Most expats who move to the UK for the first time will need to get a National Health Service (NHS) number and a National Insurance number (NI/NINO). One is related to the UK’s public health system and the other is required for employment purposes. We explain what they are and why you need each one.

UK NHS

What is my NI number?

Anyone who wants to work in the UK is required to have an NI number. This number is made up of a combination of numbers and letters and it is used by the UK government to record your taxes while you’re employed in the UK. It also allows the government to keep a record of any contributions that are owed to you when you leave the UK.

You only need to apply for it once and your number remains the same for life. So, if you leave the UK and end up returning, you won’t have to apply for it again.

Why do I need an NI number?

Generally, employers won’t allow you to work until you receive your NI number. Should you decide to work before receiving yours, you will be required to pay emergency National Insurance contributions. This means that your income will be taxed at an extremely high rate, reducing your nett pay significantly.

How do I get my NI number?

You have to be present in the UK before you can be issued with your NI number. The process can be quite time-consuming and admin-heavy, and you should expect to do a lot of queuing and running around for documents. It can also take anywhere from four to eight weeks to receive your number. The good news is that there are companies that can do it all for you, something which is worth considering when you’re new to a country and trying to find your feet. They can also ensure you get your number sooner. So, if you’ve already started working, you can avoid paying more tax.

What is my NHS number?

The NHS is the UK’s public health system. It’s funded by the government through taxes and is free for all UK citizens. Non-UK citizens are allowed access to the NHS, but need to pay a fee, known as the immigration health surcharge (IHS), when they apply for their visa. The fee varies for each visa and you pay the total amount up front for each year that you will be staying the UK. From 31 December 2020, this fee will apply to citizens from the EU, EEA and Switzerland.

The fee is structured as follows:

  • £470 per year for a student visa or Youth Mobility Scheme visa
  • £470 per year for visa and immigration applicants who are under the age of 18 at time of application
  • £624 per year for all other visa and immigration applications

So, if you’re applying for a five-year visa at £624 per year, you’ll pay £3,120 on application. Your dependants will pay the same amount as you. The fee is mandatory if you’re applying for a visa that’s valid for more than six months, but it also gives you peace of mind that you are covered should you have a health emergency.

It also important to note that even if you’re entitled to free NHS healthcare, you might be charged for some NHS services, like dental treatment, prescriptions and spectacles. It is advisable to contact them directly for information on what is not covered.

How do I find my NHS number?

When you register with the NHS, you’ll receive a unique identity number. This number helps healthcare staff and service providers match you to your health records to ensure that you receive more dependable and effective care.

Your number consists of a unique 10-digit code and is located on medical cards and documents. This number also allows healthcare workers to identify patients and ensure that there aren’t any mix-ups.

The NHS system is designed to ensure that patient records are up-to-date, test results are matched to the correct patient, medication is dispensed correctly, and that correspondence reaches the right person.

How to get an NHS number

You can get an NHS number simply by registering with the GP practice in your area.  You will need the following information to register:

  • Show you are legally living in the area either permanently or temporarily (you must go to your closest GP or your request to register may be denied)
  • Be able to show that you plan to stay for six months or longer

If you started living in the UK after 31 December 2020

You’ll only be able to access the NHS if you have:

  • A visa and paid the immigration health surcharge
  • A visa and are exempt from the immigration health surcharge
  • Indefinite leave to remain
  • Permission to stay as a family member of an EEA citizen who was living in the UK by 31 December 2020


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