The Immigration Health Surcharge
With immigration policy changes that took effect in April 2015, there are essentially two categories of migrants to the UK:
- People from the EU who do not require a visa, who are automatically eligible for free NHS treatment
- People from outside the EU who require a visa, most of whom must pay the new Immigration Health Surcharge (IHS)
To find out who is exempt from paying the IHS, and who needs an IHS reference number even if they are exempt from paying, visit gov.uk to read their ‘Pay for UK healthcare as part of your immigration application‘ page.
To find out if you need to pay the IHS, and to obtain your IHS reference number if required (even if you’re exempt from paying), visit ‘Check if you need to pay towards your healthcare in the UK‘ at the gov.uk website.
To find out how much the Immigration Health Surcharge should cost you if you have to pay it, try this calculator.
For people who must pay it, payment of the immigration health surcharge means you can access NHS hospital services free of charge.
Registering with a GP
Everyone who is eligible for NHS treatment (whether they have to pay IHS or not) needs to be registered with a local general practitioner (GP), a primary care doctor. If you are a student, your educational institution should help you with the process of registering with a GP.
GPs can issue prescriptions for blood glucose test strips, insulin, glucagon and ketone test strips.
A GP can also refer you to an NHS diabetes specialist service (considered a hospital/secondary care service).
GPs cannot coordinate funding for insulin pumps or insulin pump supplies – these must be handled at the secondary care/hospital level. If you use a pump, be sure to ask your GP to refer you to a diabetes specialist centre that provides insulin pump therapy at your first appointment. Input:JDRF has a list of pump services we hear good things about. These clinics also have a good reputation for the quality of care they offer for people on insulin injections.
It can take a few weeks to get your proof of address so you can register with a GP and it usually takes two months from the time you get the referral to a hospital to your first clinic appointment. For this reason, Input:JDRF suggests bringing 3-4 months’ worth of everything you use. Some GPs only give a minimum of test strips until requested by a diabetes specialist to increase their prescriptions, so having extra test strips is wise.
It is also sensible to bring long-acting insulin for your backup plan in case of a pump malfunction prior to your first GP appointment, and it is worthwhile having glucagon too. Insulin syringes can be bought over the counter at pharmacies.
If you use a pump, it’s a good idea to bring a letter in English (if possible) from your diabetes clinic in your home country that explains the reasons why you were initially put on a pump and confirms that your diabetes care team believes the pump is helping you. So much the better if you would have been eligible for a pump under the NICE criteria explained in our step-by-step guide to insulin pump access.
If you are coming to the UK to visit for less than six months, you will not be eligible for free NHS treatment during your stay. Bring all medical supplies with you that you expect to need, get good travel insurance that will cover medical expenses, and be prepared with funds to pay upfront for doctors’ appointments if you need medical treatment while you are in the UK.
Special information for students coming to the UK to study
If you are a student requiring a visa, you’ll fit into one of these subcategories:
- Course or programme lasts under six months (see Short-term student visa)
- Course or programme lasts six months or more (see Student immigration: the basics)
- If you’re a student on a course lasting under six months, you will not be eligible for free NHS treatment during your stay. Bring all medical supplies with you that you expect to need, get good travel insurance that will cover medical expenses, and be prepared with funds to pay up-front for doctors’ appointments if you need medical treatment while you are in the UK.
If your course will last six months or more, you’ll have to pay the immigration health surcharge when you apply for your visa.
You don’t have to pay the immigration health surcharge if you are a student from Australia or New Zealand, or the Falkland Islands (or another group listed here).
Medical exemption certificates
If you settle in England as an adult aged 18 or over, when you register with an NHS GP, you must ask about getting a medical exemption certificate. A medical exemption certificate means you won’t pay the prescription charge for anything a doctor prescribes (ever).
If any other adults in your household need ongoing medication but don’t have one of the conditions listed on the exemption list, they can take out a prescription pre-payment certificate for £104/year. (That is the maximum anyone in England should pay per year for prescriptions.)
Children and prescription charges
There are no prescription charges for children.
Settling in Scotland, Northern Ireland or Wales
If you settle in Wales, Northern Ireland or Scotland, there are no prescription charges for anyone.