Healthcare is one of the most important aspects of life abroad that many Nigerians don't fully research before relocating. The systems differ dramatically from Nigeria's largely out-of-pocket model, and understanding how to access care in your new country can be confusing. This guide demystifies healthcare systems in major destination countries and provides practical advice for navigating medical care abroad.
Whether you're on a work visa with employer-provided insurance, a student with limited coverage, or navigating a public healthcare system for the first time, this guide will help you understand your options and make informed decisions about your health.
United Kingdom: The NHS
The National Health Service (NHS) provides healthcare that is largely free at the point of use for UK residents. As someone paying the Immigration Health Surcharge (IHS) with your visa, you're entitled to NHS care just like British citizens.
Registering with a GP
Your first priority upon arrival should be registering with a General Practitioner (GP). The GP is your primary healthcare provider and gateway to most NHS services:
- Find a local GP surgery (clinic) near your home
- Check if they're accepting new patients
- Complete a registration form (available at the surgery or online)
- Provide identification (passport, BRP) and proof of address
- You may be asked to complete a new patient health check
You can search for GP surgeries on the NHS website (nhs.uk) by entering your postcode.
How the NHS Works
GP as Gatekeeper: Unlike Nigeria where you can walk into any specialist, the NHS uses GPs as gatekeepers. For most non-emergency issues, you see your GP first, and they refer you to specialists if needed.
Appointments: Book appointments in advance (sometimes weeks for non-urgent matters). Same-day or next-day appointments exist for urgent issues. Many surgeries offer online booking and telephone consultations.
A&E (Accident and Emergency): For genuine emergencies only—serious injuries, chest pain, difficulty breathing, severe bleeding. Wait times can be long for non-urgent cases.
111 Service: Call 111 for urgent medical advice when it's not a 999 emergency. Available 24/7.
What's Free:
- GP consultations
- Hospital treatment
- A&E visits
- Mental health services
- Prescriptions (in Scotland, Wales, Northern Ireland)
What You Pay For:
- Prescriptions in England (ÂŁ9.90 per item in 2025, or prepayment certificate)
- Dental treatment (subsidized, not free)
- Eye tests (unless exempt)
- Certain services like cosmetic procedures
NHS Challenges and Tips
The NHS, while excellent, faces pressures that can affect access:
- Long wait times for specialist referrals (weeks to months)
- Difficulty getting GP appointments in some areas
- Limited dental availability
Tips:
- Register with a GP immediately, even if healthy
- Use NHS App for booking appointments and viewing records
- Pharmacists can treat many minor ailments
- Consider private insurance for faster access to specialists
United States: Insurance-Based System
The US healthcare system is primarily private and insurance-based. Without insurance, healthcare costs can be devastating. Understanding your coverage is essential.
Types of Insurance
Employer-Sponsored Insurance: Most working Americans get insurance through their employer. As an employee, you'll typically be offered coverage as a benefit. Plans vary in coverage, cost, and network.
Marketplace Insurance (Obamacare): If your employer doesn't offer insurance, you can purchase plans through healthcare.gov during open enrollment periods.
Medicaid: Government insurance for low-income individuals. Eligibility varies by state and may be limited for recent immigrants.
Key Insurance Terms
Premium: Monthly payment for your insurance plan.
Deductible: Amount you pay out-of-pocket before insurance kicks in (can be $500-$10,000+).
Copay: Fixed amount you pay for specific services ($20-$50 for doctor visits).
Coinsurance: Percentage you pay after meeting deductible (often 20%).
Out-of-Pocket Maximum: Maximum you'll pay annually before insurance covers 100%.
Network: Doctors and hospitals that have agreements with your insurer. Out-of-network care costs significantly more.
Getting Care
Primary Care Physician (PCP): Similar to a GP, your main doctor for routine care. Some plans require PCP referrals for specialists.
Urgent Care: Walk-in clinics for non-emergency urgent issues. Cheaper and faster than ERs.
