Do You Need Health Insurance When Moving to the UK? What Expats Should Know (2026)
Estimated reading time: 16 minutes
Moving to the UK doesn’t always mean healthcare is automatic. NHS access depends on residence rules and the Immigration Health Surcharge, and even eligible expats may face waiting times and out-of-pocket costs for prescriptions, dental and optical care. This guide explains how UK healthcare really works in 2026 and how to decide between NHS-only, UK private, or international health insurance.
Updated 20/01/2026
Moving to the UK comes with plenty of practical decisions—where to live, how to set up banking, what to do about schools, and, very quickly, what happens if someone in the family gets ill. The UK is famous for the NHS, and many expats arrive assuming healthcare will simply “work itself out” once they land. In reality, access depends on your immigration status and where you live in the UK, and even when you are eligible, the experience can feel very different from private systems elsewhere.
This guide explains how NHS eligibility works, what the Immigration Health Surcharge (IHS) does (and does not) cover, what you can expect around waiting times, and why a significant number of expats still choose supplementary private health insurance for peace of mind, family coverage, and continuity of care—especially if they are used to faster specialist access, private maternity pathways, or consistent care for chronic conditions while living internationally.
- The short answer: do you need health insurance to move to the UK?
- How UK healthcare works in practice: NHS vs private
- NHS eligibility: who gets “free” NHS care and why it’s not about nationality
- The Immigration Health Surcharge: what it covers, what it doesn’t, and common misunderstandings
- “Ordinarily resident” and settled status: the phrase that matters more than people realise
- Registering with a GP: your first healthcare admin task in the UK
- What’s free and what’s not: prescriptions, dental, optical, and hospital charging rules
- Waiting times: why “eligible” doesn’t always mean “timely”
- Why many expats choose supplementary private cover anyway
- Family coverage: what changes when children are involved
- Continuity of care abroad: the overlooked reason international plans matter
- How to decide what level of cover you actually need
- What to look for in private or international health insurance
- Where Cigna Healthcare fits: peace of mind, family protection, continuity across borders
- FAQs
- A practical checklist for your first 90 days in the UK
The short answer: do you need health insurance to move to the UK?
For many expats, health insurance is not a strict legal requirement to enter the UK—especially if you are coming on a visa route that already includes payment of the Immigration Health Surcharge. If you pay the IHS as part of your visa application, you typically gain access to NHS care on a similar basis to residents once you arrive.
But “not legally required” is not the same as “not needed.” There are three reasons health insurance still matters when moving to the UK:
First, not everyone is covered by the NHS in the same way. Visitors and short-term stays can be charged for certain NHS services, and some people only discover where they stand after an unexpected appointment or hospital visit.
Second, the NHS is a national treasure, but it is under strain. Waiting times for non-urgent care can be long, and accessing certain services quickly—specialists, elective procedures, some diagnostics—can be difficult depending on where you live and how pressured local services are.
Third, even when NHS care is available, many people still pay out-of-pocket for parts of healthcare in the UK, such as prescriptions in England, dental treatment, optical care, and faster private consultations.
So the best way to think about it is this: the NHS may cover your core healthcare needs, but many expats choose private insurance to control timing, choice, comfort, and continuity—particularly for families or anyone managing ongoing conditions.
How UK healthcare works in practice: NHS vs private
The UK has a mixed healthcare landscape. The NHS is publicly funded and provides the majority of care. Private healthcare exists alongside it—sometimes through employer benefits, sometimes purchased personally—and it tends to focus on faster access, more choice of specialist, and a different hospital experience rather than replacing emergency care.
In everyday terms:
The NHS is usually your default for urgent and essential care, GP-led services, and most hospital treatment pathways.
Private care is often used for speed (appointments and diagnostics), choice (specific consultants), convenience (appointment times), and comfort (private rooms, shorter waits in some settings).
It’s also common for people to blend the two. For example, an expat may register with an NHS GP, use the NHS for urgent or emergency needs, but use private insurance for specialist consultations, scans, or elective procedures.
If you’re arriving from a country where private insurance is the norm, the UK can feel reassuring in one way (there is a safety net) and surprising in another (access can be slower and more structured than you’re used to).
