The Immigration Health Surcharge (IHS) is a fee levied on visa applicants seeking leave to enter or remain in the UK. In this way, visa holders will have access to NHS services.
As a successful visa applicant, you can start using these services once you have paid the IHS or if you are exempt from paying it. If your visa application is unsuccessful or withdrawn, you will be entitled to an IHS refund. You may also be reimbursed in various other instances.
Below we look at the IHS refund and IHS reimbursement rules in more detail.
What is the Immigration Health Surcharge (IHS)?
When applying for a visa to come to the UK to live or work, you might need to pay a healthcare surcharge. This is called the Immigration Health Surcharge (IHS). Whether or not you need to pay, and how much, will depend on the type of immigration status that you are applying for.
You will usually need to pay the IHS if you are applying for a visa or immigration application outside the UK for more than 6 months, or if you are applying inside the UK for any length of time. Where the surcharge applies, the current rates are:
- £470 per year for a student or Youth Mobility Scheme visa
- £470 per year for under 18s
- £624 per year for all other applications.
The IHS is to be increased to £1,035 per main applicant and to £776 for students and child applicants. The date is yet to be confirmed by the Government, but it is expected to be after either 16 January 2024 or 21 days after both Houses of Parliament have approved the change, whichever is the later date.
You will pay for a full year if your application includes part of a year that is more than 6 months, but just half of the yearly amount for any part of a year less than 6 months. Any dependants aged 18 or over usually need to pay the same amount as you. In either case, payment will need to be made when you submit your application.
What are the IHS refund rules?
The exact surcharge you will have to pay will depend on how much leave is granted by UK Visas and Immigration (UKVI). You’ll automatically get a partial IHS refund if you paid for more years than you were granted leave or any dependants on your application are refused leave. You will receive a full IHS refund if:
- you paid the surcharge twice
- your visa application is refused
- you withdraw your application before a decision has been made.
If you’re entitled to either a full or partial refund for any of these reasons, you will not have to do anything to get it. It will automatically be paid to the account or card you paid with. You will usually get your refund within 6 weeks of getting a decision on your application, although it can take longer if you appeal or seek an administrative review after your visa application is refused. If any appeal or administrative review is successful but you’ve already received your IHS refund, you will need to repay the surcharge on the basis of your successful application.
You may also be eligible for an IHS refund if your healthcare is paid for by an EU country, or if either you’re a qualified healthcare professional or you work in a healthcare setting.
You will not receive a refund if your visa application is successful but you decide not to come to the UK, or if either you leave the UK or are told to leave before your visa expires.
Enquiry about your IHS reimbursement
If you have not received your IHS refund within 6 weeks of any decision on your visa application, appeal or administrative review, you should contact the IHS refunds team at: nhsbsa.IHSreimbursements@nhs.net.
What if my healthcare has been paid for by an EU country?
If you’re an EU citizen, or a citizen of Norway, Iceland, Liechtenstein or Switzerland, and you move to the UK to either work, study or to settle, you will be subject to immigration control under the UK’s new points-based system. This means you will need permission from UKVI in order to be lawfully in the UK. You may also need to pay the immigration health surcharge at the time of your visa application if you’re coming to the UK for a stay of more than 6 months.
The full surcharge amount will need to be paid upfront for the duration of your visa. If, however, your healthcare is paid for by an EU member state, and you have a UK visa that started on or after 1 January 2021, you may be eligible for a full or partial IHS refund, provided you hold an S1 certificate registered with the NHS Business Services Authority.
You can also apply for an IHS refund if you were granted a visa on or after 1 January 2021 as a full-time student in UK higher education. To be eligible you must not work in the UK and hold a European Healthcare Insurance Card (EHIC) issued in an EU country.
Applications for IHS refunds open from 1 January 2022, although your refund will be backdated to include any payments made for a visa starting on or after 1 January 2021. The amount you will be refunded will depend on the date your S1 certificate or EHIC runs out.
Am I eligible for an IHS refund as a health and care worker?
Under the Health and Care Worker visa you will be exempt from paying the immigration health surcharge. If, however, you have come to the UK on a different visa, but go on to meet the eligibility criteria for the exemption, you will be reimbursed for any surcharge paid in respect of any 6-month period from 31 March 2020 where you’re working in a relevant health or social care context. The backdated exemption also extends to eligible family members.
