Healthcare in New York: insurance, deductibles and life without the NHS

In New York your health insurance card is as important as your passport, because without it a trip to A&E can cost more than a month's rent.

The short version

• The UK and the US have no reciprocal health agreement. The NHS and your GHIC don't cover you in New York [1].
• Most British residents are insured through their employer. If you're not, you can buy a plan on NY State of Health, the state marketplace, or take out international health insurance [2][3].
• From 1 January 2027, people in the US on most temporary visas can still buy marketplace plans but no longer get federal help with the premiums [3].
• US insurance comes with deductibles, copays and coinsurance, so even insured care costs something at the point of use [4].
• In a real emergency, call 911. Hospital emergency departments must screen and stabilise you whether or not you can pay [5].

Pound conversions in this guide use the Bank of England spot rate of 5 November 2026 (£1 = USD 1.3476).

Why the NHS and GHIC stop at Heathrow

Once you live in the US you're no longer ordinarily resident in the UK, so you're not entitled to free NHS hospital treatment on a visit home either, with a few exceptions. The GHIC is a card for state healthcare in the EU and a handful of other countries. The US isn't one of them, and the FCDO's "Living in the USA" guide says plainly that the US has no reciprocal health agreement with the UK [1].

The FCDO travel advice for the USA, when we checked on 7 November 2026, warned that medical treatment is expensive, that there are no special arrangements for British visitors, and that some hospitals may ask non-residents for a deposit on admission [6]. That's written for holidaymakers, but it's the same system you'll be living in. Our guide to the NHS when you live abroad explains what you can still use back home.

Where your cover comes from

Employer plans

On a work visa, you'll usually be offered a choice of plans when you join, with a short deadline to pick one. Typically you'll choose between a plan with a lower premium and a higher deductible and one where you pay more each month and less when you're ill. Get your spouse and children on it at the same time, because adding them later usually needs a qualifying life event.

NY State of Health and the 2027 change

New York runs its own marketplace, NY State of Health, where you can compare Qualified Health Plans. Open enrolment begins on 1 November every year, and low-income adults who may qualify for Medicaid or the Essential Plan can apply at any time [2].

Immigration status matters here. HealthCare.gov says lawfully present immigrants, which includes people on valid non-immigrant visas, can get marketplace cover. But from 1 January 2027 only lawful permanent residents (green card holders) and a few other groups listed there qualify for the federal savings that bring the premium down [3]. In practice, a Brit on a temporary visa buying their own plan for 2027 should budget for the full premium. The Essential Plan and Medicaid have their own immigration rules, so check your eligibility directly with NY State of Health before you count on either.

International health insurance

Global policies can be a good fit if you're in New York for a year or two, or if your employer offers one. Read the small print on the US: many international policies exclude it or price it separately, because US care is so expensive. Check how they pay hospitals (direct billing or you pay and claim back), and whether pre-existing conditions are covered.

If your partner is American and you're weighing up cover across both countries, our sister site ExpatStateside has a guide to health insurance between countries.

Speaking American insurance

The vocabulary is a bit of a minefield. These are the words that decide what you pay [4]:

• Premium: what you pay every month for the plan, whether you use it or not.
• Deductible: what you pay for covered care before the plan starts to pay. With a $2,000 deductible (about £1,480), you pay the first $2,000 of covered care yourself.
• Copay: a fixed amount for a service, such as a set fee for a GP visit.
• Coinsurance: a percentage of the cost you pay after the deductible, such as 20%.
• Out-of-pocket maximum: the most you'll pay in a year for covered care, after which the plan pays in full.
• In-network: doctors and hospitals that have a deal with your insurer. Going out of network can cost you far more, so check before you book.

A consultant in the UK is a "specialist" here, and many plans want a referral from your primary care doctor first, rather like a GP referral back home. Ask for an itemised bill after any big treatment and compare it with the insurer's "explanation of benefits". Mistakes are common, and querying them is normal.

Finding a doctor in New York

Every doctor in New York speaks English, so the challenge isn't language. It's finding one who takes your insurance and new patients.

1. Log in to your insurer's website and search its directory for in-network primary care doctors near home or work.
2. Ring the practice to check they're in network for your exact plan and taking new patients. Directories go out of date.
3. Book a first check-up early. New-patient appointments can take weeks, and you'll want a doctor on file before you need one.
4. Bring your UK records. Ask your UK GP practice for a summary, and a list of your prescriptions with the drug names.
5. Register with a pharmacy. Chains such as CVS and Walgreens (which runs Duane Reade) are everywhere. Your doctor sends prescriptions to the one you choose.

A quick tip for the medicine cabinet: paracetamol is sold as acetaminophen in the US, often under the Tylenol brand. Some medicines you buy over the counter in Boots need a prescription here, and the other way round.

The big hospital systems in the city include NYC Health + Hospitals, the public system that runs Bellevue, as well as the large private and university networks. Which one you use mostly depends on your insurance network.

Emergencies, urgent care and the cost of getting it wrong

• Life-threatening emergency: call 911 or go straight to a hospital emergency department. Under federal law (EMTALA), a hospital with an emergency department must give you a medical screening and stabilising treatment regardless of your ability to pay [5]. The bill still comes later.
• Urgent but not an emergency (a sprain, a nasty cough, stitches): use an urgent care clinic. They're on high streets all over the city, usually walk-in, and far cheaper than the emergency department. Check your plan covers the one you pick.
• Telehealth: most insurers offer video appointments with a low copay, handy for prescriptions and minor problems.
• An ambulance is usually billed separately and can be expensive. Many New Yorkers take a taxi to the hospital when it's safe to do so.

If your insurer gets a bill wrong, appeal it. And if you're uninsured, ask the hospital about financial assistance before you pay anything.

NYC Care if you fall through the gaps

NYC Care is a programme run by NYC Health + Hospitals for New Yorkers who don't qualify for, or can't afford, health insurance. Members get a card and can use primary and preventive care, specialist care, mental health services and low-cost medicines through the public hospital system [7]. It isn't insurance, it won't help outside NYC Health + Hospitals, and the eligibility details are on the NYC Care website. It's a safety net, not a plan.

Before you fly, and when you're back on a visit

• Have cover in place from the day you land. A gap between your visa start date and your employer plan starting is the classic trap; travel insurance can bridge it.
• Pack a supply of any regular medication, with a copy of the prescription.
• If you need dental and eye cover, check whether your plan includes them. They're often separate policies.
• On trips home, you'll usually need travel insurance for the UK too, as you may be charged for NHS hospital care once you live abroad.

If you'd like a recommendation for a GP who's good with expats, our community group for Brits in the US is the place to ask.

Sources

1. GOV.UK (FCDO): Living in the USA
2. NY State of Health: the official health plan marketplace
3. HealthCare.gov: Coverage for lawfully present immigrants
4. HealthCare.gov glossary: Deductible
5. CMS: EMTALA, the federal emergency treatment law
6. GOV.UK (FCDO): USA travel advice, health
7. NYC Care (NYC Health + Hospitals)

Keep reading

• Cost of living in New York vs London and the UK average
• US work visas for Brits: E-2, L-1, H-1B and O-1
• The NHS when you live abroad (and the S1 for pensioners in the EU)
• Moving abroad checklist for Brits