NHS eligibility: who gets “free” NHS care and why it’s not about nationality
One of the most important points for expats is that NHS entitlement is primarily based on residence status, not on your passport.
In broad terms, if you are living in the UK lawfully and “properly settled” for the time being—and especially if you’ve paid the Immigration Health Surcharge as part of a longer-term visa—you are usually entitled to NHS treatment on a similar basis to a UK resident.
However, the UK also has rules for charging “overseas visitors” for certain NHS services. This can apply to people who are not considered ordinarily resident in the UK, even if they have spent time living here previously.
Because these rules can feel technical, the practical takeaway is: your entitlement is linked to your immigration and residence position at the time you access care, not the fact you have moved your belongings or rented a flat.
This is also why healthcare planning should happen before you fly. If you arrive believing you are covered and later learn you are chargeable for a specific treatment type, it can be financially painful at exactly the wrong moment.
>> Read more about UK National Health Service (NHS): How It Works in 2026 – Complete Guide
The Immigration Health Surcharge: what it covers, what it doesn’t, and common misunderstandings
If you apply for a UK visa for more than six months, you are commonly required to pay the Immigration Health Surcharge (IHS) as part of the application. This is paid upfront for the length of the visa.
The IHS is best understood as a contribution that allows access to NHS services; it is not private insurance and it is not a promise of immediate access.
What the IHS generally does:
It gives you access to NHS healthcare on broadly the same basis as a UK resident (subject to the rules of your visa and residence position).
It helps cover the cost of NHS hospital and community care you may need while living in the UK.
What it does not do:
It does not guarantee short waiting times.
It does not mean everything is free at the point of use (some charges still apply, especially in England).
It does not provide international cover outside the UK
It does not provide private healthcare choice or private hospital access.
It’s also worth knowing that healthcare policy can change, and discussions around healthcare funding and eligibility can become politically charged. For expats, the safest plan is to treat NHS access as essential but not always sufficient for your expectations and family needs.
“Ordinarily resident” and settled status: the phrase that matters more than people realise
The term “ordinarily resident” shows up repeatedly in UK healthcare rules and guidance. It’s used to decide who receives free NHS secondary care (hospital care) in England, in particular.
In plain English, it means the UK is your normal place of residence, on a lawful and properly settled basis for the time being.
This matters because:
Some people assume that paying taxes or National Insurance automatically means “free NHS care.” It doesn’t.
Some people assume that being registered with a GP settles the question. It doesn’t.
Some people assume that owning property in the UK makes them eligible. It doesn’t.
In practice, for many long-term visa holders and people with settled status/indefinite permission to live in the UK, eligibility is straightforward. Where it becomes more complex is short-term stays, people in between statuses, or those who spend significant time outside the UK and return for care.
If your situation is unusual—frequent cross-border living, a short visa, or a period between visas—this is exactly where private health insurance becomes more than a “nice-to-have.”
Registering with a GP: your first healthcare admin task in the UK
For most expats, registering with a GP (General Practitioner) is the front door to routine healthcare in the UK. GPs handle common illnesses, ongoing prescriptions, referrals to specialists, sick notes, and a wide range of preventative care.
A key point that surprises many expats: in England, you do not need proof of address, ID, or proof of immigration status to register with a GP. You may be asked for basic details, and sometimes a practice may request extra documentation for administrative reasons, but lack of documents should not be used to refuse registration outright.
Why registration matters so much:
Referrals: Many NHS specialist services require a GP referral.
Prescriptions: Ongoing medications are typically managed through the GP.
Maternity pathways: Early GP contact can speed up referral to midwife services.
Children: Vaccination schedules and routine paediatric support often flow through primary care.
That said, GP access can vary wildly by location. In some areas you’ll get an appointment quickly; in others you may need to use online triage, wait for a call-back, or be offered a nurse appointment first. This variability is one of the reasons supplementary private care can feel reassuring—especially in the early months while you’re still building a local healthcare routine.
What’s free and what’s not: prescriptions, dental, optical, and hospital charging rules
Many expats arrive expecting that “the NHS is free.” The truth is more nuanced.
