If you’re a Brit who’s been living in the U.S.—or anywhere abroad, really—and you’re returning to live in the UK, you’ll be able to use the NHS again for your healthcare. (Goodbye, expensive American health insurance! Hello again, our beloved and eternally underfunded health service!)

What You Need To Do

Simply complete a GMS1 form to register with your closest GP. Here’s a handy guide on how to register with a GP practice when you get back home.

Proving your Eligibility

According to official government sources, the first time you have treatment anywhere in the NHS you will need to bring proof that you are eligible for free healthcare. You should bring at least 2 of the following documents.

Proof of residence in the UK, which includes:

• proof of your purchase of property or a tenancy agreement
• recent utility or council tax bill payment
• UK bank account showing recent UK activity

Employment status, which includes:

• payslip or letter from employer
• a recent bank statement
• unique tax reference number
• documentation from your local job centre to show that you are receiving job-seekers allowance

You can also use documents that prove you no longer live abroad. For example, paperwork to show that you have:

• sold or rented your house in your previous country of residence
• terminated employment or studies in your previous country of residence
• shipped goods or transferred assets to the UK
• ended insurance policies and utility contracts

Navigating the differences between the U.S. healthcare system and the NHS

A word to the wise, if you’ve become accustomed to the U.S. healthcare system, re-engaging with the NHS might require a bit of an adjustment. Here are some positives and negatives to returning to the UK healthcare system after living in the U.S.

The Positives

The biggest advantage of using the NHS is, of course, the money. Unlike the U.S., where healthcare can be prohibitively expensive without insurance, the NHS provides healthcare that is free at the point of use.

In the U.S., even with insurance, a trip to the emergency room can result in out-of-pocket costs ranging from hundreds to thousands of dollars. On average, an ER visit in the U.S. costs around $1,200, with prices varying widely depending on the services needed.

The NHS, by contrast, is designed to ensure that emergency care is accessible to everyone without financial burden. Whether it’s a minor injury or a severe health crisis, you won’t have to worry about the cost when seeking urgent medical attention in the UK.

Statistics show that the NHS handles over 1 million patients every 36 hours, and while we all know it’s not without its flaws, it is one of the most comprehensive public health systems in the world. For those who have lived in the U.S., where healthcare costs are a leading cause of debt, returning to the NHS can feel like a financial relief.

The Negatives

Of course, there are also plenty of challenges the UK healthcare system. The NHS is notoriously under strain, with longer waiting times for non-emergency treatments and a shortage of medical staff. If you’ve become used to the quicker (albeit more expensive) access to specialists in the U.S., adjusting to NHS wait times can be frustrating.

The average wait time for a non-urgent consultant-led treatment in the NHS was 14.6 weeks in 2023, a figure that highlights the pressure on the system.

Additionally, the range of services covered by the NHS might differ from what you’re used to in the U.S. Some treatments and medications available in America might not be covered, or might only be available through private healthcare in the UK.

In a Nutshell

Returning to the UK and rejoining the NHS offers significant financial relief, particularly in emergency situations, where the costs in the U.S. can be overwhelming.

However, the trade-offs will likely include longer wait times and potentially less immediate access to emergency care. Ultimately it’s all about understanding NHS’s strengths while being prepared for its limitations.