Expats Have To Pay For NHS Care
The NHS is a residency-based system and so non-UK-residents, including UK nationals who move abroad on a permanent basis lose their entitlement to free NHS healthcare. It is important to understand your rights and know which expats have to pay for NHS care.
If you are classed as ‘ordinarily resident’ in the UK (basically if the UK is your permanent home) you will be entitled to free hospital treatment through the NHS. Provided you are in the UK on a lawful and properly settled basis you are able to use the NHS. It is not dependent upon nationality, payment of UK taxes, national insurance contributions, being registered with a GP, having an NHS number or owning property in the UK.
If you are a UK national living outside the UK, you will not generally be able to use NHS services for free when visiting the UK. You will need to take out travel insurance cover when visiting the UK, as you would when visiting any other country. Any treatment you may have to pay for will be charged at 150% of the national NHS rate.
However, if you were living in an EU country, Norway, Iceland, Liechtenstein or Switzerland by 31 December 2020 and you have an S1 you will be able to use NHS services in England without charge when visiting the UK. An S1 is for those who have their healthcare in the EU paid for by the UK and is available to those who get a UK State Pension or some other UK benefits, and posted workers, who are people working abroad for UK companies or organisations.
The Withdrawal Agreement locks in the S1 rights so that those who were resident in an EU country before 31st December 2020 but do not yet qualify for an S1 will be able to apply for one when they reach retirement age. If you arrive after 31st December 2020 you will not be able to use an S1 to obtain coverage in EU countries or in the UK when visiting the UK.
If you’re a UK national who does not qualify for an S1 and you move to an EU country, you can only use NHS services for free if you have an EHIC, PRC or S2 to show your healthcare costs are funded by the EU country where you now live, or another exemption applies.
EHIC cards are issued with a validity for five years. It was agreed that any EHICs that had been issued before 31st December 2020 would remain valid until they expired.
Some former UK residents do not have to pay for NHS treatment when visiting England. This includes UK war pensioners, UK government employees, and UK nationals living in the EU on or before 31 December 2020.
You should check before travelling to the UK whether you qualify for an exemption from charging or will be required to pay for your treatment.
Emergency Treatment
Emergency treatment through the NHS is free whatever your residence status. So, anyone needing to access NHS services including A&E, family planning or treatment for an infectious disease or a physical or mental condition caused by violence is able to do so free of charge. The only caveat is that they must not have come to the UK to seek this treatment.
You should take out appropriate travel insurance when visiting the UK, as you would when visiting any other country. Any treatment you may have to pay for will be charged at 150% of the national NHS rate.
People Living Outside The EEA
People who live outside the EEA, including former UK residents, should make sure they are covered by personal health or travel insurance, unless an exemption applies to them. Anyone who does not have insurance will be charged at 150% of the NHS national tariff for any care they receive.
The NHS tariff price for a normal maternity birth can range from £2,244 to £3282. For a major hip operation with an intermediate stay in hospital it is £7,826. So for non-residents without proper insurance cover these would cost £3,282 and £11,739 respectively.
Exemptions
There are several groups of people who are exempt from charging or entitled to free care because they remain ordinarily resident despite spending time outside the UK. UK Crown servants, British Council or Commonwealth War Graves staff, those working in UK government-funded posts overseas, and the spouse/civil partner and children under 18 of these people, are exempt from charging if they were ordinarily resident prior to leaving the UK for that purpose. Those who were not ordinarily resident in the UK before taking up such a post will be charged.
There is also no change for armed forces members, war pensioners and armed forces compensation scheme recipients and their families, who are not required to have formerly been an ordinary resident of the UK.
Returning To The UK To Settle
Citizens who return to the UK on a settled basis will be classed as ordinarily resident and will be eligible for free NHS care immediately.
Note that these changes apply in England. Different measures may apply in Scotland, Wales and Northern Ireland. Check with your local health authority.
FAQs
All overseas visitors will be charged 150% of the cost of NHS treatment for any care they receive, unless they are exempt from charges for NHS hospital treatment. For more information see: guidance on overseas visitors hospital charging regulations.
Are British expats entitled to NHS treatment? ›
If you do not live in the UK as a lawful permanent resident, you are not automatically entitled to use the NHS services without charge. The NHS is a residency based healthcare system, partially funded by the taxpayer. Hospital treatment is only available without charge to those who live in the UK on a settled basis.
