For Expatriates in the UK, Health Insurance Requires Research
The United Kingdom is one of the most popular destinations in the world for expats. It has easy flight connections, a wide array of business opportunities, and the attraction of not having to learn a new language. It’s easy to see why it’s so beloved by American expats and those from around the world. And part of the UK’s appeal is the superb reputation of its health care system. But for expats in the UK for the first time, there are a lot of logistics to sort out.
Health Insurance for Foreigners in the UK is Often Oversimplified
Information about accessing public healthcare in the UK is often oversimplified. A short version goes something like this: An expat is a foreign citizen living in the UK – legally – in order to work. And if you’re working in the UK, the cost of healthcare is deducted from your paycheck. Therefore, you’re in!
In reality, the situation is more nuanced. Healthcare in the UK is publically funded (yes, through payroll tax as a primary means). It’s known as the NHS or National Health Service. It’s available for everyone who is permanently residing in the UK (in other words, the people who are funding it). But where is that line between the long-term visitor, business person, expat, and permanent resident?
Can International Citizens in the UK Use the NHS System?
Access to the NHS isn’t based automatically on citizenship but rather on residency. To fully enjoy the services of the NHS – including both primary care and secondary care (hospital services) – you must be considered an “ordinary resident”. But who decides what “ordinary” means? In legal terms, it means your immigration status is “indefinite leave to remain”. Sometimes this is also referred to as being “settled” in the UK.
This page of the UK government’s website walks you through the process of determining if your immigration status is “indefinite leave to remain”. If your status is anything but “indefinite leave to remain”, you should carry private health care insurance.
UK Health Care – A Partial Solution Means Partial Healthcare
However, there’s an alternative approach that works well for some expats. If you’re coming to the UK on a temporary stay visa and that visa is for a term of more than 6 months, there’s good news. You’ll have to pay an immigration health surcharge during the application process. That surcharge is a hefty £150 for students and £200 for everyone else. But it really is good news! It’s your gateway to access NHS primary care.
However, it’s only a partial solution. There are some services under the NHS for which you have to pay a contribution like dentistry, eye care, and prescriptions. You are also only covered for primary care. Secondary care (hospital-based care) is not included, as your status is not “indefinite leave to remain”.
Does the UK Healthcare System Fall Short for Foreigners?
All the paperwork and organization is well worth it, for once you have an NHS card, a job, and a UK address, you can register with a local GP for ongoing medical care. That GP can also refer you to specialist services and order tests.
Related: Five Tips for Becoming an Expat
However, expats should note that a common criticism of the NHS is that waiting lists to see specialists are growing. Another is that there are not sufficient resources to run the system. This is one of the primary motivations for UK residents and expats alike to carry supplemental health care insurance. Such coverage offers more comfortable care, including private rooms should you be hospitalized, as well as access to non-public physicians and specialists.
Best Health Insurance Plans for Expatriates in the UK
Expatriates in the UK have many options for their global medical coverage. Two leading providers are listed below. Cigna Global Medical is a great option for most and you benefit as their global headquarters are located in Glasgow. GeoBlue Xplorer plan is an excellent option for US citizens living in the United Kingdom as they will provide up to 9 months of coverage back in the USA as well as worldwide.
The Best Global Medical Insurance Plan for US Citizens in the UK
- Customize your medical coverage to suit your needs
- Define your deductible and prescription benefits
- Choose providers either in or out of our elite network
A Leading International Health Plan for All Foreigners in the UK
- Access to Cigna Global’s network of trusted hospitals, clinics, and doctors
- The flexibility to tailor a plan to suit your individual needs
- The convenience and confidence of 24/7/365 customer service
Appreciating the Role of the NHS in British Society
The NHS has had its share of ups and downs over the course of its 70-year history. In post-war Britain, it was a saving grace to many impoverished families and communities who were still struggling to rebuild. In the early 1980s, it faced major scandal over contaminated blood products, which resulted in the deaths of over 1,000 people. During the administration of the Thatcher government, restructuring arguably led to a decline in quality of care. And during the campaign for the “Brexit” referendum, the NHS’s strained resources once again were in the news. Pro-Brexit campaigners argued that funds earmarked for sustained the European Union should be redirected for British health care.
But throughout the highs and lows, the overall standard of health care in the UK remains excellent. The NHS is a cherished national institution. Expats from America who harp on about NHS wait times may well find themselves rebuked about their own health care system. You’ve been warned!
Why Expats in the UK Should Never Gamble on Their Health
Expats in the UK tempted to forgo coverage in favor of taking their chances may find they’re in for a rude surprise should they need urgent healthcare. While costs are more modest than in the United States, even a short hospital visit in the UK can quickly add up to thousands of dollars. This story from a British expat living in America who needed to access emergency healthcare while on a return visit home to England gives some great insight into the costs and structure of British health care from the point of view of a citizen who’s also an expat themselves. As always, when it comes to your health, you’re better safe than sorry. Expats should also consider an international medical insurance plan to ensure they are covered in other countries they may be traveling to as well as back in their home country.