Emergency Room (ER): For genuine emergencies. Very expensive without insurance. Even with insurance, expect significant costs.
Tips for Nigerians in the US
- Understand your insurance plan thoroughly before needing care
- Always check if a provider is in-network before scheduling
- Negotiate bills—US healthcare prices are often negotiable
- Use telehealth services for convenience and cost savings
- Never ignore medical bills—they affect your credit
- Keep emergency savings for healthcare costs
Canada: Provincial Healthcare
Canada's healthcare is publicly funded but administered provincially. Each province has its own health insurance plan.
Provincial Health Cards
Upon becoming a resident, apply for your province's health card:
- Ontario: OHIP (Ontario Health Insurance Plan)
- British Columbia: MSP (Medical Services Plan)
- Alberta: AHCIP (Alberta Health Care Insurance Plan)
- Quebec: RAMQ
Wait Period: Most provinces have a 3-month waiting period before coverage begins. Private insurance is essential during this time.
What's Covered
Covered:
- Doctor visits
- Hospital stays
- Medical tests
- Surgery
- Emergency care
Not Covered:
- Prescription drugs (except in hospital)
- Dental care
- Vision care
- Mental health counseling (often limited)
- Physiotherapy (limited)
Most Canadians have supplementary private insurance (often through employers) for these excluded services.
Tips for Nigerians in Canada
- Get private insurance immediately upon arrival for the wait period
- Register for provincial health plan as soon as eligible
- Find a family doctor—walk-in clinics are for urgent care only
- Use pharmacy for minor ailments—pharmacists can prescribe some medications
- Consider employer or private supplementary insurance for drugs and dental
Germany: Public and Private Insurance
Germany has a dual system of public (gesetzliche) and private (private) health insurance. Most employees are in the public system.
Public Health Insurance
If you earn below a certain threshold (around €67,000/year in 2025), you must join public health insurance. Contributions are split between employee and employer (approximately 15% of salary total).
Major public insurers include TK, AOK, Barmer, and DAK.
Private Health Insurance
High earners, self-employed individuals, and civil servants can choose private insurance. Private insurance offers more choice and potentially faster access but premiums increase with age.
What's Covered
German public insurance is comprehensive:
- Doctor visits
- Hospital care
- Prescription medications (with small co-pays)
- Mental health care
- Preventive care
- Dental care (basic)
- Vision (basic)
Tips for Nigerians in Germany
- Register with an insurance provider immediately upon arrival
- Your employer will typically help with this process
- Find a Hausarzt (family doctor) who speaks English if needed
- Bring prescriptions from Nigeria—they may need to be converted by a German doctor
- Learn key medical terms in German or have a translation app ready
Bringing Medical Records
Before leaving Nigeria:
- Obtain copies of all medical records
- Get records translated if not in English
- List all current medications with generic names
- Obtain vaccination records
- Get enough prescription medication to last initial months
- Obtain prescriptions in international format
Mental Health Abroad
Relocating is stressful, and mental health support abroad differs from Nigeria:
- Mental health is treated more seriously in most Western countries
- Counseling and therapy are widely available
- Stigma is generally lower than in Nigeria
- Many employers offer Employee Assistance Programs (EAP)
- Culturally competent therapists exist for immigrant populations
Don't hesitate to seek help if you're struggling with adjustment, anxiety, or depression.
Emergency Contacts
Know emergency numbers in your new country:
- UK: 999 (emergency), 111 (urgent but not emergency)
- US: 911
- Canada: 911
- Germany: 112 (emergency), 116 117 (non-emergency medical)
- EU (general): 112
Conclusion
Healthcare abroad is different from Nigeria, but once you understand the system, you'll find it's often more accessible and comprehensive. Register with primary care providers early, understand your insurance coverage, and don't wait until you're sick to figure out how the system works.
Your health is your most valuable asset. Taking time to understand healthcare in your new country protects that asset and ensures you can access care when you need it.
Stay healthy!