Depending on when you paid the surcharge, you will get a full or partial refund. If you paid on or after 31 March 2020, you will be entitled to a full refund. If you paid before 31 March 2020, you’ll get a partial refund. You’ll be reimbursed for any 6-month period that your IHS payment covered after this date you were working in a qualifying role.
There are different ways to get your money back if you’ve paid the IHS, depending on your visa and job role. If you a hold visa under the Tier 5 Government Authorised Exchange Medical Training Initiative or Tier 5 Medical Training Initiative, a refund will be requested on your behalf by the Academy of Medical Royal Colleges and processed by UKVI. Notification will be sent to you when payment of the refund has been made.
If you hold a Tier 2 (General) visa and you’re a medical professional, you should again get an automatic refund. If you do not hold a Tier 2 (General) visa, or work in another health or care role, you may instead be able to apply for an IHS reimbursement.
If you have a Tier 2 visa as a medical professional
If you are already in the UK on a Tier 2 (General) visa, working in an eligible health or social care occupation, you should benefit from a backdated IHS exemption. Eligible job roles include nurses and doctors, and various other qualified healthcare professionals. If you’re eligible, you will be sent a refund for any time remaining on your visa after 31 March 2020. This will automatically be paid to the account or card you used to pay the surcharge.
If you have not received your IHS refund and you think you qualify, you will need to email the IHS refunds team at: nhsbsa.IHSreimbursements@nhs.net. In your email you should include your name, your sponsor’s name, your Certificate of Sponsorship (CoS) number, your IHS number and the date on which you paid the surcharge. You will usually get a reply within 6 weeks and any refund will be sent back to the account or card you paid with.
If you do not have a Tier 2 visa or work in another health or care role
You can apply online for an IHS reimbursement if either you’re a medical professional but not eligible for an automatic refund, for example, where you do not hold a Tier 2 (General) visa, or you work in another role in a healthcare setting. A healthcare setting includes hospitals, GP practices, care homes and community healthcare facilities.
To be eligible for an IHS reimbursement, you must have paid the surcharge and:
- work for an eligible organisation, for example the NHS or the Care Quality Commission
- be working or have worked in health and social care for at least 6 months, and
- have worked for an average of 16 hours or more a week in that role.
Your job does not need to be in frontline care, so long as it is providing a service related to the delivery of health or social care. This can include the provision of administrative support and management, such as a receptionist in an NHS or care setting, or even a role in support facilities management, such as cleaning or catering. The qualifying period of 6 months can include paid leave, such as maternity or statutory sick leave, although you will not qualify if you had unpaid leave or were unemployed for more than 28 days during the last 6 months.
You can apply for an IHS reimbursement for a single period of 6 months at a time, where the money is paid in 6-month instalments, in arrears, covering the period from 31 March 2020 onwards. This means that you will need to continue to apply every 6 months to claim for additional periods of time where you qualify under the rules.
An application under the IHS reimbursement scheme must be made online on the UK government website. To apply you will need your IHS number, your National Insurance number, your email address, the name of your employer and scanned or screenshot copies of your payslips for the 6 month period that you’re claiming for. If you’re applying for your dependants, you will also need their IHS number.
Your application will be processed by the NHS Business Services Authority (NHSBSA) and, provided the claim falls within the scheme rules, your approved claim will be passed to UKVI for a refund to be issued to you within a period 6 weeks using the original payment method.
At DavidsonMorris we have the experience to advise you on the most appropriate UK visa for your circumstances and have the insight to make the process as smooth as possible.
As a team of immigration lawyers and former Home Office employees, we have an established reputation for effective and efficient management and processing of visa applications, and for providing expert visa-related advice to suit your needs.
IHS refund FAQs
How long does it take to get IHS refund?
The processing times for IHS refunds can vary depending on the reason for the refund. However, this will usually be within 6 weeks of any decision on your visa application or 6 weeks from the date of any reimbursement application.
Who can claim IHS refund?
You can claim an IHS refund if your visa application is refused or withdrawn. You may also be entitled to a reimbursement if your healthcare is paid for by an EU country, or you work in health and social care.
How do I get a refund from the UKVI?
In some instances, you may receive an automatic refund from UKVI for any healthcare surcharge paid, for example, where your visa application has been refused or withdrawn. If you’re eligible, you may also apply online under the IHS reimbursement scheme.
Last updated: 27 November 2023