What Happens if an American Goes to the Hospital in the UK?

If you’re an American traveling in the UK and suddenly need medical care, you might panic. You’re used to calling your insurance company, checking your network, and wondering how much your copay will be. But in the UK, none of that matters-at least not right away.

You don’t need insurance to get emergency care

The NHS treats anyone who walks into an emergency department, no matter where they’re from. If you break your arm in Edinburgh, have a heart attack in Manchester, or get hit by a bus in London, you will be treated. No one will ask for your insurance card. No one will ask if you can pay. The moment you arrive, you’re treated like a UK resident.

This isn’t charity. It’s the law. The UK’s National Health Service is required by the NHS Constitution to provide emergency care to all, regardless of nationality, immigration status, or ability to pay. That includes tourists, students, and even undocumented visitors.

So if you’re in serious trouble, just go to the nearest A&E (Accident & Emergency). Don’t delay. Don’t call ahead. Don’t worry about paperwork. Your first priority is getting help.

But what about non-emergency care?

Emergency care is free. Everything else? Not so much.

If you need a doctor’s appointment for a cough, a rash, or a chronic condition like diabetes, you can’t just walk into a GP clinic and be seen. General Practitioners in the UK only register patients who are legally resident. Tourists aren’t eligible. That means if you’re feeling unwell but not in danger, you’re stuck.

Your best bet? Go to a walk-in center or an NHS 111 service. Call 111 for free advice-they’ll tell you whether you need urgent care, can wait, or should see a private clinic. Some walk-in centers will treat tourists for minor issues like infections or injuries, but they might charge you later.

And here’s the catch: if you’re not from the EU, Iceland, Liechtenstein, Norway, or Switzerland, you’ll likely be billed for non-emergency care after the fact. That includes things like X-rays, prescriptions, specialist referrals, or even stitches for a deep cut.

How much could it cost?

The UK government charges overseas visitors for non-emergency services at 150% of the NHS cost. That’s not a small fee.

For example:

• A simple GP consultation: £40-£60 (about $50-$75)
• An X-ray: £100-£150 ($125-$190)
• One night in hospital: £400-£700 ($500-$900)
• A prescription: £9.65 per item (about $12), even if you’re not a resident

And if you need surgery? A knee replacement can cost upwards of £10,000 ($12,500). A heart procedure? $30,000 or more.

These aren’t hypothetical numbers. In 2024, the NHS billed overseas visitors over £2 billion for care they received. Most of it came from Americans, Canadians, and Australians-people who assumed their travel insurance would cover everything.

Travel insurance? You need more than you think

Most American travel insurance policies cover emergencies-but not always what you think.

Some policies only pay if you’re treated in a private hospital. Others won’t cover pre-existing conditions. A few won’t pay if you’re treated in a public NHS hospital, even though that’s where you’ll go.

Check your policy. Look for these exact phrases:

• “Covers treatment in public hospitals”
• “Includes emergency care abroad without pre-authorization”
• “Covers pre-existing conditions (if stable)”

If your policy says “private facilities only,” you’re at risk. The NHS will treat you, but your insurer might refuse to pay because you didn’t go to a private clinic.

Also, many policies have a $10,000 or $25,000 cap. That’s not enough for serious care. A single ambulance ride in London can cost $800. Add an MRI and overnight stay? You’re already over $5,000.

Consider upgrading to a policy with at least $100,000 in medical coverage. Companies like Allianz, World Nomads, and GeoBlue offer plans that explicitly cover NHS treatment and include repatriation.

What if you get a bill?

Don’t ignore it.

The NHS has a dedicated team that sends bills to overseas visitors. If you leave the UK without paying, they’ll send the bill to your home address. If you don’t pay, they can report it to credit agencies, sue you, or block you from re-entering the UK.

But here’s the good news: you can negotiate.

Many people get bills for services they didn’t get-or for things that should’ve been free. If you were in an emergency, you can appeal. Send a letter with your passport, travel dates, and proof of insurance. The NHS often reduces or waives charges if you can prove you were in genuine distress.

One American tourist in Bristol broke her hip during a hiking trip. She got a £12,000 bill. She appealed, showed her travel insurance policy, and the NHS cut the bill to £1,500. She paid it in installments.

What about prescriptions?

If you need medication while in the UK, you’ll pay £9.65 per item-even if you’re from a country where prescriptions are free.

Some drugs, like insulin or asthma inhalers, are essential. Don’t skip doses. But don’t assume your US prescription will work. UK pharmacies don’t fill foreign prescriptions. You’ll need to see a doctor to get a new one.

Some pharmacies offer emergency supplies for a fee if you’ve run out. Ask for “emergency supply of medication.” They can help.

What about mental health?

If you’re having a panic attack, suicidal thoughts, or a severe anxiety episode, go to A&E. You’ll be seen.

But follow-up care? That’s harder. NHS mental health services prioritize UK residents. Tourists might get a one-time assessment, but ongoing therapy or medication management? Unlikely.

If you’re on medication for depression or anxiety, bring enough for your entire trip-and a copy of your prescription. Don’t rely on the UK system to refill it.

Bottom line: Be prepared

Here’s what you should do before you fly:

1. Buy travel insurance with at least $100,000 in medical coverage that includes public hospitals.
2. Bring a printed copy of your policy and emergency contact numbers.
3. Carry a 30-day supply of all your prescriptions-with the generic names listed.
4. Know that A&E is your friend for emergencies, but not for routine care.
5. Keep your passport and travel documents handy. You might need them to prove you’re a tourist.

The UK healthcare system is generous-but it’s not a safety net for bad planning. Americans who treat it like home care end up with bills they never expected. Those who plan ahead? They walk away with stories, not stress.

What if you’re staying longer?

If you’re moving to the UK for work, study, or retirement, the rules change. You’ll need to register with the NHS and pay the Immigration Health Surcharge (IHS)-currently £776 per year for most people. Once you pay that, you get the same access as a UK citizen.

But if you’re just visiting? You’re a visitor. And visitors pay.