The UK’s National Health Service (NHS) is admired around the world. It has also sparked debate as to whether a service based on need rather than ability to pay is as good as it sounds.
It can confuse foreigners who are unsure which treatments are free under the NHS and what they have to pay for.
But this guide is about more than just the NHS. It gives information about accessing healthcare as an expat in the UK, which parts of healthcare are paid under the S1 certificate, finding a GP and private insurance.
Can expats use the NHS as soon as they arrive in the UK?
Some NHS treatments are free to anyone who needs them regardless of how long they have lived in the United Kingdom. These include accident and emergency (A&E), ambulance transportation, some infectious disease treatments, birth control, general practitioner (GP) visits as an NHS or temporary patient and compulsory psychiatric treatment such as mental health emergencies that poses a potential risk to themselves or others. All children born in the UK are automatically entitled to NHS treatment.
What will I have to pay for?
You will need to pay the Immigration Health Surcharge if you plan to be in the UK for more than six months along with a family or student visa. It can also apply to certain work visas. If the surcharge applies, you’ll have to pony up when you pay your visa fees. It also applies to spouses, partners and dependent children, costing £1,035 per year. For people under the age of 18 and those on student or youth mobility visas, the cost is lowered to £776 per year. The surcharge doesn’t apply if you’re on a health and care worker visa or applying to remain in the UK permanently.
Most people in the UK have to pay for their prescriptions, dental treatment and optical expenses such as glasses and contact lenses. The exception is Scotland where all prescriptions are free.
You’re entitled to free NHS prescriptions if you’re over 60, under 16, aged 16-18 and in full-time education, if you’re on income-based benefits (which most expats are not entitled to unless they have permanent residency), you’re pregnant or have given birth in the past 12 months, you have a condition that entitles you to a medical exemption certificate or you qualify for the NHS Low Income Scheme. Again, it is rare for expats to have access to this scheme.
Most cosmetic treatments are not covered by the NHS with a few exceptions including reconstructive surgery for breast cancer patients who have undergone a mastectomy.
What is the S1 certificate?
For some expats, healthcare costs are covered by a European Economic Area (EEA) country or Switzerland under the S1 certificate.
This may include:
• people sent to the UK on a work posting by an EEA or Swiss employer;
• people who live in the UK but work in an EEA country or Switzerland (known as a frontier worker);
• people who live in the UK and get either a state pension or certain exportable benefits from an EEA country or Switzerland;
• eligible family members and dependents of people who fit into these categories.
S1 certificates are issued by the EEA states or Switzerland. If you’re not sure if you’re eligible, check with the relevant EEA or Swiss health insurance authority.
How do I find a GP?
Finding a GP can be a postcode lottery. As soon as you arrive in the UK, you can register with a GP in your local area. Some GP practices will be at capacity and unable to accept new NHS patients, so you might have to shop around. Word of mouth can be a good way to find a good GP. Asking neighbours and friends who live nearby for recommendations is often useful, as is checking out local forums on platforms such as Facebook and Next Door.
The NHS website offers a find-a-GP service. Enter your postcode to see a list of local GPs with practical; contact information, online registration links, patient reviews and whether or not they’re accepting new patients. Some GPs accept out-of-area patients (which can be useful if you move but have found a GP you like.
Is it worth taking out private insurance?
The UK’s private healthcare market is growing; it is largely driven by patients frustrated by long NHS waiting periods, especially for orthopaedic and ophthalmology treatments. Private health insurance is booming in the UK, either through individuals purchasing policies or as a perk of employment. Private health insurance has become an increasingly popular employee benefit, either fully funded by the employer or through employee salary deductions.
It is a personal decision as to whether it’s worth taking out private insurance in the UK. For many patients it represents good value for receiving tests and treatments quickly. Alternatively, patients without private insurance can pay for private treatment out of their own pockets.
Ultimately, it comes down to affordability and the value you place on being able to receive services in a more timely manner than the NHS can sometimes provide.
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Read more about the UK here in Dispatches’ archives.
Georgia Lewis
Georgia Lewis is an Australian expat who spent five years living in the United Arab Emirates before moving to London in 2011. She is a freelance writer and editor. When she's not writing or editing, she loves cooking, trying new restaurants, going to the theatre and travelling. Her favourite destinations are the Greek islands, Mallorca, Oman and Vietnam.
