IHS (£1,035/year)
- Full NHS access included
- Private insurance optional
Global Talent Visa
- Pay IHS
- Full NHS access
- Popular with tech workers who often get private insurance through employers
Student Visa
- Pay reduced IHS (£776/year)
- Full NHS access
- Many universities offer supplementary insurance
Family Visa
- Pay IHS for each family member
- Full NHS access for all
- Private insurance optional
Standard Visitor Visa
- No IHS payment
- No NHS access (except emergency)
- Travel insurance strongly recommended
Private Insurance Options
Private health insurance is optional in the UK but offers significant benefits alongside NHS coverage.
Why Get Private Insurance
- Faster access: See specialists within days, not weeks
- Choice: Pick your consultant and hospital
- Private rooms: Better hospital amenities
- Extended treatments: Physiotherapy, mental health, etc.
- Dental and optical: Often better than NHS provision
UK Private vs International Insurance
- UK Private (BUPA UK, AXA Health, Vitality): UK-only coverage, works alongside NHS, often cheaper
- International (Cigna Global, BUPA Global, Allianz): Worldwide coverage, portable if you relocate, better for frequent travelers
Common Private Insurance Uses
- Skipping NHS wait times for non-urgent surgery
- Access to specific consultants
- Mental health treatment (NHS waits can be very long)
- Physiotherapy and rehabilitation
- Private maternity care
Recommended Plans
Your best option depends on how long you're staying and whether you need coverage outside the UK.
| Provider | Type | Best For | From |
|---|---|---|---|
| NHS (via IHS) | Public System | All visa holders | £1,035/yr |
| BUPA UK | UK Private | UK-focused coverage | £80/mo |
| AXA Health UK | UK Private | Corporate plans | £70/mo |
| Cigna Global | International | Global mobility | £180/mo |
| Allianz Care | International | EU expats | £150/mo |
| BUPA Global | International | Premium service | £220/mo |
For Most Visa Holders
Pay the IHS and rely on NHS. Add UK private insurance if you want faster access:
- BUPA UK: The UK's largest private health insurer, strong hospital network
- AXA Health UK: Good value, strong corporate plans
- Vitality: Rewards healthy behavior with discounts
For Global Mobile Expats
If you travel frequently or might relocate:
- Cigna Global: Excellent worldwide coverage, English support
- BUPA Global: Premium service, strong mental health coverage
- Allianz Care: Good for EU connections, high-deductible options
For US Expats in the UK
- Aetna International: US coverage when visiting home
- GeoBlue: Blue Cross network access in the US
Find Your UK Coverage
Compare private insurance options to complement your NHS access.
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Expected Costs
NHS (via IHS)
- IHS: £1,035/year (paid upfront)
- GP visits: Free
- Hospital care: Free
- Prescriptions: £9.90/item in England (free elsewhere)
- Dental checkup: £26.80 (NHS rate, if available)
UK Private Insurance
- Basic plans: £50-80/month
- Comprehensive: £100-200/month
- Family plans: £200-400/month
International Insurance
- Mid-range (Allianz, IMG): £120-180/month
- Comprehensive (Cigna, BUPA Global): £180-300/month
Private Care (Out-of-Pocket)
- GP consultation (private): £80-150
- Specialist consultation: £150-300
- MRI scan: £300-700
- Hip replacement: £12,000-15,000
Common Questions
Can I use the NHS immediately after arriving?
If you've paid the IHS as part of your visa, yes. Register with a GP surgery near your address—this is your gateway to NHS services. Registration usually takes a few days.
What if I need care before my visa is approved?
Visitors without IHS can use NHS emergency services (A&E) but may be charged. For non-emergency care, you'll need travel insurance or pay privately. Get travel insurance before arriving.
Is private insurance worth it if I have NHS access?
Depends on your priorities. NHS is excellent for emergencies and serious conditions. Private insurance helps with wait times for non-urgent care, mental health services, and gives you more choice. Many expats find a combination works best.
How do EU citizens access UK healthcare post-Brexit?
New EU arrivals need visas and pay IHS like other nationalities. Those with settled/pre-settled status keep NHS access. The EHIC/GHIC only covers temporary visits, not residence. If you're moving from the EU, you need a visa and IHS.
Can I get an NHS dentist?
NHS dentists exist but are scarce. Many areas have long waiting lists or no availability. Private dental care or dental insurance is common among expats. Budget £200-400/year for basic private dental care.
Ready for Life in the UK?
Compare health insurance options to complement your NHS coverage.
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Disclaimer: UK immigration rules and NHS eligibility criteria change frequently. IHS rates are subject to government updates. Verify all information with UK Visas and Immigration (UKVI) and NHS guidance before making decisions.