NHS services that are often free at the point of use
Some NHS services are generally free for everyone, and some are free for people who are eligible for NHS care as residents. For example, urgent care in emergency departments is typically provided regardless of ability to pay upfront (though charging rules can still apply for certain follow-on care depending on status).
Charges you should expect as normal in the UK (even if you’re fully eligible)
Even with full NHS entitlement, you may still pay for:
Prescriptions in England (many people are exempt, but many working-age adults pay per item).
NHS dental treatment in England (banded charges).
Optical costs (eye tests are free only for certain groups; glasses are usually paid for privately unless you qualify for vouchers)
Some travel vaccinations and certificates.
Private letters and certain medical admin services.
Scotland, Wales, and Northern Ireland have different rules in some areas—prescription charges, for example, are not applied in the same way across the whole UK—so it’s worth checking what applies where you will actually live.
Why this matters for expats
If you’re budgeting, it’s easy to forget “small” healthcare costs that add up for families: two parents needing prescriptions, a child needing dental work, an eye test plus glasses, and suddenly “free healthcare” feels less free.
This is also where private health insurance—especially plans that include outpatient care, prescriptions, or routine dental/optical options—can turn unpredictable costs into something more stable.
Waiting times: why “eligible” doesn’t always mean “timely”
The NHS provides high-quality care, especially for urgent and complex medical needs. But when it comes to non-urgent pathways—specialist referrals, elective surgery, and some diagnostics—waiting times have become one of the defining issues in UK healthcare.
Expats can feel this acutely because:
You may not yet understand how referrals and triage work in the UK.
You may be used to directly booking a specialist.
You may need continuity for an existing condition and not want gaps in monitoring.
You may be planning pregnancy and want predictable appointment schedules.
In the UK, “urgent” cases are prioritised, which is exactly how it should be. But it means elective and routine cases can wait longer, and those waits can be stressful if you’re managing pain, uncertainty, or a condition that affects day-to-day life.
This is one of the biggest drivers behind supplementary private cover: not because the NHS is “bad,” but because timing matters—and expat life is already full of change.
>> Read more about NHS Waiting Times Explained: What to Expect in 2026
Why many expats choose supplementary private cover anyway
Supplementary private cover is rarely chosen because someone distrusts the NHS. More often, it reflects how it feels to relocate to another country and the quiet calculations people make when they are responsible not only for themselves, but for partners and children as well.
One of the strongest drivers is peace of mind. When everything else in life is new—from postcodes to school systems—the idea of also navigating uncertainty around healthcare can feel overwhelming. Even expats who fully intend to rely on the NHS often want the reassurance that, if something does arise, they are not starting from zero. Private cover can remove the persistent background worry of “what if we can’t be seen quickly?” and replace it with a sense that options exist, even if they are never used.
Cigna Healthcare provides international medical insurance designed around expat life. Members can access private doctors and specialists quickly, with multilingual support and simple claims wherever they live.
It’s often chosen by newcomers to the UK who want private healthcare for themselves and their families alongside NHS access.
There is also a desire to feel looked after at a time when energy is already stretched thin. Relocation is demanding in ways that are hard to quantify: paperwork, unfamiliar systems, new routines, and the emotional weight of starting again. In that context, private healthcare pathways can feel simpler and more humane. Appointments are often easier to schedule, communication can feel more direct, and the overall experience offers a degree of control that is comforting when so much else feels provisional.
For families, the motivation is often even clearer. Parents frequently choose supplementary cover not because they expect serious illness, but because children have a way of becoming unwell at exactly the wrong moment. Fast access to paediatric advice, ENT specialists, allergy assessments, or same-day reassurance can make an enormous difference when you are navigating illness far from your usual support network. In these situations, private cover becomes less about luxury and more about reducing stress at vulnerable moments.
Alongside these emotional considerations sit very practical ones. Timing matters, particularly for expats who are used to booking specialist appointments directly. Private insurance can offer faster access to consultations, scans, and diagnostic tests, which can be invaluable when symptoms are disruptive but not considered urgent within the NHS system. This is especially relevant during the first year in the UK, when registering, referrals, and local waiting lists are still unfamiliar.
