Are you entitled to FREE NHS treatment on a spousal visa?

Then you need to contact the clinic and ask for and pay your outstanding bill.

I stopped at the front on my way out to pay and was told that if there was any charge it would be given at the pharmacy. Maybe it was included in the prescription fee.

We are contemplating moving back (one of us is a UK citizen and the other is from the US) and he is coming with a pre-existing condition. Would he still be able to get NHS insurance, and would that include nursing care, care homes, community care and personal care at home?

Do people with a spousal visa qualify for this care if he's under the council's assessment threshold? Thank you!

The NHS is not insurance, it’s universal healthcare for everyone and is free for those who qualify for it (this includes people on a spousal visa - for which you pay an NHS levy). There’s no such thing as a ‘pre-existing conduction’ on the NHS - everything is treated, regardless of your medical history.

If he needs long-term care in an NHS hospital, that will be free on the NHS, but things like care homes have to be paid for yourself (it’s not the NHS). Some people may be entitled to help with care home costs from the government, but I don’t know the details regarding visa holders - that may come under entitlement to government benefits, not the NHS.

For example, my grandmother needed a hip replacement and was in hospital for several months afterwards - the operation and all the hospital care was free, but when she later went into a care home, she had to pay high weekly fees to live there, which were not covered by the NHS, and instead were partly covered by renting out her house, but my parents had to use some of their money as well.


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This sticky topic was created over 16 years ago and has had some notes added on, some questions answered, etc.

But - is the main answer still valid? It's not until the post just before this reply that was dated 3 years ago that says
" it’s universal healthcare for everyone and is free for those who qualify for it (this includes people on a spousal visa - for which you pay an NHS levy)."


So when I look at the application guidance today specifically regarding the Immigration Health Surcharge (IHS) (refer to : https://www.gov.uk/healthcare-immigration-application/who-needs-pay ), this  doesn't specifically exclude people applying on a spouse visa  if they're outside the European Econmic Area (EEA).

Or does it?

That page says "For visa applications made outside the UK, you need to pay if: you’re a national of a country outside the EEA, you’re applying for a visa to work, study or join your family in the UK for more than 6 months (but you’re not applying to remain in the UK permanently)"

On the other hand -  a spousal visa expresses an intent to live permanently in the UK doesn't it?

I have seen repeated comments in the Visa & Citizenship topic in the forums about paying the IHS as part of the applicaton (curently £400year increasing to £624/year starting Ocotber 1 2020) . (refererence: https://homeofficemedia.blog.gov.uk/2020/06/29/media-factsheet-immigration-health-surcharge/ )

Can someone help clarify the topic header of free NHS treatment vs the IHS? I feel like i'm missing some nuance in the answer about getting free NHS treatment. If you're paying the IHS, the NHS treatment isn't free per se is it? Based on what I've read I've just been assuming I'll have to pay the IHS.

Yes, people on spousal visas can get ‘free’ access to the NHS, same as a U.K. citizen does (which the exception of IVF treatment), as long as they pay the IHS surcharge first.

In fact, you cannot even get a spousal visa without first paying the IHS surcharge... as you have to pay the full surcharge for the entire length of the visa upfront when you apply for the visa (currently £1200 for a spousal visa - £400 x 3 years). They cannot issue the spousal visa until you have paid the IHS surcharge.

Once you have paid it and you have the visa, you are entitled to ‘free at point of service’ use of the NHS for the duration of your visa.


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When they say ‘not applying to remain in the UK permanently’, they mean you’re not applying for Indefinite Leave to Remain (ILR), also known as permanent residence in the U.K.

You cannot qualify for ILR until you have lived in the U.K. for 5 years on qualifying visas. Once you have ILR you are entitled to claim UK government benefits... hence the reason you no longer have to pay the IHS surcharge.

So, for the 5 years you spend on ‘spousal’ visas in the U.K., the IHS surcharge is charged as follows:

Spousal visa, valid 2 years 9 months
IHS surcharge = £400/year x 3 years (rounded up) = £1200

Further Leave to Remain (FLR(M)), valid 2 years 6 months
IHS surcharge = £400/year x 2.5 years = £1,000

Indefinite Leave to Remain, permanent residence
No IHS surcharge

Obviously these prices will increase in October when the surcharge goes up.


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It is not free.

It is not free.

True.  Around here, we usually write "free" with quotation marks around it.  Buuuuuuuut, compared to what healthcare costs in the US, it's a bargain.