You may need to pay a healthcare surcharge, called the ‘immigration health surcharge’ (IHS), as part of your UK immigration application.
You will then be able to use the National Health Service (NHS). You will however still need to pay for certain types of services, such as prescriptions, dental treatment and eye tests.
How much is the Immigration Health Surcharge?
From 27 October 2020, the immigration health surcharge costs:
- £624 per year main rate for visa and immigration applications
- £470 per year discounted rate for student visa holders, those on the Youth Mobility Scheme and children under the age of 18
Dependants will usually pay the same amount as the main visa applicant.
The exact amount you have to pay depends on how much leave you are granted.
You pay half of the yearly amount if your application includes part of a year that is less than 6 months.
You pay for a whole year if your application includes part of a year that is more than 6 months.
Your visa or immigration application won’t be granted if you don’t pay the healthcare surcharge or your application will be delayed if you don’t pay the right amount.
How does the Immigration Health Surcharge work?
If you have paid the surcharge or you were exempt from paying it, and your visa allows you to be here for more than six months, you will be entitled to free NHS hospital treatment in England on the same basis as an ordinarily resident person. This will apply from the date your visa is granted until it expires.
However, if your visa is curtailed or ended earlier than planned by the Home Office, you will become chargeable for any further NHS hospital treatment from that date on, even if you have paid the surcharge. You will also be charged for any non-exempt treatment you received before the start date of your visa.
If you apply for an extension of your visa, you might also have to pay a further surcharge. If you apply for, and are granted, indefinite leave to remain, you will not have to pay the surcharge.
Paying the surcharge only gives you access to services the NHS provides. Paying the surcharge does not mean you are treated faster. Doctors will assess the urgency of your condition in the same way as ordinarily resident patients are assessed, and if necessary will be placed on a waiting list.
Do you have to pay the Immigration Health Surcharge?
For visa applications made outside the UK, you have to pay if you:
- are a national of a country outside the European Economic Area
- are applying for a visa to work, study or join your family in the UK for more than 6 months (but you’re not applying to permanently remain in the UK)
- have applied and paid your visa fee on or after 6 April 2015
For immigration applications made from within the UK, you have to pay if you:
- are a national of a country outside the EEA
- are making an immigration application for any length of time (but you are not applying to permanently remain in the UK)
- have applied and paid your application fee on or after 6 April 2015
The IHS will be extended to future EEA temporary migrants coming to the UK after 1 January 2021.
Do NHS & social care workers have to pay the Immigration Health Surcharge?
Individuals changing to the new Tier 2 Health and Care visa will get a full refund of any IHS they paid to cover the period from 31 March 2020. To qualify, the individual must have worked for an average of at least 16 hours a week in an eligible health or social care role for a period of at least six months prior to 31 March 2020.
Where the visa holder is eligible, their dependants also qualify for a refund of the IHS.
Refunds should be applied automatically where the IHS was paid after 31 March 2020. Visa holders who have not yet been reimbursed are advised to email the IHS refunds team.
When you need an IHS reference number
You still need to use the service to get an immigration health surcharge reference number but you won’t need to pay if you:
- are a child under 18 who has been taken into care by a local authority; or
- you’re a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you’re their dependant)
Note that since April 2017, the IHS applies to all those applying for a visa for more than 6 months under the Tier 2 (ICT) category (ie the previous exemption no longer applies).
If you fall under one of these exemptions, the IHS online system will recognise your status and that you are exempt from the fee, and will issue your healthcare surcharge reference number that you need for your application.
You will be able to use the National Health Service (NHS) even if you’re exempt from paying.
When you don’t have to pay or get an IHS reference number
You don’t need to get an immigration health surcharge reference number or pay the healthcare surcharge if:
- you are applying for a visitor visa – instead, you’ll have to pay for any healthcare you get through the NHS at the point you use it
- you’re applying for indefinite leave to remain*
- you’re a diplomat or a member of a visiting armed forces and not subject to immigration control
- you’re a dependant of a member of the UK’s armed forces
- you’re the dependant of a member of another country’s armed forces who is exempt from immigration control
- you’re an EU citizen or their family member exercising European Union treaty rights or making applications under the EEA Regulations or EU settlement scheme
- you’re a British Overseas Territory citizen resident in the Falkland Islands
- you’re an asylum seeker or applying for humanitarian protection (or you’re their dependant)
- you’re a domestic worker who has been identified as a victim on slavery or human trafficking
- you’re applying for discretionary leave to remain in the UK as someone who has been identified as a victim of slavery or human trafficking (or you’re their dependant)
- the Home Office’s domestic violence concession applies to you (or you are their dependant)
- being made to leave the UK would be against your rights under Article 3 of the European Convention of Human Rights (or you’re their dependant)
You will be able to use the NHS if you are exempt from paying – except if you are on a visitor visa, in which case you will have to pay for any care you get through the NHS at the point you use it.
*You have to pay the healthcare surcharge if you applied for indefinite leave to remain but are only given limited leave. You will be told by UK Visas and Immigration if this happens.
When do you pay the Immigration Health Surcharge?
You must pay the healthcare surcharge for you and any dependants before you submit or send your visa or immigration application (or book an appointment at a premium service centre).
You will be contacted by UK Visas and Immigration if you didn’t pay the surcharge (or didn’t pay enough) as part of your visa or immigration application.
Your visa or immigration application will be turned down if you don’t pay the full amount:
- within 10 working days if you’re inside the UK
- within 7 working days if you’re outside the UK
How to pay the healthcare surcharge
You must make the payment before you submit or send your visa or immigration application (or book an appointment at a premium service centre).
There are 5 steps to paying the healthcare surcharge and finishing your visa or immigration application.
- Register to use the service.
- Answer questions to see if you must pay the healthcare surcharge or if you’re exempt.
- Pay online if you’re not exempt. You pay the healthcare surcharge in the same currency as your visa application fee.
- You’ll be sent an email with an immigration health surcharge reference number. This will also be shown on screen when you’ve paid. You’ll need to write this on the cover of your visa application if you’re applying online from outside the UK, the cover sheet if applying online from inside the UK or on the application form if applying by post. You need this reference even if you’re exempt from paying the healthcare surcharge.
- Finish your application form and pay your visa or immigration application fee.
You need to pay by cash at an embassy or visa application centre if you’re in Bangladesh, Myanmar or the Democratic People’s Republic of Korea. You can pay in cash or use the online service if you’re in Nepal.
Information you need to make the payment
You’ll be asked for:
- your name
- your nationality
- the type of visa you’re applying for
- your passport or travel document number
- date of birth
- an email address
- your visa application centre if you’re applying overseas
- your course dates if you’re applying as a student
You will also need the same details for:
- any person applying for a visa or other immigration application with you, eg a dependant
- any person you are applying to join or remain who is already in the UK (you don’t need to add this person’s details if they are a UK or EEA citizen)
You will also need their leave expiry date if you are joining someone in the UK (or immigration health surcharge reference number if they have one).
Please contact us if you have any concerns or questions relating to the Immigration Health Surcharge affecting you or your employees.