TL;DR: Yes, foreigners can use the NHS in the UK, but what is free and what is chargeable depends entirely on immigration status. Short-term tourists get only limited free care (such as A&E and certain infectious disease treatment) and must pay for most other services. Most visa holders staying over six months pay the Immigration Health Surcharge upfront, which then gives them NHS access on broadly the same basis as residents. Refugees, asylum seekers, and those with settled status are generally entitled to full free NHS care.
“Can foreigners use the NHS” sounds like a single question, but the honest answer depends entirely on which kind of foreigner is asking. A tourist on a two-week holiday, a student on a four-year visa, and a refugee are all in genuinely different positions, and conflating them is where most of the confusion online comes from.
It Depends Entirely on Your Immigration Status
NHS entitlement in the UK is not based on nationality at all. It is based on immigration status, and for most visa holders, on whether a specific upfront payment, the Immigration Health Surcharge, has been made. This is the single most important distinction to hold onto before anything else.
In broad terms, there are four categories worth understanding separately: short-term tourists and visitors, visa holders who have paid the Immigration Health Surcharge, people with settled or indefinite status, and refugees or asylum seekers. Each has a genuinely different relationship with the NHS, and the rest of this guide covers each in turn.
Short-Term Tourists and Visitors
If you are visiting the UK for a holiday or short trip without a visa requiring the surcharge, your access to free NHS care is limited.
Certain services remain free to everyone in the UK regardless of immigration status, including initial treatment in an accident and emergency department, treatment for certain specified infectious diseases, and family planning services excluding abortion. Beyond these specific exceptions, most GP appointments, hospital treatment involve a charge for visitors without the relevant entitlement.
Pharmacist advice and the NHS 111 service for non-emergency medical advice remain available to anyone in the UK, including tourists, free of charge. For more detail on the practical routes available to short-term visitors needing care, including antibiotics, the options and process are covered in depth elsewhere on our site.
Visa Holders Who Have Paid the Immigration Health Surcharge
Most people coming to the UK on a visa lasting longer than six months are required to pay the Immigration Health Surcharge (IHS) as part of their application, and this payment is what unlocks broader NHS access for the duration of their stay.
GOV.UK confirms that most people need to pay the IHS as part of their online immigration application, and that you can start using the NHS free of charge from the date your visa starts, provided you have already paid the surcharge where required. This covers the majority of visa categories, including work visas, student visas, and family visas.
The current standard rate is £1,035 per year for most adult applicants, with a reduced rate of £776 per year for students, their dependants, Youth Mobility Scheme participants, and applicants under 18. GOV.UK’s guidance on how much you need to pay confirms the charge is calculated for the full length of visa permission applied for, with part-years handled in specific ways depending on length, and dependants aged 18 or over usually paying the same rate as the main applicant.
Once paid, this entitles you to use NHS services broadly on the same basis as a permanent UK resident for as long as your visa remains valid. It is genuinely a significant upfront cost for longer visas, since the full amount must be paid for the entire visa duration before the application can be processed, rather than spread over time.
Important Things the IHS Does Not Cover or Guarantee
A few common misunderstandings are worth clearing up directly, since they catch many visa holders by surprise.
Paying the surcharge does not create what is called “ordinary residence” for NHS purposes, and it does not guarantee unrestricted access to absolutely everything the NHS offers. GOV.UK is clear that you will still need to pay for certain types of services even once the surcharge is paid, including dental treatment, eye tests, and assisted conception services — exactly the same charges that apply to UK residents who are not otherwise exempt.
If the Home Office has not yet made a decision on your visa application, you may need to pay for NHS treatment in the meantime, since the entitlement linked to the surcharge only begins once your visa is actually granted and starts. If your immigration status later changes, for example if a sponsored visa is curtailed or ends earlier than originally planned, entitlement linked to the surcharge does not automatically continue — once you no longer hold valid leave, you may become chargeable for NHS services again, subject to the standard overseas visitor charging rules.
People With Settled Status, Refugees, and Asylum Seekers
Beyond temporary visa holders, several groups have a more straightforward and complete relationship with the NHS.
Anyone with Indefinite Leave to Remain, or status granted under the EU Settlement Scheme, is generally entitled to full NHS care on exactly the same basis as a British citizen, without needing to pay the Immigration Health Surcharge. This reflects a more permanent, settled relationship with the UK rather than a temporary, time-limited stay.
Refugees and asylum seekers are also generally entitled to free NHS care, regardless of how their claim is currently progressing through the system. This is a distinct and separate basis for entitlement from the visa and surcharge system described above, reflecting the UK’s specific obligations towards this group.
How to Actually Register and Access Care
Once you are in the UK with the right to use NHS services, registering with a GP practice is the practical first step to actually accessing most of what the NHS offers, beyond emergency care.
Registering gives you an NHS number and access to routine GP appointments, referrals, and the wider NHS system. This typically involves visiting a local practice in person with identification and any relevant immigration documents, and it is genuinely worth doing this as soon as you arrive and settle, rather than waiting until you are already unwell and need care urgently.
In the period before you are registered, or if you are still working out the right practice for you, NHS 111 and pharmacists remain accessible for advice without any registration required, and can help direct you appropriately in the meantime.
Frequently Asked Questions
Do I need to pay the Immigration Health Surcharge if I have private health insurance?
Yes. The surcharge is a mandatory part of most visa applications and cannot be avoided or reduced by also holding private health insurance. The two are entirely separate, and having insurance does not exempt you from paying the IHS.
Can I get a refund on the Immigration Health Surcharge if I don’t use the NHS?
No, generally not. The surcharge is non-refundable even if you do not use NHS services during your stay. Refunds are only available in specific circumstances, such as certain visa refusals, rather than simply for non-use.
Do EU citizens still get free NHS care after Brexit?
This depends on individual immigration status rather than EU citizenship alone. EU citizens with settled or pre-settled status under the EU Settlement Scheme generally retain NHS entitlement, while those arriving more recently on other visa routes follow the same rules, including the Immigration Health Surcharge, as other foreign nationals.
Can I register with a GP before I arrive in the UK?
No, GP registration is done in person at a practice once you are physically in the UK, with identification and relevant documents. It is worth doing this promptly after arrival rather than waiting until you need care.
What happens to my NHS access if my visa is refused or ends early?
If your visa is refused, you may be entitled to a refund of the surcharge in some circumstances. If your visa ends earlier than planned while you remain in the UK, your NHS entitlement linked to that surcharge payment does not automatically continue, and you may become chargeable for further treatment.