Most visa holders pay the immigration health surcharge — currently around £1,035 a year per adult — which gives full NHS access. Private health insurance is bought on top, mainly to skip waits: the NHS list stands at 7.3 million treatments with a 12.4-week median. Most UK insurers require you to be UK-resident, so check eligibility terms before applying.
- ✓The IHS (~£1,035/year per adult) buys NHS access — including its 12.4-week median waits.
- ✓Most UK insurers require applicants to be UK residents; exact rules vary, so check before applying.
- ✓UK PMI covers treatment in the UK; international PMI travels with you — different products, different prices.
You've already paid for the NHS: the IHS explained
Most people coming to the UK on a visa longer than six months pay the immigration health surcharge (IHS) as part of their application — currently around £1,035 per adult per year of the visa, with a discounted rate for students and under-18s (figures change periodically, so check gov.uk for the current rate). In return you get NHS care on the same basis as any UK resident: GP registration, hospital treatment, A&E, maternity — no bills, no claims.
That's genuinely comprehensive, and worth saying clearly: you do not need private insurance to be treated in the UK. What the IHS doesn't buy is speed. You join the same elective queues as everyone else, and those queues are long: 7.3 million treatments on the waiting list (May 2026), a median wait of 12.4 weeks, and 1 in 12 people waiting over 38.6 weeks. Around 1 in 4 people also wait six weeks or more for key diagnostic tests.
Why new arrivals buy private cover anyway
Beyond waiting lists, a few reasons come up repeatedly with people new to the UK:
- Familiarity. If you're used to a system where you book a specialist directly and are seen that week — common across much of Europe, Asia and the Gulf — NHS referral pathways and waits can be a shock. Private cover restores something closer to what you know.
- GP access. NHS GP appointments can take days or weeks to get. Most private policies include a digital GP service with video appointments, typically same-day or next-day.
- Employment norms. Many skilled-visa employers offer group health cover as standard. If yours does, join it — group schemes often skip medical history questions entirely, which matters if you have existing conditions.
- Certainty while settling. A new country means no established GP relationship and unfamiliar systems. A private policy gives you a single clear route: call the insurer, get referred, get seen.
The NHS is brilliant — most new residents come to rate it highly, especially for emergencies and serious illness. The waiting is what private cover addresses, and it's the honest reason to buy.
Can visa holders actually get UK health insurance?
Usually yes, but eligibility rules matter. Most UK insurers require applicants to be resident in the UK — typically meaning you live here, are registered or intend to register with a UK GP, and in some cases intend to stay for a minimum period. Some insurers ask that you've been resident for a qualifying period or hold a visa of a minimum length; others are more relaxed. The rules vary by insurer and change, so treat this as a question to ask directly rather than an assumption either way.
Underwriting works the same as for anyone else: no medical exam, but pre-existing conditions are generally excluded — either via a moratorium (typically a five-year look-back, with cover potentially restored after around two symptom-free years) or full medical underwriting. Medical records from overseas count: declare your history accurately even if it happened abroad, because an undeclared condition can void a claim.
Compare cover for your new life in the UK
UK PMI vs international PMI: which do you need?
New arrivals often discover two different products with similar names. UK private medical insurance covers private treatment in the UK, assumes the NHS exists as your emergency backstop, and is priced accordingly. International PMI covers you across multiple countries, often includes evacuation and repatriation, and is typically substantially more expensive because it can't lean on any national health service.
| UK PMI | International PMI | |
|---|---|---|
| Where you're covered | UK private hospitals | Multiple countries / worldwide plans |
| Emergency care | NHS (A&E is not covered privately) | Varies by plan; may include emergency cover |
| Typical buyer | Settled UK residents, skilled-visa workers | Globally mobile staff, frequent relocators |
| Relative price | Lower — UK average ~£80/month per adult | Higher — often a multiple of UK PMI |
The rule of thumb: if the UK is now home and you'll be treated here, UK PMI is usually the better-value fit. If you'll move between countries every year or two, or want treatment options in your home country, international PMI earns its higher price. Some people on assignment already hold international cover through their employer — check before buying anything, as UK treatment may already be included.
