When people budget for a job abroad they think about the visa fee and the flight. Health cover is the cost that catches them out. In some countries it is paid upfront before the visa is even issued. In others it comes out of every pay slip, or it does not start until you have lived there for three months.
This guide explains how health cover works for foreign workers in five popular destinations, what it costs in 2026, and how to protect yourself during the weeks when you are not yet covered by anything.
Quick comparison
| Country | How workers are covered | What you pay |
|---|---|---|
| United Kingdom | National Health Service (NHS), funded through a surcharge paid with the visa | £1,035 per person per year, paid upfront |
| Germany | Compulsory health insurance, usually a statutory fund | About 8.75% of gross salary, with the employer paying the same |
| Canada | Provincial public health plan | No premium in most provinces, but a wait of up to 3 months in some |
| Australia | Private Overseas Visitors Health Cover, required by the visa | Varies by insurer and family size |
| United States | Private insurance, usually through the employer | Monthly premium plus deductibles and co-pays |
United Kingdom: the Immigration Health Surcharge
Most people applying for a UK work visa pay the Immigration Health Surcharge (IHS) as part of the application. It is £1,035 per year for each adult and £776 per year for children under 18, and you pay for the whole length of the visa in one go. A single worker on a three-year Skilled Worker visa pays £3,105. A five-year visa costs £5,175, and every dependant pays the same again.
In return you use the NHS on broadly the same basis as a UK resident from the day your visa starts. You still pay for prescriptions in England, dental treatment and eye tests.
There is one major exception. If you qualify for the Health and Care Worker visa, which covers doctors, nurses and many other health professionals, you and your dependants do not pay the surcharge at all. For a family of four on a five-year visa that is a saving of about £18,000.
Germany: insurance is compulsory
Everyone living in Germany must have health insurance, and you will be asked to prove it when you collect your residence permit. Employees are normally enrolled in a statutory health fund (gesetzliche Krankenversicherung). You choose the fund and your employer registers you.
The general contribution rate is 14.6% of gross pay. Each fund adds its own supplementary rate on top, which averages 2.9% in 2026. The total is split equally between you and your employer, so about 8.75% comes off your salary. Contributions are only charged on income up to €69,750 a year.
Two details matter for families and higher earners:
- A spouse who does not work and your children are covered under your statutory membership at no extra cost
- If you earn more than €77,400 a year you may choose private insurance instead. It can be cheaper when you are young and single, but premiums rise with age, each child needs a separate policy and switching back to the statutory system later is difficult
Statutory cover starts on your first day of employment. If you arrive earlier, for example to look for housing, you need a private travel or “incoming” policy for the days in between. German embassies usually ask for this when you apply for the visa.
Canada: watch the waiting period
Canada’s public health care is run by each province and territory. Whether a temporary foreign worker qualifies, and how quickly, depends on where you live and how long your work permit is. Some provinces make newcomers wait up to three months before coverage begins.
The Canadian government advises newcomers to buy private insurance to cover that waiting period. Even after you have a provincial health card, most plans do not pay for prescription medicines outside hospital, dental care or eye care. Many employers offer a group benefits plan for those costs, so ask about it when you receive the offer. Apply for your health card as soon as you arrive, because the waiting period usually runs from the date you establish residence in the province.
Australia: a visa condition
Temporary skilled workers on the Skills in Demand visa (subclass 482) are subject to visa condition 8501. It requires you to hold adequate health insurance for your entire stay, and you must show evidence of it when you apply. Most workers buy Overseas Visitors Health Cover from an Australian insurer.
Australia has reciprocal health care agreements with a small number of countries, including the United Kingdom, Ireland and New Zealand. Citizens of those countries can enrol in Medicare. Everyone else needs private cover for every family member on the visa. Letting the policy lapse is a breach of your visa conditions, so set the premium up as an automatic payment.
United States: read the benefits package carefully
The United States has no universal public system for working-age people. Most employees get insurance through their employer, and the employer usually pays a large share of the premium. Health costs are high enough that the quality of this plan can change the real value of a job offer by thousands of dollars a year.
Before you accept, ask for the plan summary and check four things:
- Premium: how much is deducted from each pay cheque, for you alone and with your family
- Deductible: the amount you pay yourself each year before the insurer starts paying
- Out-of-pocket maximum: the most you could have to pay in a year
- Start date: employers may impose a waiting period of up to 90 days before cover begins
If there is a waiting period, buy short-term cover for it. A single emergency room visit without insurance can cost more than the flight that brought you there.
Covering the gap: what to look for in a private policy
Nearly everyone who relocates has a period with no cover. It may be the days before a job starts, a provincial waiting period or an employer’s probation window. A private international or travel medical policy fills that gap. Compare policies on these points and not on price alone:
- Medical limit. Check the maximum the policy pays for hospital treatment, and whether the embassy sets a minimum for your visa
- Pre-existing conditions. Many cheap policies exclude them completely. If you have a long-term condition or take regular medication, read this clause first
- Maternity. Often excluded or subject to a waiting period of 10 to 12 months
- Emergency evacuation and repatriation. Useful, and required for some visas
- Excess or deductible. A low premium with a high excess may not help with ordinary doctor visits
- Who is covered. Make sure every family member travelling with you is named
- Whether the insurer is recognised. Some embassies only accept policies from insurers licensed in the destination country
Travel insurance and international health insurance are not the same product. Travel insurance is built for short trips and emergencies. International health insurance is built for people living abroad and includes routine care. For a gap of a few weeks, travel medical cover is normally enough. For a year abroad without access to a public system, you need the second kind.
Five questions to ask your employer before you sign
- From what date am I covered, and by which scheme or insurer?
- Are my spouse and children included, and who pays their premium?
- Will you pay or reimburse the health surcharge or the insurance my visa requires?
- Does the plan include dental, vision and prescription medicines?
- What happens to my cover if my employment ends?
Get the answers in writing. A relocation package that looks smaller on paper can be worth more once health costs for a whole family are included.
Related guides
- UK Nursing Jobs for Overseas Nurses in 2026: NMC Registration, Salary and Full Costs
- How to Open a Bank Account and Build Credit After Moving Abroad for Work
- UK Skilled Worker Visa in 2026: Salary Threshold, Fees and Who Still Qualifies
Official sources
- GOV.UK: pay for UK healthcare as part of your immigration application
- Make it in Germany: health insurance
- Government of Canada: health care for newcomers
- Australian Department of Home Affairs: adequate health insurance
- HealthCare.gov: coverage for immigrants
Figures were checked in October 2026 and change regularly. This article is general information, not insurance, financial or immigration advice. Compare policies and read the full terms before you buy.
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