Jan-Peter van Tijk
I wish I'd found InterNations sooner: It would have made my first few month as an expat in London much less overwhelming.
Both the public healthcare system and privatehealth insurance sector in the UK have advantages and disadvantages. If you are having difficulties understanding what these options entail, our UK healthcare system overview will help inform your decision. You will find all the relevant information you need about theNational Health System(NHS), the UK’s free publicly-funded healthcare system. You will be pleased to know that it is residence-based rather than an insurance-based, meaning that all UK residents, including expats, can access many NHS services free of charge.The system provides primary healthcare for everyone, regardless of residential status. But you have to be a resident to access secondary care. One of the downsides is that waiting times can be long and you will have fewer alternatives for treatments. In this section, you will find detailed information on your public and private alternatives, and other essential aspects of health care, such as finding a doctor and giving birth.
How Healthcare Works in the UK
It is impossible to explain the UK healthcare system without drawing upon the history of the NHS. Launched in July 1948, it is known worldwide for being the first healthcare system funded by general taxation, which provides free care at the point of use. Moreover, it fully recognizes health as a right, meaning thatfree care is granted on the basis of need rather than the payment of fees or insurance. In simpler words, if you are relocating to the UK, you will have access to free healthcare via the NHS. Even though the standard of medical facilities is good, be warned: the waiting lists can be long, and your choices might be limited.
UK Healthcare Facts
- Even though the NHS is often the target of criticism due to its long waiting times and increasing staff and supplies’ shortages, the Commonwealth Fund health thinktank carried out an analysis of healthcare systems in 11 rich nations. It found that the NHS is the best, safest, and most affordable.
- If you are a UK resident, you are entitled to receive NHS care, but you can opt to pay for private healthcare or use a combination of both.
- If you are an NHS patient, your main contact for health-related matters will be your GP (General Practitioner). The appointments with your GP are generally are quite short. They last between 8 and 10 minutes.
- If you require more specific care, your GP will refer you to a specialist.
Does the UK have Free Public Healthcare for Non-residents?
Yes, but even though the UK has a free healthcare system that is regarded as one of the best in the world, it has faced challenges in recent years, mainly due to underfunding. There is also a smaller private sector available for those who want it and can afford it.
Which are the Pros and Cons of the UK Healthcare System?
In comparison to the NHS, patients report receiving a higher standard of care, which is probably due to a simple equation: patient numbers are lower and spending budgets are larger. As you can see, the UK healthcare system has advantages and disavantages you should consider if you are permanently relocating. In this case, you will be entitled to all the services provided by the NHS, reducing health care costs to a minimum. Should you decide to get private medical insurance anyway, you will certainly have faster access to specialists, better facilities and reduced waiting times.
What Does Public Healthcare Cover?
Everything from a doctor’s appointment to emergency surgery is free; however, dental and eye care treatments generally carry a fee. Healthcare is provided for non-residents, on the basis that they have not specifically traveledto receive free treatment. Everyone is entitled to free primary care services (e.g. GP consultation) or emergency treatments; however, you will need to be registered as an NHS patient in order to access secondary care services (e.g. specialists).
How Does the National Health Service Work?
Once you’ve registered with the NHS, a GP (general practitioner) is your first port of call for most medical issues. You have the legal right to choose your GP. You may go about this in different ways; for example, you can ask people you trust for recommendations or you can do research online. A GP practice cannot refuse you, unless they have reasonable grounds, such as not having capacity to take you on board. You can change practice if you wish, without providing any reasons. Registration is done at the GP by completing a GMS1 form.
In order to do this, you will need to provide the following documents:
- Valid ID (e.g. passport, national identity card, etc.)
- Proof of address (e.g. bank statement, utility bill, etc.)
What Services does the NHS Provide?
The NHS is very comprehensive, and as long as you are ordinarily a resident (live in the UK lawfully, settled, and voluntarily). It entitles you to the following free services:
- consultations with your GP and nurse;
- treatment at accident and emergency (A&E);
- treatment for minor injuries in clinics;
- maternity services;
- sexual health services and contraception;
- if referred by your GP, treatment with a specialist.
