United Kingdom Health Insurance
The complete guide!

How does the state health insurance system work?

Set up in 1948, the NHS is regarded by many Britons as an essential pillar of the state. It is currently run by the Department of Health and Social Care, and is the world’s largest public healthcare provider. Organisationally, it is complex, varying across the four countries of the UK and comprised of NHS Trusts, around 200 CCGs (Clinical Commissioning Groups) which are run by GPs and other local healthcare professionals.

The NHS is free at the point of delivery. It is not a reimbursement scheme for British residents, including expats. You will not be charged for hospitalization. The NHS is funded out of income-linked deductions from your salary, but you will be able to seek treatment even if you are unemployed, as long as you are a resident of the UK.

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Who is eligible for state healthcare?

Everyone is eligible if they are resident in the UK. However, if you are not coming from an EU member state, and you are planning to remain in the UK for more than six months but not intending to move there permanently, you may be required to pay a surcharge (the Immigration Health Surcharge or IHS) at the time of your visa application.

There are a number of exemptions to this surcharge, which you can find listed on the UK government’s website.

How do you apply to join the state health insurance system?

You will be automatically covered by the NHS once you arrive in the UK, but you must register with a medical practice and you will need to complete a GMS1 form, including the same information that you used when you filled out your visa.

If you are visiting, you can sign up with a surgery as a temporary measure if you fall ill. If you are an EU citizen and have an EHIC card, then you must bring this with you to any GP or hospital appointments.

If you are coming to the UK for more than six months, but are not planning permanent residence, you should inform the visa section and you might have to pay the IHS surcharge.

What is covered by the state health insurance system?

Primary care is free at the point of delivery. You will not be asked to pay anything when you visit your doctor, but you must register with a doctor when you arrive. Eye care is not covered, except for medical emergencies such as detached retinas.

Not all treatment will be available for free to expats living in the UK – some screening services may not be free, for instance, unless they are offered by your surgery.

Hospital treatment is free to everyone regarded as ‘ordinarily resident’ in the UK.

Are retirees covered by state medical insurance?

You will be covered if you are from the EU and have an EHIC card, for as long as Britain is in the EU.

If you come from outside the EU, you will be able to access the NHS once you have paid the IHS charge: currently this stands at £400 per person.

Are students covered by state medical insurance?

You will be covered if you are from the EU and have an EHIC card, for as long as Britain is in the EU.

If you come from outside the EU, you will be able to access the NHS once you have paid the IHS charge. The fee for students and their dependants is £300 per person per twelve months of leave granted, or £150 per 6 months of leave.

Will your family be covered by your insurance?

Your family will be covered under the NHS but must pay the IHS charge separately.

Is dental treatment covered by state health insurance?

There are some NHS dentists who operate on a co-pay system: you will have to contribute to the cost of your treatment, but it is nationally capped. Dental treatment under the NHS has a small upfront and non-refundable charge for check-ups, hygienists’ consultations, and basic treatments, including root canal surgery.

What are the contribution rates for state health insurance?

Contributions are divided into classes. Class I is for employees earning more than £166 a week, who are under state pension age. This will be around 12% of your gross income and will be automatically deducted by your employer. If you are self-employed, HMRC will let you know how much you have to contribute after you have submitted your tax return.

Why buy private health insurance?

Many Brits do not take out private insurance since the NHS provides comprehensive coverage. Typical reasons for going private are to reduce treatment waiting times or to enjoy the increased level of comfort offered by private hospitals.

Like many public systems, the NHS prioritises serious illness, so if you need a hip replacement, you may have to wait several months, especially if you are in a busy urban area; but if you are diagnosed with cancer, youm will be fast-tracked.

However, the level of actual medical treatment across public and private systems remain the same – medical personnel are often shared between the two sectors.

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What is covered by private health insurance?

More advanced dental treatment and elective cosmetic surgery will be covered, along with the range of treatments under the NHS.

How much does private health insurance cost?

This will depend on your particular needs — for instance, whether you have any pre-existing conditions — and the kind of package you are looking for. A more expensive package will provide you with more extensive health coverage.

For those seeking international private medical insurance (iPMI) cover for multiple countries including the United Kingdom, numerous variables can have an impact on the cost.

The most important variables are:

  • age (the higher the more expensive)
  • area of cover (i.e. in addition to the United Kingdom, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
  • product choice (higher end insurance products are more expensive)

Other variables include:

  • deductibles
  • co-insurance
  • payment frequency
  • gender
  • nationality
  • country of residence

As so many variables have an effect on the cost of international private medical insurance in the United Kingdom it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Which companies offer private health insurance?

The big international companies all operate within the UK, including:

  • Allianz
  • Aviva
  • AXA
  • Bupa Global
  • Cigna Global
  • Pacific Prime
  • Prudential

You should also check with your employer as to whether they have an arrangement with a private provider.

Glossary of health insurance terms

For those whose first language is not English, interpretation may be available in larger urban hospitals and doctors’ surgeries, and much of the literature produced by the NHS is multilingual.

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