International Health Insurance in the UK for Expats

The IHS is a fee that Americans and other non-UK nationals must pay as part of their visa application for stays of more than six months. As of 2025, the rate is £1,035 per year for adults. The IHS is paid upfront as part of the visa application fee and covers the full duration of the visa. Paying the IHS entitles you to NHS services throughout your stay without any further charge at the point of use. Children under 18 pay a reduced rate. Some visa categories are exempt from the IHS, including those with Indefinite Leave to Remain.

The NHS provides comprehensive coverage but is experiencing significant pressures. NHS satisfaction among the public fell to a historic low in 2024. Waiting times for GP appointments typically run one to three weeks. For non-urgent specialist referrals, the NHS 18-week target means waits of several weeks to months. Some specialisms – particularly mental health, orthopaedics and dermatology – can have considerably longer waits. Private health insurance provides faster access to specialists and planned procedures, and individual policies in the UK typically run £50-100 per month – considerably more affordable than private insurance in most other countries.

Private health insurance in the UK typically covers faster access to specialist consultations, planned hospital treatment, diagnostics and some outpatient services. It works alongside the NHS rather than replacing it – emergency care and most routine GP services remain NHS-based. Private insurance can dramatically reduce waiting times for specialist appointments and planned procedures. International health insurance through ExpatInsure can provide broader cover including worldwide emergency cover, making it more useful for Americans who travel frequently or split time between the UK and US.

For most routine healthcare needs in the UK, NHS access through the IHS is sufficient. However, there are situations where international health insurance provides important additional value. If you travel frequently outside the UK or visit the US, international health insurance covers you in those countries – NHS does not. If you want faster access to specialists without NHS waiting times, private cover is beneficial. If you plan to return to the US periodically and need health cover there, an international plan that includes US coverage may be the most practical solution. ExpatInsure can help you assess what level of cover is right for your situation.

No. US Medicare does not provide coverage outside the United States in most circumstances. This means that even with NHS access through the IHS, American retirees in the UK should understand that their US Medicare coverage does not apply here. International health insurance that includes US coverage can be important for Americans who split their time between the UK and the US or plan to return to the US for visits. ExpatInsure can help you find options suited to your situation.