You do not need private medical insurance for the Global Talent Visa. What you pay instead is the Immigration Health Surcharge, £1,035 per person per year, and it gives you access to the NHS on the same basis as somebody who already lives here.

You pay it at stage two, when you submit the visa application itself, which is after your endorsement has been granted. There is nothing to pay towards healthcare at the endorsement stage. The surcharge is then paid upfront for the entire length of visa you are requesting rather than annually: one year is £1,035 per person, three years £3,105, and five years £5,175 per person. That is normally the largest single line in the budget, well ahead of the £766 in endorsement and visa fees.

Every dependant pays it too, at the same point and on the same terms. Rates for children can differ from the adult rate, so check the current figures before working out a family total, and see my notes on bringing family members for how their applications run alongside yours.

What the surcharge buys is genuine NHS access: registering with a GP, hospital treatment, accident and emergency, maternity care, all on the same terms as a resident. You still pay what residents pay for prescriptions, dental treatment and eye tests. If your visa application is refused or withdrawn, the surcharge is normally refunded, although the application fee is not.

Plenty of people also hold private cover, usually because an employer provides it or because they want faster access to specialists, but it is a choice rather than a requirement and it does not reduce what you owe in surcharge.

Because the cost scales with the length of visa, it is worth deciding that length deliberately rather than by default. A five-year grant costs more on the day you apply, but a shorter one means paying the visa fee and a second round of surcharge when you extend, and it can leave you extending while you wait to qualify for indefinite leave to remain. The rest of the numbers are in my breakdown of what the visa costs.

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