Last updated on September 15th, 2023 at 12:39 am
If you’re thinking of moving to the UK, you’ll need to know the basics of navigating the British health system. In this article created by the Remitly team, we’ll give you the lowdown on how to get health insurance in the UK. That includes understanding the NHS, UK healthcare, medical insurance in the country, and more.
How the healthcare system works in the UK
The UK health system offers free healthcare, funded by taxpayers, to everyone living in the UK (England, Northern Ireland, Scotland, and Wales) through the NHS (the national health service).
In addition, you can also access a private healthcare system, as many people in the UK choose to do with private health insurance.
Public healthcare in the UK is funded by taxpayers and is considered one of the best, safest, and most affordable healthcare systems around. You might wonder why you even need to consider private health insurance on top of what the NHS offers.
While it’s true that many NHS services are free and accessible for both UK residents and visitors, plenty of services aren’t covered. In fact, 10.5% of the UK population also carry private health insurance, which hints that there are some gaps in the services and treatments offered through the NHS.
Can foreigners access the NHS?
The NHS is based on your residency rather than insurance. All residents of the UK can access it regardless of their immigration status.
People from other countries who are only visiting the UK on a vacation or business trip can use the system to obtain routine and urgent medical care as needed. However, if you don’t live in the UK legally on a permanent basis, you might need to pay a health surcharge to access NHS services.
If you haven’t paid the surcharge and don’t have any medical insurance that offers international coverage, you’ll usually be assessed 150% of the standard NHS tariff for any treatments you need.
There are some exceptions to this rule. For instance, some countries have reciprocal healthcare agreements with the UK. If you qualify for public healthcare in one of these countries, you typically won’t pay for accessing public healthcare in the UK or will qualify for a deeply discounted rate. For example, people who hold a European health insurance card from an EU nation will usually pay less for care.
What does the NHS cover?
NHS provides all kinds of care services for free, as long as you’re considered a resident of the country. This includes a vast range of medical conditions and treatments, such as:
- Accident and emergency
- Care services
- Chronic illnesses
- Hospital treatment
- Maternity care
- Mental health services
- Minor injuries
- Specialist treatment
While most medical services provided by the NHS are free, there are a few exemptions that you’ll need to pay for, including:
- Prescription medication, which costs £9.65 per item
- Dental treatment, ranging from £25.80 for examinations, diagnosis, scaling and polishing, and preventative care through to £306.80 for work like crowns, dentures, and bridges
- Eye tests, which cost £22.14 at a clinic or £60.04 at home
- Corrective lenses, which range from £41.70 to £229.70 depending on the type
- Wigs and fabric supports, which cost £9.35 for surgical stockings through to ~£300 for a full bespoke human hair wig
- GP (general practitioner) services for the provision of certificates for a health insurance policy
Some services through NHS are available to everyone, even non-UK residents like overseas visitors. These include:
- Emergency treatment (although there are healthcare costs for emergency surgery) in NHS hospitals
- Family planning services (exclusions include abortions or infertility treatment)
- Treatment for infectious diseases
- Treatment for physical or mental conditions caused by torture, female genital mutilation, domestic violence, or sexual violence
What are private hospitals in the UK?
A private hospital is a healthcare facility that operates outside of the National Health Service. They provide emergency services, routine maternity care, physical therapy, and all the other services typically provided by public hospitals. However, you can’t use NHS plan cover to pay for services.
Instead of receiving payment from the NHS, private facilities charge patients directly. They also accept private health insurance, but which types of medical coverage specific hospitals accept varies.
Anyone can access care through private hospitals, including immigrants and foreigners. You don’t need UK medical insurance to seek care, but if you don’t have it, you will need to pay for the total cost out of pocket.
How to access public health insurance in the UK
For new patients in the NHS healthcare system, a local doctor or GP (general practitioner) is the first place to go. You’ll discuss your medical history and get a complete exam during your first visit with your local GP.
Your GP will also have you fill out paperwork to register with their practice and to receive an NHS number. An NHS number is a unique 10-digit number that identifies you in the NHS system.
