NHS Access for Newcomers to the UK: IHS, GP Registration and What's Free

Llandora·Updated 2026-10-14

⚠️ Disclaimer: For general information only — not tax, financial, legal, or medical advice. Figures may be outdated or incorrect; tax rules change frequently. Verify important decisions with the CRA/IRS or a qualified professional (for health topics, a licensed healthcare provider). You use this information at your own risk.

The short answer

The UK's National Health Service is one of the world's most generous public health systems — but newcomers are often surprised by what is and isn't free, and by the Immigration Health Surcharge (IHS) they must pay before they even arrive. This guide covers the mechanics of access: who pays what, how to register with a GP, and where the charges hide.

The Immigration Health Surcharge: the entry ticket

Most visa applicants coming to the UK for more than 6 months must pay the IHS upfront, for the full visa duration, as part of the visa application:

£1,035 per person per year for most adult applicants
£776 per person per year for students, student dependants, Youth Mobility Scheme applicants and children under 18
£0 for Health and Care Worker visa holders (full exemption)
Charged in 6-month blocks — part of a block rounds up

For a 3-year Skilled Worker visa, one adult pays £3,105 before boarding the plane; a family of two adults and two children pays £10,866. It is frequently the single largest line item in the move's budget, and it is non-refundable if your visa is granted (refunded only if the visa is refused or you leave early in some cases — check the current refund rules on gov.uk).

Key point: paying the IHS is what makes you "ordinarily resident" for NHS purposes. From the start date of your visa, you can use the NHS on broadly the same terms as a UK resident.

Registering with a GP: do it immediately

Your GP (general practitioner) is the front door of the NHS — you need a GP referral for almost all specialist care. Registration is free and you do not need proof of address, immigration status or an NHS number to register, though practices may ask for ID.

Practical steps:

Find practices near your postcode on the NHS website and check they are accepting new patients.
Register online or with a GMS1 form at the practice.
You will be issued an NHS number (a 10-digit identifier) — keep it; it follows you for life in the system.

Do this in your first week. GP appointment waits can run to weeks, and you want to be in the system before you need it. If you take regular medication, bring a supply plus a letter from your doctor describing the prescription — the GP will need to re-prescribe under UK formularies.

What is free and what is charged

With IHS paid (or once ordinarily resident), these are free at the point of use:

GP consultations and most GP services
Hospital treatment (A&E, inpatient, outpatient) that is clinically necessary
Maternity care

These carry charges even for residents (rules differ across the four nations):

Prescriptions in England: a flat charge per item (around £9.90 — confirm the current figure; Scotland, Wales and Northern Ireland prescriptions are free)
Dental treatment: NHS dentistry has fixed charge bands in England and Wales, and many practices have no NHS capacity — private dentistry is the norm for many newcomers
Eye tests and glasses: generally paid privately for working-age adults
Wigs and fabric supports: charged

Visitors (under 6 months, no IHS paid) get free A&E and GP consultations in practice, but are charged 150% of the national tariff for secondary hospital care — travel insurance is essential, not optional.

Secondary care: how referrals work

Unlike many countries, you cannot self-refer to a specialist in most cases. The path is: GP → referral → hospital consultant → treatment. Waiting lists for non-urgent referrals are long (often many months) — this is the system's most criticized feature, and newcomers used to direct specialist access should calibrate expectations.

Private health insurance exists as a top-up (Bupa, AXA Health, Aviva are the large providers), mainly buying faster access to elective procedures. It does not replace the NHS for emergencies.

Frequently asked questions

Does the IHS cover my dependants?

Each person pays their own surcharge at their own rate — there is no family discount. Budget per head.

I am on a Student visa. Do I pay the full rate?

No — students (and their dependants, and under-18s) pay the reduced £776/year rate.

Can I use the NHS before my visa starts?

No — free NHS access runs from the visa start date. Arrange cover for any gap.

What if I need a dentist urgently?

NHS dentists accepting new patients are scarce in many areas. For urgent pain, call NHS 111; otherwise budget for private dentistry — it is one of the largest surprise costs for newcomers.

Do I need private insurance on top?

Not for access — the IHS buys you full NHS access. Some newcomers add private cover for faster elective treatment or for services the NHS charges for (dental, optical).

Sources

Home Office, Pay for UK healthcare as part of your immigration application: https://www.gov.uk/healthcare-immigration-application
Home Office, Immigration Health Surcharge caseworker guidance: https://www.gov.uk/government/publications/immigration-health-surcharge-caseworker-guidance/immigration-health-surcharge-caseworker-guidance-accessible
Davidson Morris, Immigration Health Surcharge 2026: https://www.davidsonmorris.com/immigration-health-surcharge/

This article is general information about how NHS access works for newcomers, not medical advice. Immigration and NHS charging rules change — confirm current rates on gov.uk before you apply.

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