With some exemptions (e.g. people with chronic illnesses, cancer sufferers), patients are required to pay for:
- dental care;
- eye care;
- wigs and fabric supports.
UK Healthcare Costs
Even though prescriptions are paid, they have a fix priced, regardless of the type of medication or the quantity you require per treatment. The current prescription charge is 9 GBP per item (11.50 USD). In the UK, pharmacies are commonly called chemists. The major chain is Boots, but many supermarkets have them in their premises. There also many online alternatives, such as Lloyds Pharmacy and Chemist Direct.
All ordinary UK residents are entitled to hospital treatment. However, if it’s not an emergency then your GP or a qualified healthcare professional must refer you. Emergency services are free of charge for everyone, including non-residents. However, non-residents will need the relevant health insurance to access non-urgent free hospital care (primary care) in NHS hospitals in the UK.
Once you are registered with a GP, you will be able to book consultations for free. It is unusual to get a same-day appointment.
You will usually be able to book or change an appointment directly at your GP practice in three different ways:
- via phone;
- in person (you can directly schedule an appointment at reception).
Other Health Services in the UK
Even though for medical matters your GP will usually be your first port of call, you may not need to go to the doctor for some minor ailments. There are health services in the UK for that don’t require an appointment and could be able to help you.
- Pharmacists are trained professionals who are qualified to give advice on minor conditions that do not require a prescription (e.g. sore throats, stomach aches, minor burns).
- If you have an urgent medical issue, which is not life-threatening call NHS 111, where you will be able to speak to a trained adviser who will instruct you on what to do next.
- If you visit111.nhs.uk and answer questions about your symptoms online, you will be advised on an appropriate course of action, depending on your circumstances.
- Sexual health servicesare free and available to everyone. You do not need to be registered for a GP or give any information if you do not wish to. Visit any sexual health center to get tested for sexually transmitted infections and/or for contraception advice.
An Overview of Private Health Insurance
You may decide that the right course of action for you is to take out health insurance or supplement public care with a private policy. However, how does health insurance work? If it is not offered to you as part of your employee benefits package, and you can afford it, you might want to consider it, as it will allow you to choose the level of care you get, and how and when it is provided. As a general norm, private hospitals and specialist clinics have much shorter waiting lists and better infrastructure, but costs can be rather high.
Do you Need Health Insurance in the UK?
If you are relocating to the UK, you don’t need private medical insurance, unless you have a specific reason to not use the NHS. Bear in mind, that if you decide to get treated privately, but don’t have private insurance, it can be quite expensive, particularly for serious conditions. This could leave you with mounting medical bills. You should consider all these factors before deciding whether or not to take out private medical insurance.
UK residents usually only have private health insurance for one of the following reasons:
- their company provides it as part of an employment package;
- they want to avoid waiting times;
- they want to have more control over the medical treatments they receive.
Quick Facts About Private Health Insurance in the UK:
- Around 13%of UK consumers claim to have some level of private medical insurance.
- The majority of private policies exclude mental health, maternity services, emergency care, and general practice.
- In the UK, your postcode might affect the price of your medical insurance. Providers base their premiums on the claims made by certain groups of people, which is usually influenced by their place of residency and age.
What is the Average Cost of Health Insurance in the UK?
Even though the actual price you will end up paying depends on numerous factors, just to give you an idea, the average price of a premium for private health insurance is 1,450 GBP per year (1,900 USD).
Types of Health Insurance Plans
Generally, you will be able to either take out a personal or family insurance package, and premiums will depend on the level of cover, age, pre-existing medical conditions and lifestyle (e.g. smoking, alcohol consumption, etc.). When you use your insurance, you will usually have to pay an excess fee, which means that you will pay for a percentage of the total cost. Another important factor to consider is the type of medical insurance you will choose, as this will significantly impact the coverage you will get.
There are two main types of medical insurance:
- Moratorium: excludes most pre-existing medical conditions that you have suffered from in the past five years.
- Full medical underwriting: also excludes any medical conditions you have suffered from in the last five years. But, after two years on the policy, your insurer may start covering you for that condition.
In certain circumstances, you can also acquire private healthcare as a one-off. For instance, if you need a specific treatment or operation that has a long waiting list on the public service. However, this option can be very expensive.