Expats returning home — and leavers
British citizens returning after years abroad face a mirror-image version of this. NHS entitlement is based on being ordinarily resident, not citizenship — once you're back and settled, NHS care resumes, no surcharge needed. But you rejoin the waiting lists like everyone else, and any conditions picked up abroad count as pre-existing to a new UK insurer. If you hold international PMI, check whether it covers UK treatment during your transition rather than cancelling on arrival day.
Moving the other way — leaving the UK — a standard UK policy generally won't travel with you beyond limited emergency provisions. Tell your insurer before you go; the options are usually switching to an international plan or ending cover. And if you later return, remember that gap: a new policy will exclude what happened in between, so timing the switch carefully protects your underwriting history.
Frequently asked questions
Do visa holders need private health insurance in the UK?
No — the immigration health surcharge most visa holders pay (currently around £1,035 a year per adult) gives full NHS access, so nobody on a long-term visa is uninsured. Private cover is optional and bought mainly for speed: NHS elective waits run a 12.4-week median, while private consultations typically happen within days.
Can I get UK health insurance on a skilled worker visa?
Usually, yes. Most UK insurers will cover skilled worker visa holders who live in the UK and are registered (or registering) with a UK GP; some apply minimum-stay or residency-period conditions. Rules vary by insurer, so confirm eligibility before buying. Also check your employer first — many skilled-visa employers offer group cover that's better than anything you'd buy personally.
Does the immigration health surcharge cover private treatment?
No. The IHS buys NHS care on the same basis as any UK resident — GP, hospital, emergency and maternity care with no bills. It doesn't fund private hospitals or let you skip NHS queues. Private medical insurance is a separate, optional purchase on top, which is exactly how it works for British citizens too.
Will UK health insurance cover conditions I was treated for abroad?
Generally not at first. Pre-existing conditions are excluded wherever they were treated — an insurer's moratorium typically looks back five years across your whole medical history, including overseas. Declare foreign treatment accurately; undisclosed history can void claims. Under a moratorium, an excluded condition may become covered after around two years without symptoms or treatment, though terms vary.
Should new UK residents get UK PMI or international health insurance?
If the UK is now home, UK PMI usually wins — it's built around UK private hospitals with the NHS as your emergency backstop, and costs around £80 a month for an average adult. International PMI costs a multiple of that and earns it only if you genuinely need cover across countries, relocate frequently, or want treatment options at home.
Can new UK residents use private cover for GP appointments?
Yes — and it's one of the benefits new arrivals value most. Most UK policies include a digital GP service with same-day or next-day video appointments, which sidesteps the wait for NHS GP slots while you're still getting registered and settled. You should still register with an NHS GP, though: it anchors your care and many insurers expect it.
I'm a British expat moving back — do I need health insurance to use the NHS?
No. NHS entitlement follows ordinary residence, not a surcharge — once you're back and genuinely settled, NHS care resumes free at the point of use. The catch is queues and history: you join waiting lists like everyone else, and a new UK policy will exclude conditions from your years abroad as pre-existing. Some returning expats keep international cover through the transition.
Do UK insurers have residency requirements for new arrivals?
Most do. Typical requirements are that you live in the UK, are registered or intend to register with a UK GP, and sometimes that you intend to remain for a minimum period or have held residence for a qualifying spell. Each insurer sets its own rules and they change, so ask directly — an ineligible policy is one that may not pay out.
Is health insurance for visa holders more expensive?
Not inherently. UK insurers price on age, postcode, cover level and underwriting — not nationality or visa type — so an eligible visa holder pays the same as a British neighbour of the same age. Costs rise for new arrivals mainly when they need international PMI instead, or when overseas medical history leads to more exclusions on a new policy.