UK Health Insurance for Foreigners 2026 -- IHS, NHS Access and Private Cover

Last reviewed: 26 April 2026

UK health insurance for foreigners is a layered framework that depends on the individual’s visa type, country of origin, length of stay, and whether they have paid the Immigration Health Surcharge (IHS). Unlike many countries where expatriates must purchase private health insurance to access healthcare, the UK’s NHS provides comprehensive healthcare to all individuals with Indefinite Leave to Remain (ILR), settled status, or a visa of more than 6 months duration who have paid the IHS -- regardless of nationality. Understanding the IHS, NHS access rules, and the role of private health insurance in supplementing NHS care is essential for foreign nationals planning to live or work in the UK. For the full expat health insurance picture for British nationals abroad, see our UK expat health insurance guide. For how UK tax residency affects healthcare entitlements, see our UK tax residency guide.

The IHS is administered by the Home Office and is paid as part of most visa applications for stays of more than 6 months. The current IHS rate is £1,035 per year per adult (£776 per year for students and those under certain youth mobility schemes), as published by the Home Office in its Immigration Health Surcharge guidance at gov.uk/healthcare-immigration-application. The IHS is paid upfront for the entire visa period at the time of visa application; a 2-year visa costs £2,070 for an adult; a 5-year visa costs £5,175. IHS payers are entitled to free NHS treatment (subject to NHS charges for prescriptions, dental, and optical) on the same basis as UK residents. IHS does not entitle the holder to free dental care beyond NHS emergency dentistry, or to free optical care; these require NHS registration and may carry charges.

Immigration Health Surcharge: who pays and how

The IHS applies to most visa categories for stays of more than 6 months: Skilled Worker visas, Student visas, Family visas, BNO Holder visas, Temporary Worker visas, and most other non-EEA immigration categories. It does not apply to: indefinite leave to remain (ILR) holders; refugees and asylum seekers (who access NHS without IHS); those with settled status under the EU Settlement Scheme (EUSS) who are exercising their rights under the Withdrawal Agreement; diplomatic mission staff under the Vienna Convention; and some other specific exemptions. The IHS is paid online at the Home Office IHS portal (apply.immigration-health-surcharge.service.gov.uk) as part of the visa application process; the IHS receipt number is included in the visa application. Dependants on the same visa application also pay the IHS (£1,035 per adult dependant; children pay the same rate as adults unless a student exemption applies). The Home Office reviews the IHS rate annually; the current rate of £1,035 was set in February 2024 and represents an increase from the prior rate of £624 per year. NHS England at nhs.uk/using-the-nhs/healthcare-abroad confirms the entitlement framework for IHS payers.

EU nationals and EHIC/GHIC in the UK

EU nationals visiting the UK for temporary stays can access medically necessary NHS treatment using their European Health Insurance Card (EHIC) issued by their EU member state, under the Withdrawal Agreement social security reciprocal provisions (applicable to EU nationals exercising treaty rights in the UK before 31 December 2020) and under the UK-EU Trade and Cooperation Agreement (TCA) reciprocal healthcare provisions for visitors from EU member states. An EHIC-holding EU tourist in the UK can access NHS A&E, GP treatment for urgent conditions, and hospital treatment that becomes necessary during the visit; the EHIC does not cover routine or elective treatment. EU nationals who move to the UK for more than 6 months must apply for the appropriate visa and pay the IHS to access the NHS on a resident basis; the EHIC does not substitute for the IHS during long-term UK residence. The UK’s GHIC (UK Global Health Insurance Card) is the UK equivalent for UK nationals visiting EU member states; it does not give EU nationals any additional rights in the UK beyond what the EHIC provides. NHS England publishes the healthcare for overseas visitors guidance at gov.uk/guidance/nhs-entitlements-migrant-health-guide.