What is Health Insurance Coverage for Hospital Treatment like in the UK?
If you decide to go for private treatment, UK hospital costs will depend on the treatment, the hospital provider, and the location. In terms of your insurance, “hospital cover”will pay for some or all of the costs ofhospitaltreatment as a private patient, whereas “general treatmentcover”will pay a percentage or the entire cost of services, such as physiotherapy or optical care.
UK Private Health Insurance Costs
To give you a rough idea of the costs of private treatments, here are some price averages and ranges:
- Consultations: Around 200 GBP (250 USD)
- Surgical procedures: From GBP 1,000 (1,300 USD) to 10,000 (13,000 USD)
If you want a more specific idea, Nuffield Health, which is one of the major private hospital providers in the UK, has itemized pricing lists for its 31 hospitals.
Private Health Insurance Providers
There are some health insurance companies widely used by expats, which cover treatments in the UK. The main ones are:
- Allianz Care
- BUPA Global
- Cigna Global
How to Get Health Insurance in the UK?
When you have a clearer idea of your needs and requirements, you can find many comparison sites online, which will help you make an informed decision based on your specific needs. However, all the different types of insurance, levels of cover, pricing and benefits can be confusing and overwhelming. You could seek an expert to guide you through the process, and advise you on health insurance, protection, and wellbeing services. As part of our settling in services, you will find this type of assistance and more; you don’t have to take on all the complexities of an international relocation on your own.
Best Private and Public Hospitals
In England, the Care Quality Commission (CQC) works to ensure care centers’ performance is monitored, inspected and regulated. In March 2020, they released a new care directory, with ratings of health and social care services in the UK, including private and public hospitals.
How to Find a Doctor or Dentist
You will need to know exactly how to find a doctor and dentist when you arrive in the UK, as looking after your health should always be top priority. A good way to start is to ask colleagues or friends for recommendations. However, you must be aware that GPs and dental practices are only obligated to accept you if you reside within the area they service (unless they are at full capacity).
How to Find a Family Doctor in the UK
When trying to protect your family’s health, it is important to know how to find a family doctor quickly. You will be pleased to know the National Health Service (NHS) in England has a search engine for medical services. This can be used to find a General Practitioner that services the community in your vicinity. It might pay to search for reviews so you can find the one best suited to you. There is also a search engine for Northern Ireland, Wales, and Scotland.
Registering with a GP in the UK
When you find a practice that suits your needs, you will need to register with them as an NHS patient. In order to do this, you can go into the practice and talk to their receptionists. They will give you a form to fill in with your details. Some practices have their own version of required information, but you can download the standard form called GMS1 from GOV.UK.
If you have newborns or children under five, the NHS runs a Child Health Promotion Program. This service was made to help check the health and developmental progress of your young ones. You can inquire with your GP for more detailed information.
Your GP is there to help with all your medical enquiries that are not an emergency, so you are probably wondering how long it takes to see a doctor. NHS England claims that around half of all GP visits are on the same day or within 24 hours.
After arriving at your GP appointment, they will assess you, prescribe medications, talk over how to take medicines, and talk to you about options, specialist, or send you to more urgent care if necessary.
What is the Average Waiting Time to See a Doctor in the UK?
As your GP is for non-emergency care, it works on an appointment-based system. If you suddenly find yourself falling ill, many practices offer a ‘walk in service’; however, this is usually only for a few hours in the mornings as they are often very busy with their scheduled appointments.
Most GP appointments are very short, on average lasting around 10 minutes. If they think your problem needs more detailed attention, they will let you know how to find a specialist related to your problem.
How to Find a Dentist in the UK
After finding you and your family a GP, you will need to find out how to find a dentist. In the UK, dental care is available in two ways, privately or through the NHS. In order to receive private treatment, you will have to find a dentist offering private care. Some dentists offer both private and NHS-based treatments. NHS dentists can be found using the service finder on the NHS website.
When choosing between private or NHS-based treatment, there are some key factors to consider.
Some of the benefits of private dental care:
- Appointments are usually longer allowing for a more detailed and relaxed service.
- Easier access to services without delay.
- Health and cosmetic care are taken into consideration.
- Higher quality of treatment materials.