Can a US citizen get free healthcare in the UK? ›
IMPORTANT: Anyone in the UK can receive treatment at an NHS facility, no matter their residency status. However, tourist visitors to the UK do not typically qualify for free NHS treatment. Any care beyond emergency treatment and certain other services will likely incur a fee.
Do UK expats need health insurance? ›
It's not compulsory. But although free NHS healthcare is available in the UK to expats, you need to be an official resident before you can use it (unless it's an emergency). The time it takes to sort that out may create a coverage gap for you and your family.
Do you have to pay for NHS in America? ›
The U.S. government does not provide health benefits to citizens or visitors. Any time you get medical care, someone has to pay for it. Healthcare is very expensive. According to a U.S. government website, if you break your leg, you could end up with a bill for $7,500.
Can I not pay for NHS? ›
NHS treatment is free to people classed as ordinarily resident in the UK. Determining residency isn't as straight forward as where you were born, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS Number, having a British passport or owning property in the UK.
Can I lose my British citizenship if I live abroad? ›
In most normal circ*mstances you will not lose your British citizenship if living abroad unless you opt to renounce your status as a British citizen and give up your British passport. If you have any questions about British Citizenship, our experienced immigration lawyers can help you.
Am I still a UK resident if I live abroad? ›
You can live abroad and still be a UK resident for tax, for example if you visit the UK for more than 183 days in a tax year. Pay tax on your income and profits from selling assets (such as shares) in the normal way. You usually have to pay tax on your income from outside the UK as well.
What benefits are available for expats returning to the UK? ›
You may qualify for benefits such as Pension Credit (PC), Universal Credit (UC), Housing Benefit (HB), and Council Tax Reduction (CTR) once you return to the UK. These are means-tested benefits, so your income and capital, for example savings, are taken into account when working out your entitlement.
Can I use my US health insurance in the UK? ›
A U.S. health insurance plan will likely not cover any medical costs in the U.K. While traveling, there's always a risk of illness or injury, so a travel insurance policy with travel medical insurance is essential for international travel. For example, road safety is a consideration for a U.K. trip.
The nearest US embassy or consulate can help travelers locate medical services and notify your friends, family, or employer of an emergency. They are available for emergencies 24 hours a day, 7 days a week, overseas and in Washington, DC (888-407-4747 or 202-501-4444).
Why is healthcare free in the UK but not the US? ›
In the UK, a national system of healthcare, paid for by all citizens through taxes, provides a universal safety net. The US has settled for a complicated mix of private insurance and government subsidized programmes, often managed by private companies. The result is not just whether one has or does not have insurance.
Do I have to pay National Insurance if I don't live in the UK? ›
You might have to pay National Insurance in the UK while you're working abroad. It depends on where you're working and how long for. If the country you're working in does not have a social security agreement with the UK, you may need to pay social security contributions there.
How much does health insurance cost for expats? ›
How much does international health insurance cost? The annual cost of an international medical insurance plan will range from as low as $500, with limited benefits, to as much as $8,000 for a comprehensive global medical insurance policy, including coverage in the USA. The average cost is $5,500 per year.
Do expats pay National Insurance in the UK? ›
To be eligible for class 2 contributions, expats living and working overseas need to have paid national insurance for at least three years. If this is not the case, they must have lived and worked in the UK immediately before leaving and have lived in the UK for three years in a row.
Can a foreigner work for the NHS? ›
How can I work in the NHS as an overseas health professional? Anyone from outside of the UK (excluding from the Republic of Ireland) will need permission from UK Visas and Immigration (UKVI) to work in the UK and may also need entry clearance before travelling here.
Does NHS cover internationally? ›
Therefore, if you're abroad, you won't be receiving 'NHS treatment' per se. However, the GHIC card can offer a similar level of healthcare access, often at reduced costs or even for free, depending on the country's healthcare system you're dealing with. You might also wonder about reimbursem*nts.
Does Scotland have free healthcare for tourists? ›
Can I get free NHS care when I visit Scotland? Yes. If you normally live in the EEA or Switzerland, you will not have to pay for treatment that is necessary while you are here.
How much is NHS maternity care? ›
The NHS Trust must tell you if you will be charged for your maternity care. The amount you are charged will depend on how complex your care has been. The cost may not be easy to predict. The minimum that you can expect to be charged for maternity care resulting in a birth is around £7000 (as of 2021).
