US citizens moving to the UK part 5: Healthcare, banking and housing

Key Takeaways:

• The NHS is accessible to all UK residents, but visa applicants must pay an Immigration Health Surcharge upfront as part of their visa application.
• Opening a UK bank account is straightforward, with basic accounts available for as little as £1 and no monthly fee, but the direct debit system is central to everyday financial life.
• From May 2026, most short-to-medium residential rentals are governed by the Renters’ Rights Act 2025, with tenancies running on a month-to-month basis and landlords only able to terminate on specified grounds.
• There are no restrictions on non-UK citizens buying property, but non-resident purchasers face a 2% Stamp Duty Land Tax surcharge.

Accessing healthcare in the UK: The NHS and private options

The UK operates a public healthcare system (the National Health Service, or NHS) which is accessible to all UK residents. Visa applicants are required to pay an Immigration Health Surcharge as part of their visa application, which then enables them to access the NHS for free once in the UK. The cost of the surcharge is £776 for children and students and £1,035 per year for all other applicants. All years of the visa are payable upfront; for example, the total surcharge for a three-year visa would be £3,105, or £2,328 for a child or student.

Some NHS services must still be paid for at the point of access, including prescriptions and dental treatment. Non-British or Irish nationals usually need to prove their immigration status when they access services, such as when registering with a doctor. There is no requirement to hold private health insurance for the UK, and payment of the Immigration Health Surcharge is still mandatory even if someone does have private medical cover. However, private health insurance may be of practical benefit in some cases where NHS waiting times are long and accessing treatment privately could be faster.

Opening a UK bank account: What Americans should expect

Most UK banks still operate from a combination of physical premises and online, although online banking is encouraged and there are some banks which operate wholly online. It is also possible to open a current or savings account with a building society. The larger building societies operate much like banks, although it is more common for people to have their main account with a bank.

Income and deposit requirements for many UK bank current accounts are low and you can generally open a basic account with a deposit of as little as £1 and no monthly fee. A basic current account will be sufficient for all day-to-day banking needs. However, most banks operate tiers of accounts, with a monthly or annual fee being payable for the higher tier accounts. These accounts also often have minimum income or deposit rules, for example needing to earn over £100,000. The premium accounts offer different services which may or may not be worth paying for, depending on your needs. For example, they can offer travel and gadget insurance, aircraft lounge entry, concierge services or favourable mortgage rates as part of the premium packages. UK accounts tend to have fewer package benefits than US accounts but are also cheaper.

The direct debit system and everyday payments

In the UK it is very common to pay regular bills such as utilities and local authority council tax using automated payments under the direct debit system. It is possible to pay such bills as they come in, but utility providers in particular tend to offer less favourable rates to non-direct debit users. When opening an account for a utility such as water or energy, you will be asked to consent to a direct debit being set up. If you agree, the provider will organise the direct debit with your bank. Direct debits can generally be cancelled through your online banking, although you should let the provider know if you do this. It is also very easy to make one-off same-day payments either online or through your UK bank’s secure app, for example to send money to friends or family, or to pay a one-off invoice. If you want to set up a regular payment to someone yourself, this can be done digitally by creating a standing order in your online banking or app. Third-party payment apps are very rarely used for this purpose in the UK.

Renting in the UK: Your rights under the Renters’ Rights Act

From 1 May 2026, short-to-medium (seven years or less) residential rentals with an annual rent at or under £100,000 are governed by the Renters’ Rights Act 2025. Tenancies run on a month-to-month basis and can be ended by the tenant on two months’ notice. Landlords can only terminate on specified grounds, for example sale or the property being required for a relative to live in, unless there is a tenancy breach. Rent reviews cannot be more frequent than annual and the tenant may challenge the increase.

Landlords cannot require more than a month’s rent in advance as a deposit. Tenants’ deposits are protected by Government-approved schemes, such as the Tenancy Deposit Scheme, rather than being paid directly to the landlord. Tenants are advised to take out insurance for their property contents, but buildings insurance is the landlord’s responsibility. It is usual for the rental process to be managed by a letting agent who will handle references and payments. You will need to prove your entitlement to rent by providing your immigration documents to the agent or obtaining a share code via the relevant government website. Note that this is the legal position in England; Wales and Scotland have different tenancy laws.

Buying property in the UK: What non-UK citizens need to know

There are no restrictions on non-UK citizens buying property. However, purchasers pay Stamp Duty Land Tax (SDLT) on the purchase price, a one-off tax, and if any purchaser is deemed non-UK resident at the time of purchase there is an additional 2% surcharge. This can be reclaimed in some circumstances if the buyer becomes UK resident within 12 months of the purchase. Again, the property tax position is different in Wales and Scotland.

This is Part 5 of our eight-part series, “US citizens moving to the UK.” Read the other posts in this series for guidance on immigration, tax residence, inheritance planning, US tax traps and education.