NHS access for settled status and ILR holders

EU nationals who hold settled status under the EU Settlement Scheme (EUSS), and non-EEA nationals who hold Indefinite Leave to Remain (ILR), are entitled to free NHS treatment on the same basis as UK citizens -- without paying the IHS. EUSS settled status holders are covered by the Withdrawal Agreement; their NHS entitlement is equivalent to UK citizenship for healthcare purposes, with no time limit. Pre-settled status holders (those who have not yet completed 5 years of continuous UK residence) are entitled to NHS treatment on the same basis as settled status holders under the Withdrawal Agreement, provided they are exercising their Withdrawal Agreement rights in the UK. The NHS charges overseas visitors (those without IHS, settled status, or ILR) for non-emergency treatment at a rate of 150% of the NHS tariff; the overseas visitors regulations (NHS (Charges to Overseas Visitors) Regulations 2015, as amended) set out the categories of chargeable and exempt treatment. A&E treatment is free to all individuals regardless of immigration status or nationality, as is GP registration for temporary residents and treatment for certain communicable diseases.

Private health insurance for foreigners in the UK

Private health insurance in the UK is available to foreign nationals regardless of visa status, from FCA-authorised insurers (listed at register.fca.org.uk). Private health insurance provides: faster access to specialists (without NHS waiting times, which averaged 7.6 weeks for consultant appointments in Q3 2025 per NHS England waiting time statistics); access to private hospitals and consultants of the patient’s choice; private rooms; and coverage for treatments not always available on the NHS (certain diagnostics, physiotherapy, mental health therapy). The ABI (abi.org.uk) estimated that approximately 4.2 million people in the UK held individual private health insurance in 2025, with a further 5.5 million covered by employer group schemes. For a healthy foreign national aged 35, private health insurance with a UK insurer (Bupa, AXA Health, Aviva, Vitality) costs approximately £50-£120 per month for a comprehensive plan; for a 50-year-old, approximately £120-£250 per month. Premiums are affected by: age, smoking status, prior medical conditions (moratorium or full medical underwriting), and the chosen excess (£100-£500 excess reduces premiums by 15-30%). FCA’s Consumer Duty (PS22/9, effective July 2023) requires UK health insurers to ensure products deliver fair value to customers and that terms are clearly communicated.

NHS dental, optical and prescription charges for foreigners

NHS dental charges apply to all adults in England (including IHS payers) unless exempt (exempt categories include pregnant women, those who have given birth in the previous 12 months, full-time students under 18, and those on certain income-related benefits). NHS dental charges in England for 2025/26 are: Band 1 (check-up, X-ray, scale and polish) £30.50; Band 2 (fillings, extractions) £83.50; Band 3 (dentures, crowns, bridges) £287.40 -- per NHS England published charge schedule at nhs.uk/nhs-services/dentists/dental-costs. Prescription charges in England are £9.90 per item for 2025/26; a prepayment certificate (PPC) covering unlimited prescriptions costs £111.60 for 12 months, per NHS Business Services Authority (nhsbsa.nhs.uk). Optical care (glasses and contact lenses) is not covered by the NHS for adults; NHS sight tests are free for over-60s and certain exempt categories. Foreign nationals in Scotland, Wales, and Northern Ireland face different charges; NHS prescriptions are free in Scotland and Wales. Private dental and optical care is available from commercial providers at UK market rates.

Employer group health insurance for foreign workers in the UK

Many UK employers provide group private health insurance as an employment benefit for their UK workforce, including foreign national employees. Employer group health insurance is not a taxable benefit in kind for employees under HMRC’s group income protection and group life rules (provided the scheme meets the relevant HMRC qualifying conditions for group arrangements); this makes it a tax-efficient benefit compared to equivalent salary increase. For foreign nationals on Skilled Worker visas who have paid the IHS, employer group health insurance supplements NHS access by providing faster specialist referrals, private room admissions, and additional coverage (dental, optical, mental health) beyond the NHS standard. Group insurance premiums for an employer covering, say, 50 employees run approximately £30-£90 per employee per month depending on the age profile and cover level, according to ABI group insurance market data 2024. The FCA’s ICOBS sourcebook (at fca.org.uk) governs group health insurance marketing and sales conduct; employers arranging group health insurance for their workforce should use an FCA-authorised employee benefits broker.

