If you're an American moving to the UK, understanding the National Health Service (NHS) is essential. This article explains how healthcare in the UK works, what’s covered by the NHS, how visa status affects access, and what to expect in terms of costs and services. Whether you're relocating permanently or visiting temporarily, this guide will help you prepare and make informed decisions about your healthcare needs.
For Americans relocating to the UK, the healthcare system can feel unfamiliar. With no insurance cards, copays, or private providers by default, the UK's National Health Service (NHS) operates on an entirely different model.
Understanding how healthcare works in the UK, whether you're visiting, studying, working, or settling permanently, will help you access the services you need without confusion or unexpected costs.
Unlike the US, the UK’s healthcare is largely funded through general taxation and provided by the NHS.
It’s designed to be free at the point of use for UK residents. You won’t need private insurance to access a GP or hospital, and you won’t be billed for treatment in the same way as you might be in the US.
However, not everyone is automatically entitled to free NHS care, and some services still carry standard charges. As an American in the UK, your access will depend on your visa status and how long you plan to stay.
If your move is long-term, such as for work, study or family, you’ll typically need a UK visa, and as part of that process, you must pay the Immigration Health Surcharge (IHS).
You are treated as an ordinary NHS patient for the length of your visa.
Immigration Health Surcharge – GOV.UK
These fees are paid up front as part of your visa application.
Once you arrive, you should register with a local GP practice. You’ll typically need:
Registration is free, and GPs are your first point of contact for almost all health issues.
How to register with a GP – NHS
If you’re travelling to the UK on a tourist or short-stay visa, you will not have access to most NHS services for free.
Travel health insurance is therefore essential.
Healthcare for visitors to the UK – NHS
Even for those with full NHS access, some services still incur standard charges:
US health insurance providers do not cover NHS treatment. The NHS does not bill your US insurer, and there is no system for direct reimbursement. This means:
| Situation | Access to NHS | Notes |
|---|---|---|
| Long-term move with visa + IHS | Yes | Full NHS access, treated like a UK resident |
| Short-term visitor | No | Limited to emergencies only |
| US health insurance | No | Not valid in the NHS |
| Already living in UK long term | Yes | Must be ordinarily resident |
The UK offers a high standard of healthcare, and once you’re eligible, the system is straightforward to use. For Americans, the key is to understand your visa status and whether you’ve paid the Immigration Health Surcharge. Don’t assume your existing insurance will be accepted, and always prepare for out-of-pocket charges for things like prescriptions and dental care.
