Immigration Health Surcharge: IHS Rules

immigration health surcharge

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As part of your UK immigration application, you may need to pay the ‘immigration health surcharge’ (IHS). Failing to pay the IHS where it is due will mean your application will be rejected and not processed.

In this guide, we answer frequently asked questions from visa applicants, including what the immigration health surcharge is, who has to pay it and how much it costs.

 

Immigration Health Surcharge 2024

Following proposals published in October 2023, the UK Immigration Health Surcharge increased to £1,035 per main applicant and to £776 for students and child applicants from 6 February 2024.

Visas issued for 3 or 5 years now incur the following charges under the increased Immigration Health Surcharge:

Applicant

Total IHS charge for 3-year visa

Total IHS charge for 5-year visa

1 Adult £3105 £5175
1 Child £2328 £3880
2 Adults £6210 £10,350
2 Adults & 1 child £8538 £14,230
2 Adults & 2 children £10,866 £18,110

 

 

Adult dependants will usually pay the same amount as the main visa applicant.

The exact amount of IHS 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.

You will however still need to pay for certain types of services, such as prescriptions, dental treatment and eye tests.

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 the Immigration Health Surcharge if you are applying for a UK 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.

For immigration applications made from within the UK, you have to pay the Immigration Health Surcharge if you are making an immigration application for any length of time, but you are not applying to permanently remain in the UK.

 

Immigration Health Surcharge exemption for Health & Care Workers

Applicants for the Health and Care visa, as well as their dependants, are automatically exempt from the Immigration Health Surcharge and will not have to pay the IHS fee as part of their visa applications.

 

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)

 

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 the Health & Care Worker visa
  • you are applying as a dependant of a Health & Care Worker
  • 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, or 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.

  1. Register to use the service.
  2. Answer questions to see if you must pay the healthcare surcharge or if you’re exempt.
  3. Pay online if you’re not exempt. You pay the healthcare surcharge in the same currency as your visa application fee.
  4. 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.
  5. Finish your application form and pay your visa or immigration application fee.

 

If applying from overseas, you should check the rules of the relevant embassy or visa application centre on how to pay the IHS.

 

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).

 

Can you claims an IHS refund?

IHS refunds are paid automatically in the following circumstances:

  • The IHS has been paid twice, for example if the worker leaves employment to change to another sponsor in the UK. They will be required to pay the IHS again and will receive an automatic refund for any overpayment.
  • The visa has been refused.
  • The visa has been withdrawn.

 

A partial refund is payable if the visa application is successful but:

  • Less time is given on the visa than was applied for.
  • Any dependants on the visa application have been refused.

 

No refund is given if:

  • The visa application is successful, but the applicant does not come to the UK.
  • The worker or dependent leaves the UK before the visa ends, for example to make a new application.
  • The worker must leave the UK before their visa expires.
  • The worker is applying for indefinite leave to remain or changing to another visa where they do not need to pay the IHS.

 

Need assistance?

DavidsonMorris are UK immigration specialists. If you have a query about the Immigration Healthcare Surcharge, including the increase and its impact on your application or your employees’ applications, please contact us.

 

Immigration Health Surcharge FAQs

How much is the Immigration Health Surcharge fee in 2024?

The Immigration Health Surcharge fee currently costs £1,035 for most applicants per year of leave. A discounted rate of £776 is available for student visa holders, those on the Youth Mobility Scheme and children under the age of 18.

What is Immigration Health Surcharge?

The Immigration Health Surcharge has to be paid by most people applying for a UK visa that lasts more than 6 months.

Who pays UK health surcharge?

The Immigration Health Surcharge is paid by most UK visa applicants, including their dependants, if the visa bwing applied for will be granted for more than 6 months. Exemptions to the IHS include Health & Care Worker visa applicants and their dependants.

Last updated: 6 February 2024

Author

Founder and Managing Director Anne Morris is a fully qualified solicitor and trusted adviser to large corporates through to SMEs, providing strategic immigration and global mobility advice to support employers with UK operations to meet their workforce needs through corporate immigration.

She is a recognised by Legal 500 and Chambers as a legal expert and delivers Board-level advice on business migration and compliance risk management as well as overseeing the firm’s development of new client propositions and delivery of cost and time efficient processing of applications.

Anne is an active public speaker, immigration commentator, and immigration policy contributor and regularly hosts training sessions for employers and HR professionals

About DavidsonMorris

As employer solutions lawyers, DavidsonMorris offers a complete and cost-effective capability to meet employers’ needs across UK immigration and employment law, HR and global mobility.

Led by Anne Morris, one of the UK’s preeminent immigration lawyers, and with rankings in The Legal 500 and Chambers & Partners, we’re a multi-disciplinary team helping organisations to meet their people objectives, while reducing legal risk and nurturing workforce relations.

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