Choice is another factor that carries weight. Being able to select a provider, see a consultant at a convenient time, or book appointments around work and family commitments can feel essential rather than indulgent. For dual-career households or families adjusting to new routines, flexibility often has real value.
Finally, private insurance can simply be a better fit for expat life. Many expats travel frequently or expect their UK stay to be one chapter in a longer international journey. They may want healthcare cover that continues to make sense if they spend extended time abroad or relocate again in the future. In that context, supplementary private insurance is not a rejection of the NHS, but a way of creating continuity in a life that is, by definition, mobile.
For many expats, the NHS remains the foundation of their healthcare in the UK. Private insurance, when chosen, tends to sit quietly alongside it—not as a replacement, but as the layer that makes the overall experience feel secure, navigable, and manageable.
Family coverage: what changes when children are involved
Healthcare decisions become sharper when you add children into the equation. It’s not only about emergencies (where the NHS is strong), but about everything around them: recurring ear infections, asthma monitoring, allergy assessments, sleep issues, speech and hearing checks, minor injuries that feel major when you’re the parent, and simply wanting prompt reassurance.
Two UK-specific factors also matter for families:
GP capacity varies locally. If you’re in an area with high demand and limited appointments, it can feel harder to access routine reassurance quickly.
Dentistry can be difficult to access in some places, even when children are eligible for NHS dental care, because NHS dentist availability varies by region.
Private coverage can help families in three ways:
Speed: quicker access when a child is unwell but not “A&E unwell.”
Simplicity: fewer hoops when you’re navigating a new country
Stability: a predictable plan for care when you’re still building your UK routine.
Continuity of care abroad: the overlooked reason international plans matter
Continuity of care is easy to undervalue until you need it.
If you have an ongoing condition—thyroid issues, diabetes, migraines, inflammatory conditions, mental health support, fertility planning, oncology follow-ups, or post-surgery monitoring—relocation can disrupt your routine at the exact moment your body needs consistency.
Even if the NHS will provide the care, you may encounter:
Differences in medication brands or prescribing protocols.
The need to establish a new GP and referral pathway.
Waiting periods for specialist appointments.
A lag in transferring records (especially across borders).
International private insurance can be particularly relevant when:
You are moving to the UK but anticipate travel or future relocation.
Your employer may move you again (or you are internationally mobile).
You need to maintain a consistent standard of access across countries.
This is where global insurers often position themselves: not simply as a “faster UK option,” but as a way to keep your healthcare life coherent when your actual life is spread across borders
12. How to decide what level of cover you actually need
Not everyone needs the same solution. A smart approach is to decide based on your risk, your expectations, and your timeline.
Consider:
Your health baseline: Do you have ongoing conditions or take regular prescriptions?
Your stage of life: Are you planning a pregnancy? Do you have toddlers? Are you mid-career and time-poor? Are you supporting ageing parents abroad?
Your tolerance for waiting: Are you comfortable with NHS pathways and triage, or do you need predictability?
Your mobility: Are you likely to live in the UK long-term, or is this one stop in an international journey?
Then map those answers onto a cover style:
NHS-only (with self-funded private appointments if needed)
NHS + UK private insurance (focused on private treatment inside the UK)
NHS + international health insurance (focused on portability and continuity across borders)
Fully private pathways (less common, usually for specific needs or high budgets)
Many expats find the “NHS + international plan” combination fits best when they want the NHS safety net but also want portability, speed options, and a consistent experience.
What to look for in private or international health insurance
If you’re considering supplementary cover, look beyond the headline “inpatient vs outpatient” language and focus on how you actually use healthcare.
Key features to consider:
Outpatient cover: consultations, specialist visits, diagnostics, scans
Direct access to specialists: whether you can see a specialist without a GP referral (varies by plan)
Mental health support: therapy, psychiatry, inpatient mental health
Maternity cover: waiting periods, routine vs complications, newborn cover
Chronic conditions: how they are handled, especially if pre-existing
Prescription benefit: whether everyday medication is included
Emergency cover abroad: useful if you travel often
Evacuation and repatriation: relevant for global mobility
Network strength: access to hospitals and specialists that match your location and preferences
Claims experience and support: how easy it is to get pre-authorisations, find care, and resolve issues
For families, it’s also worth checking:
How dependants are covered
Whether paediatric care is straightforward
Whether there are benefits for routine wellbeing, vaccinations, or annual health checks (where offered
Where Cigna Healthcare fits: peace of mind, family protection, continuity across borders
When expats choose an international provider like Cigna Healtcare, it is often because the advantages match the realities of expat life rather than because they want to “opt out” of the NHS.