Some advantages of NHS dental care:
- Affordable treatment of dental issues affecting oral health.
- All NHS dentists are run on a not for profit basis, so you can rest assured that all treatment is in your best interest.
- NHS dentists only offer services that your dentist deems clinically necessary to protect and maintain good oral health.
- You may have to wait for a non-urgent appointment.
When you find a dental practice that suits your needs, you will need to register with them. This is best done by going into the practice where you will fill out a form with some history and medical questions. It is a good idea to do this before any emergencies happen, so you can receive treatment as soon as possible.
What Costs are Involved with Dental care?
Free dental care is available for those aged under 18 (or under 19 if in full-time education), pregnant women and people who have had a baby in the last 12 months.
The price you will pay for dental treatment under the NHS depends on the level of treatment and the amount of work required. In England the structure is as follows:
- first band 22.70 GBP (29.30 USD): dental examinations, polish, and scaling if required;
- second band 62.10 GBP (80 USD): also covers fillings, root canal work, and removal of teeth;
- third band 269.30 GBP (347 USD): also covers crowns, dentures, bridges, and lab work; and
- emergency treatment 22.70 GBP (29.30 USD): covers emergency care, such as pain relief, or temporary fillings.
Prices for NHS dental care vary significantly. In Scotland prices range from 5.00 to 157.60 GB, (6.50 – 203 USD), in Wales from 14.30 to 199.10 GBP (18.40-257 USD), and Northern Ireland 3.44 to 152.98 GBP (4.43 – 197 USD).
Giving Birth in the UK
Giving birth in the UK as a non-resident can seem like a daunting event. Concerns over healthcare and immigration problems will all play on your mind, but you can feel at ease knowing that there is almost no difference to giving birth in the UK as a permanent resident.
Having a Baby in the UK as a Foreigner
If you are having a baby in the UK and you are not a national, you should not be concerned; there are some key benefits of having a baby in the UK:
- In the 2019 Survey of Women’s Experiences of Maternity Care, carried out as part of the NHS Patient Survey Program, more than 80% of women surveyed said their midwives, doctors or other staff spoke to them in a clear way that was easy to understand.
- Free dental care for the duration of your pregnancy and for one year after birth.
- Free prescriptions for the duration of your pregnancy and for one year after birth.
- Most non-complicated births will allow you to choose the place of delivery; however, if you require specialist treatment, you might have to give birth in a specific hospital.
- 52 weeks’ maternity leave. To receive your Statutory Maternity Pay for 39 weeks of your 52-week maternity leave, you must have average earnings of 118 GBP (150 USD) and have been working for your employer for at least 26 weeks.
Giving Birth in the UK Without Health Insurance: What Are the Costs?
For most expats, the NHS covers the costs of having a baby in the UK. In order to qualify for free NHS treatment for childbirth you must meet the following criteria:
- have “ordinarily resident” status;
- be an EEA national and currently insured by another European state, or;
- exempt from charges (refugees, asylum seekers). For full list of exemptions see gov.uk website.
This said, in the UK, all forms of maternity care are classified as “immediately necessary treatment” and you should not be refused care for any reason. This is inclusive of all antenatal, birth, and post-natal care. If, at the time of treatment, you are unable to pay for services, you must still be treated. You should ask to speak with the overseas visitors’ manager. They can help you discuss payment options, understand your circumstances, and can arrange to waive the charges or set up a repayment plan.
Through the taxpayer-funded NHS, there is a wide variety of maternity services available to you, from GP to gynecologists, to cervical screenings, and caesarians. Your best bet is to talk to your GP or check the NHS website to find the services best suited to you.
Giving Birth in the UK for Citizenship
There is a common misconception that giving birth in the UK will grant citizenship. In some countries like the US, Canada, Chile, and Brazil, you can obtain birthright citizenship; this is not the case for the United Kingdom.
In order for a child to be registered as a British citizen at birth, either or both parents must have settled status or hold British citizenship. You can apply to receive settled status after five years of continuous residence. Children born in the UK from non-British nationals will be able to register for citizenship as soon as their parents acquire Indefinite Leave to Remain (ILR) or Settlement Status. For more detailed information visit our , where you will find all a complete guide to visa types and work Permit requirements.
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