Health insurance when moving to the United Kingdom: the checkpoints

The British health system (NHS) is residence-based, not insurance-based: most services are free for people who are “ordinarily resident”, that is, who live lawfully and on a settled basis in the United Kingdom.

To register with a GP in England, you need no ID, no proof of address and no proof of immigration status; registration does not on its own create an entitlement to hospital treatment free of charge. Even with the health surcharge paid, own shares apply, for example for prescriptions, dental treatment and eye tests, as for residents.

The British government’s NHS guidance relates to England; in Scotland, Wales and Northern Ireland, the rules on access may differ. Ask the competent body at your destination which rules apply there.

According to NHS guidance, anyone moving from abroad who is subject to immigration control counts as “ordinarily resident” only once they have indefinite leave to remain.

Anyone who is not “ordinarily resident” counts as an overseas visitor, and NHS bodies must charge for certain services and collect the charges.

Anyone applying from outside the United Kingdom for a visa or a stay of more than six months usually pays a health surcharge (Immigration Health Surcharge) with the application; visitor visas and applications for six months or less are exempt. Anyone who has paid the health surcharge or is exempt receives NHS hospital care in England for the duration of the visa essentially like a person who is ordinarily resident; NHS-funded assisted conception services are excluded.

The health surcharge is £1,035 per year of the stay, and £776 per year for students, people under 18 and participants in the Youth Mobility Scheme; for parts of a year, half applies up to six months, and the full amount above that.

You check the amount and exceptions of the health surcharge on the British government’s website on the day of your application. Whether proof of insurance is also required for your type of stay is something you clarify with the competent authority.

The health surcharge must be paid even if you have private health insurance.

More on the policy under international health insurance.

Before you deregister (Abmeldung) in Germany, you clarify in writing what happens to your current insurance. The questions below apply to any destination country. They are questions, not legal advice: the answers are in your contract documents or come from the body you ask.

You clarify three United Kingdom topics in advance with your Krankenkasse (statutory health insurer): the EHIC, a possible S1 (form for entitlement in the new country of residence) and the day your cover in Germany ends. The German EHIC continues to apply during temporary stays in the United Kingdom for medically necessary treatment in the NHS, but it replaces neither travel insurance nor does it cover private treatment.

If you have statutory insurance: questions for your Krankenkasse

• What happens to my membership when I deregister in Germany, and on what date does it end?
• Can I suspend the membership or take it up again later, and under what conditions?
• What confirmation of my previous insurance periods do I receive, and how quickly?
• What applies to co-insured family members: who stays insured and who does not?
• Is an S1 an option for me, and who issues it?
• Until which day does my cover apply, so that there is no gap between Germany and the United Kingdom?

If you have private insurance: questions for your insurer

• Does my contract end with the move, is it suspended or does it continue?
• Is there an Anwartschaft (a German option to keep certain rights in private insurance while abroad), and what is preserved under it? Ask about the difference between the small and the large Anwartschaft, and whether a new health assessment would be needed on a return.
• Does my contract apply in the destination country, and for how long at a stretch?
• Which documents do I receive in writing before I cancel?
• Does the policy apply in the United Kingdom for the entire length of stay?
• Does the insurer confirm the scope of cover, territory and term in writing?

Do not cancel any contract before it is clarified in writing what applies afterwards. We explain the connections on the pages Health insurance when emigrating and PKV and Anwartschaft. For families, there is more at Health insurance for the family abroad.

1. EHIC as a permanent solution

   The German EHIC continues to apply during temporary stays in the United Kingdom for medically necessary treatment in the NHS. Ask your Krankenkasse about the route for a change of residence.

2. Confusing the surcharge with a private policy

   The health surcharge must be paid even if you have private health insurance. Clarify what you additionally need the policy for.

3. Treating GP and hospital as the same

   Registering with a GP does not on its own create an entitlement to hospital treatment free of charge. Ask which status applies for that.

4. Transferring the rules of England

   Check which part of the country you will live in. The sources are in the section “System”.