Three strengths matter most in an expat context:
Peace of mind
International health insurance is designed around the assumption that your life is mobile and that healthcare admin should not become your second job. A strong global insurer typically offers tools and support that make it easier to locate appropriate care, understand what’s covered, and approach healthcare decisions calmly rather than reactively.
Family coverage
For expats moving with partners and children, family cover can be the decisive factor. Having one policy that protects the household—and that can keep working even if you travel or relocate again—can feel simpler than piecing together local solutions each time life changes.
Continuity of care abroad
If you want consistency—especially with ongoing conditions, planned treatment, or a desire to keep options open across countries—international cover can provide that “through line.” The goal is not just quicker access in one place, but fewer disruptions when borders, jobs, or school plans shift.
In short, Cigna’s Healthcare appeal for many expats is the combination of reassurance (someone is there when things go wrong), practicality (cover designed for families), and stability (a plan that still makes sense if the UK isn’t your final destination).
Get a free personalised quote from Cigna Healthcare based on your family and travel plans >>
FAQs
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Usually no, but it depends on your visa and circumstances. Many long-term visa holders pay the IHS and access the NHS. Others—especially visitors or those not ordinarily resident—may be charged for certain NHS services.
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You typically gain access to NHS care like a resident, but this does not guarantee fast access, and it does not remove normal UK charges such as dental and (in England) many prescriptions.
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Yes. Many people self-pay for private GP appointments, specialist consultations, scans, or treatments, particularly if they want speed for a specific issue.
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Home-country plans often have limits for long-term overseas living. Expats often either switch to an international plan or rely on NHS access plus travel insurance for short trips, depending on their needs.
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Assuming eligibility and access will be automatic, and waiting until someone is unwell to learn how registration, referrals, and local appointment availability work.
A practical checklist for your first 90 days in the UK
Confirm your immigration status and whether you paid the IHS.
Register with a GP as soon as you have an address (even temporary).
Ask your current doctor at home for a concise medical summary and medication list.
Bring a buffer supply of essential medication (within legal travel rules) to cover your transition period.
If you have children, register them with a GP promptly and understand local urgent care options.
Decide your approach:
NHS-first only
NHS + private (UK) cover
NHS + international cover
If you choose private or international insurance, check:
outpatient cover
chronic condition handling
maternity rules and waiting periods
family membership details
how care is accessed in the UK and abroad
Create a “where to go” plan:
urgent treatment centres for urgent-but-not-emergency
For all the complexity of rules and terminology, the decision around health insurance when moving to the UK usually comes down to three questions rather than legal fine print.
The first is how comfortable you are relying on NHS timing. The system is designed to prioritise clinical urgency rather than convenience, and for many people that works perfectly well. For others—particularly families, those managing ongoing conditions, or anyone used to choosing specialists directly—the structure can feel unfamiliar and slower than expected.
The second is how predictable you need life to be during the early months of relocation. Moving countries is already a lesson in uncertainty: new schools, new jobs, new neighbourhoods, new routines. Some expats are happy to navigate healthcare in the same spirit; others prefer to remove at least one variable by keeping a private or international option in reserve.
The third is how mobile your future is likely to be. If the UK is clearly home for the long term, learning to work with NHS pathways may feel like the obvious choice. If your life is spread across borders, or you expect another move in a few years, continuity can matter more than any single national system.
There is no single “correct” answer. Many expats rely almost entirely on the NHS and are well served by it. Others blend NHS care with selective private appointments. Some choose international insurance from day one because it matches the shape of their lives rather than the geography of one country.
What matters most is understanding the landscape before you need it—registering with a GP early, knowing what the Immigration Health Surcharge does and does not cover, and being honest about the level of reassurance you want for yourself and your family.
