Does the UK really have free healthcare for all?

by Brett Andrews

About UK Healthcare

The United Kingdom was the first healthcare system to be funded by general taxation. Free care is given based on need, rather than ability to pay fees or insurance. 

The National Health Service (NHS), a government entity, manages hospitals, physicians, and mental health for the UK. NHS England distributes funds to 191 Clinical Commissioning Groups to pay healthcare providers at the local level. 

Health insurance is provided for all residents here, regardless of employment. Roughly 13% of the population carries additional private insurance, which may provide quicker care access, choice of specialists, and better amenities for elective procedures. 

Usually referred to as chemists, pharmacies can be found in standalone chains like Boots or in supermarkets. Pharmacists can advise you on minor ailments that don’t require a prescription (e.g, stomach pains, allergies, coughs and colds). 

Here are some examples of what residents pay for health services: 

Finding a Physician

To find your general practitioner (GP), simply check availability for the physicians in your area, either online or by phone. A GP practice must accept you unless reasonable grounds exist to deny you, such as no capacity for new patients. 

In order to see a specialist in the public system, you need to be registered as an NHS patient. You can ask your GP for a written referral or conduct your own research in finding a specialist. This also applies to private insurance plans. 

If you have private insurance in the UK, you can contact your insurer directly for recommendations or a list of approved providers, including specialists. Dental rates may be lower outside of England, so be sure to check with your local dentist for accurate rates.

Public Healthcare

Public healthcare is free to all UK residents under the NHS system. This offer extends to non-residents, too, so long as they did not specifically travel for free healthcare. Once you’re a resident here, you’ll register with the NHS. Expats can access the NHS system after living in the UK for six months and paying the immigration health surcharge of £624 per year of your visa. 

Private Healthcare

Some Americans elect to carry private insurance if they aren’t paying into the public health system, before they reach the six-month threshold for NHS registration, or in addition to their public health coverage. Premiums may be higher if you have pre-existing conditions.

Medical conditions treated in the previous five years may be excluded for a minimum of two years.

Out-of-pocket Options

Out-of-pocket payments are generally not recommended for expat residents in the UK. Private facilities are known to charge 150 percent of their standard rates for cash payers. 

Healthcare Checklist

• Schedule final appointments with your primary care physician and any specialists you see. 
• Research your medications for availability in the UK and find alternatives where needed. 
• Stock up on prescription refills until you can get to the pharmacy in the UK. It’s a dance because you’ll save money by filling your prescriptions in the UK, but it may take time for you to learn your way around. 
• Print out and keep photographic records of all prescriptions. Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work. 
• Ask your providers for referrals abroad. You never know! For public healthcare, pay the immigration health surcharge of £624 per year when you complete your visa application. Apply for private travel insurance to handle any coverage gaps. For public healthcare, register with the National Health Service (NHS) at your first GP appointment. 
• For private healthcare, apply for private insurance and get physician names. Visit your expat Facebook group or other forums to ask for recommendations. 
• See your family doctor and get prescriptions and referrals.