Relocating to the UK comes with a lot of practical questions, and healthcare is usually near the top of the list. The UK’s system is quite different from many countries, especially if you’re used to insurance-based care. Here’s a guide to how it works for expats and what you need to do to access healthcare in the UK.
What is the NHS?
The UK’s healthcare system is built around the National Health Service (NHS). It’s a publicly funded system, which means most healthcare services are free at the point of use for residents. Instead of paying per visit or relying heavily on private insurance, the NHS is funded through taxation and National Insurance (NI) contributions. As an expat, your access depends largely on your visa status and residency.
Do expats get free healthcare in the UK?
In most cases, yes, you can get free healthcare in the UK as an expat. However, this is not automatic and not all forms of healthcare are free to access.
If you’re moving to the UK on a visa longer than 6 months, you’ll typically need to pay the Immigration Health Surcharge (IHS) as part of your visa application. This costs £1,035 per year of your visa. There are a number of exemptions based on your field of work or personal circumstances but the vast majority of people must pay the IHS before their visa is approved.
The IHS gives you access to NHS services broadly similar to a UK resident. Once you’ve paid the IHS and arrived in the UK, you can use NHS services such as:
- GP (doctor) appointments
- Hospital treatment
- Emergency care
However, some things are not fully free, including:
- Prescription medications (fixed fee per item in England)
- Dental care
- Eye tests (in many cases)
Accessing healthcare in the UK
The NHS is built around your local doctor, called General Practitioners (GPs). Your GP is your main entry point into the NHS and, unlike some countries, you usually can’t go directly to a NHS specialist without a GP referral.
After arriving in the UK, you should:
- Find a local GP surgery near your home
- Register as a patient (this is free)
- Provide ID and proof of address
Once registered, you can go to your GP for:
- General health concerns
- Referrals to specialists
- Prescriptions
How appointments and referrals work in the UK
The NHS uses a gatekeeper system:
- You contact your GP first
- They prescribe medication which you can collect from a local pharmacy
- If needed, they refer you to a specialist
- You’re then placed on a waiting list
- You’ll receive an appointment date and time from the specialist
This is one of the biggest adjustments for expats. Waiting times for non-urgent care can range from weeks to months depending on demand.
Accessing emergency care in the UK
In severe and life-threatening situations:
- Call 999 for emergency services
- Go to A&E (Accident & Emergency) at a hospital. Find your closest A&E here
Emergency treatment is free for everyone, including visitors, if it’s genuinely urgent.
In situations which are urgent but not life-threatening, you can use NHS 111 to get support, advice or be directed to the best place. You can access this by:
- Calling 111
- Visiting 111 Online
Prescriptions and medication
In England, prescriptions are not free unless they are prescribed to you as a hospital inpatient. Instead, they are provided at a subsidised cost as a fixed fee per item. See the current cost of prescriptions in England here. Scotland, Wales, and Northern Ireland differ slightly, with free prescriptions in some cases.
If you are prescribed medication, you can collect it from any local pharmacy with your prescription paper. Find a local pharmacy. Alternatively, you can sign up to the Electronic Prescription Service (EPS) and nominate a pharmacy to electronically receive your prescription.
Should you get private health insurance?
Even though the NHS covers most needs, some expats choose private insurance for:
- Faster access to specialists
- Shorter waiting times
- More choice over hospitals and doctors
Private healthcare exists alongside the NHS, but it’s optional. It is important to note that, even if you opt for private healthcare, you will still need to pay the IHS.
What about short-term visitors or new arrivals?
If you are visiting short-term and haven’t paid the Immigration Health Surcharge:
- You may be charged for most NHS services
- Emergency care is still accessible
- Travel insurance is essential
Key differences expats often notice about UK healthcare
Compared to other systems, the NHS:
- Prioritises need over speed
- Requires GP referrals for most specialist care
- Has minimal direct costs, but some waiting time trade-offs
Bottom line
The most important thing you can do early is register with a GP and understand how the referral system works. That single step makes the rest of the system much easier to navigate.
If you’re relocating to the UK, we can help give you advice or guide you through the process. Book a free consultation call with one of our relocation experts.