This article is for general information only and does not constitute tax, legal, financial or immigration advice. Rules and rates change; verify with the primary sources cited or consult a qualified adviser before acting.

FAQ

What is the Immigration Health Surcharge and how much does it cost?

The IHS is a charge paid by most non-EEA visa applicants for stays of more than 6 months, giving NHS access on the same basis as UK residents. The current rate is £1,035 per year per adult (£776 for students) as set by the Home Office in February 2024. It is paid upfront at the time of visa application for the entire visa period: a 3-year Skilled Worker visa costs £3,105 for an adult. IHS payers access NHS GP, hospital, and specialist care, but still pay standard NHS dental and prescription charges.

Do EU nationals in the UK need private health insurance?

EU nationals with settled status under the EUSS or who hold ILR have full NHS access without additional cost. EU nationals on temporary visits can use their EHIC for medically necessary NHS treatment. EU nationals who move to the UK for more than 6 months on a visa must pay the IHS to access the NHS on a resident basis; the EHIC does not substitute for IHS during long-term UK residency. EU nationals working in the UK under Skilled Worker or similar visas pay the IHS as part of their visa application.

Is A&E free for all foreigners in the UK?

Yes. A&E treatment (accident and emergency) at NHS hospitals is free to all individuals regardless of nationality, visa status, or whether they have paid the IHS, under the NHS (Charges to Overseas Visitors) Regulations 2015. Non-emergency treatment at NHS hospitals is chargeable to overseas visitors without IHS, settled status, or ILR at 150% of the NHS tariff. GP registration for temporary residents (single episode of care) is also free; ongoing GP registration requires a UK address and is typically available to IHS payers and settled status holders.

What does private health insurance cost for a foreign national in the UK?

FCA-authorised UK private health insurers (Bupa, AXA Health, Aviva, Vitality) charge approximately £50-£120 per month for a comprehensive plan for a healthy 35-year-old; £120-£250 per month for a 50-year-old. Premiums depend on age, smoking status, cover level, and excess (£100-£500 excess reduces premiums by 15-30%). Private health insurance provides faster specialist access, private rooms, and treatments beyond NHS standard coverage. Employer group schemes are typically more cost-effective than individual plans.

Are NHS dental charges the same for foreigners as for UK citizens?

Yes, for IHS payers and those with settled status or ILR who are not in an exempt category (pregnant, recently pregnant, under 18, on qualifying benefits). NHS dental charges in England for 2025/26 are: Band 1 (check-up) £30.50; Band 2 (fillings, extractions) £83.50; Band 3 (dentures, crowns) £287.40, per NHS England published charge schedule. Charges are different in Scotland, Wales, and Northern Ireland. NHS prescriptions in England cost £9.90 per item; a 12-month prepayment certificate (PPC) costs £111.60.

Can foreign nationals in the UK get private health insurance instead of paying the IHS?

No. Private health insurance does not exempt visa applicants from paying the IHS. Both the IHS and private insurance can be held simultaneously. Some employers who provide group health insurance also reimburse the IHS cost as part of their employment benefits package, making the combined arrangement effectively cost-neutral for the employee. The Home Office does not allow substitution of private insurance for the IHS payment in any visa category.

Sources

1. Home Office -- Immigration Health Surcharge: rates and eligibility (verified 26 April 2026)
2. NHS England -- NHS entitlements: migrant health guide (verified 26 April 2026)
3. NHS -- Dental charges 2025/26 (verified 26 April 2026)
4. FCA Register -- authorised UK health insurance providers (verified 26 April 2026)
5. ABI -- UK Insurance and Long-Term Savings Key Facts 2024 (verified 26 April 2026)