Healthcare in the UK for Expats: NHS Access, the IHS and What You'll Pay

The NHS provides universal healthcare free at the point of use — but the key word is resident. How you qualify depends on your immigration status:

• Visa holders pay the Immigration Health Surcharge (IHS) as part of their visa application: £1,035 per year for most visa types, £776 per year for students. Once paid, you use the NHS like a UK resident for the life of the visa.
• Settled residents (indefinite leave, settled status) access the NHS without the surcharge.
• Short-stay visitors (under 6 months) do not pay the IHS but have limited access: A&E is free for everyone, yet hospital admission can be charged at 150% of the NHS tariff — thousands of pounds for inpatient care. Maternity care can exceed £7,000 if charged.

With NHS access in place, most care is free — GP visits, hospital treatment, A&E and maternity. The costs that remain catch newcomers off guard:

Prescription charging is devolved: England charges per item (with exemptions for under-16s, over-60s, pregnancy and certain conditions), while Scotland, Wales and Northern Ireland provide all prescriptions free. If you settle in England and take regular medication, the Prepayment Certificate usually pays for itself quickly.

Private healthcare runs alongside the NHS and exists mostly to beat waiting times. A private GP consultation costs £50–100 outside London and £100–250 in Central London; online private GP services run £20–50. Private medical insurance is far less universal than in Ireland — many people hold it through an employer rather than buying it personally.

The pragmatic middle ground many expats land on: NHS for anything serious or chronic (it is comprehensive and already paid for via the IHS), private or online options for speed on routine issues. Given 2–4 week routine GP waits, paying £35 for a same-week online Doctor appointment is often the sensible trade.

After Brexit, the picture for cards is:

• EU/EEA visitors to the UK can use a valid EHIC for medically necessary state healthcare during a temporary visit.
• UK residents visiting the EU use the GHIC (Global Health Insurance Card), the UK’s post-Brexit successor to the EHIC.
• Ireland and the UK are a special case. The Common Travel Area gives Irish and British citizens the right to live, work and access healthcare in each other’s countries — broader rights than any card provides.

All of these cover visits. If you are moving to the UK, your entitlement comes from residency or the IHS — do not rely on a card from your home country beyond the transition.

Once you register with a GP, the NHS App becomes your window into your UK record — appointments, repeat prescriptions and test results. But nothing crosses the border automatically: your new GP starts with whatever you tell them. Summaries can be requested from your previous doctor, yet they routinely take weeks and arrive incomplete.

ViscaCare’s Healthcare Centre keeps your history, medications, documents and wearable data in one place on your phone — portable between whichever systems you live under. While you wait out a 2–4 week GP appointment gap, members can book an online Doctor appointment at £35, with the Doctor able to see the history you have already built up.

In rough order:

• Confirm your NHS basis — IHS paid with your visa, or settled status — and keep the confirmation.
• Register with a GP practice as soon as you have an address. It is free, you have the right to register even without ID or proof of address, and the GP shortage means some lists are closed — start early and use the NHS “Find a GP” tool.
• Download the NHS App for appointments, repeat prescriptions and your record.
• Save NHS 111 in your phone — free, 24/7, and able to book same-day slots for urgent issues.
• If you take regular medication in England, price up a Prepayment Certificate.
• Learn your nearest urgent treatment centre — no GP registration needed, and far faster than A&E for injuries.

Call 999 or 112 for life-threatening emergencies. For urgent but non-life-threatening problems, call NHS 111 first — free, 24/7, and able to direct you to the right service or book same-day appointments. A&E departments are under severe pressure, with long waits for non-urgent cases, so the 111 route usually gets you seen faster.