Once you’re registered with a GP, you can book consultations for free online on the NHS website, over the phone, or in person. That said, getting a same-day appointment is rare, and surgeries that provide walk-in services can get pretty busy.
GP appointments tend to last around 10 minutes. They’ll give you a referral if you need specialist treatment. For emergency care, you can go directly to the Accident and Emergency (A&E) department in NHS hospitals.
Do you need private health insurance in the UK?
Travel insurance is generally suitable for brief stays, and can often only be used for emergency treatment.
If you plan to live in the UK for more than a few weeks but don’t plan on becoming ‘ordinarily resident,’ you’ll be considered a ‘foreign visitor’ and charged for all services provided by the NHS.
Given the cost of hospital healthcare provision, whether through the NHS or private practices, you’ll want private medical insurance to cover any potential costs.
A hip replacement, for example, would set you back between £8,500 and £16,500, depending on which hospital you choose. This is probably why 75% of all private healthcare for UK-based patients is funded by private health insurance.
If you intend to stay in the UK for longer and register for free NHS healthcare, there are still a few reasons to consider taking out coverage for private treatment. Private coverage can allow for:
- Treatment for a service not covered by the NHS for free, like dental care or specialist medicine
- Shorter waiting times
- More choice in doctors or hospitals
- Second opinions or further testing
- A private hospital bed and round-the-clock visiting hours
Private health insurance lets patients access the UK’s private healthcare network, and can allow for more control over medical treatment.
UK health insurance plan comparison
Comparison websites are a good starting point for sifting through the many healthcare providers and insurance company options.
Here are some to check out:
- International Citizens Insurance has more information on choosing private medical insurance and free personalized help, with reportedly excellent customer service.
- Which? is a popular site in the UK for reviewing products and services.
- ActiveQuote is a British company fully authorized and regulated by the Financial Conduct Authority (FCA), which powers other comparison websites.
- MediBroker offers comparisons of international healthcare policies, with over 100 different plans covered by 30 different insurers.
How to choose UK health insurance
Whether or not you qualify for insurance coverage through the NHS, it’s important to weigh your health insurance options carefully when shopping on the private insurance market. To choose the best health insurance for you and your family members, consider:
What type of medical care does the plan cover?
Some plans offer basic family medicine and childbirth coverage only, while others will help with the cost of a broad range of services, including things like genome testing.
What are the policy limits?
Most private healthcare plans will cover costs up to a certain amount for different services. If treatment costs more, you’ll be responsible for paying the rest.
Where can I access healthcare?
Not all hospitals and medical professionals accept all health insurance plans in the UK. Double-check that there are providers in your area before you purchase a policy.
Does the policy come with any perks?
Some private health insurance plans offer perks for policyholders, such as free health education courses, discounts on items, or access to a team of virtual healthcare advisors that can answer questions about medical concerns around the clock.
What is the excess for the policy?
Excess is an important term for anyone comparing health insurance plans. It’s the amount of money your health insurance requires you to cover out of pocket for all services that you receive. In the U.S., excess is often called a copay or coinsurance.
Is the insurance right for my situation?
Many companies offer expat health insurance for permanent residents who aren’t British citizens, but not all. Others may specialize in family planning or emergency needs.
Health insurance costs
Health insurance policies vary hugely in price. Some common factors will affect your premium, like your age, where you live, your current health, and your lifestyle choices.
Whatever your age, it’s worth shopping around and updating your insurance provider if you move. This can affect your premium—especially if you leave London.
The level of coverage you want will influence how much you pay. Most insurers will initially exclude pre-existing conditions, so you’ll have to pay extra for these.
Most policies will cover inpatient treatment in full (services requiring a hospital bed). It’s the level of outpatient treatment that pushes the cost of your policy up, as this includes appointments for specialist treatment, like physiotherapy.
Consider your healthcare options
Now that you know about the healthcare system in the UK, you’re ready to weigh your options.
You don’t have to choose one type of healthcare over the other. Many UK expats who are considered ordinarily resident and eligible for NHS coverage obtain an NHS number and still buy private health insurance. Depending on your needs, this arrangement can give you the flexibility to access both systems.
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