NHS Surcharge for Migrants 2015


NHS Surcharge for Migrants 2015 (Updated 23/03/15)

The much debated NHS health surcharge for migrants, provision of the May 2014 Immigration Act, is expected to come into effect in April 2015. Secondary legislation under the Immigration Act as regards the NHS surcharge is expected to be passed later this year.

The changes, part of the Immigration Act which became law last year, will ensure that migrants make a proper financial contribution to the cost of their NHS care. In England alone, use of the NHS by overseas visitors and migrants is estimated to cost up to £2 billion a year – with £950 million of this being spent on temporary, non-EEA workers and students. In setting the surcharge levels, the government has considered the wide range of free health services available to migrants alongside the valuable contribution they make and the need to ensure the UK remains attractive to the brightest and the best from around the world.


Have you ever received medical treatment in the UK?

This question is already included on the UK Visa Application Form and, as expected, a “health surcharge” will be introduced on 6 April.

Nationals from outside the European Economic Area (EEA) coming to the UK for longer than six months will be required to pay the surcharge when they make their immigration application. It will also be paid by non-EEA nationals already in the UK who apply to extend their stay.

Have you or any family members ever received medical treatment in the UK?

If you answer YES, please answer the questions below:

  • Did you have to pay for the treatment? Where did you receive the treatment?
  • Provide Organisation Address
  • Treatment Start Date:
  • Treatment End Date:

How much will be payable?

The health surcharge will be £200 per year and £150 per year for students, payable upfront and for the total period of time for which migrants are given permission to stay in

Dependents will generally pay the same amount as the main applicant.

Where will the money be directed?

The government is set to recoup up to £1.7 billion over the next ten years to help pay for the cost of NHS treatment given to temporary migrants.

The money collected by the Home Office will be passed to the health departments in England, Wales, Scotland and Northern Ireland.

Having paid the surcharge, migrants will have the same access to the NHS as a UK permanent resident while their stay in the UK is lawful.

Non-EEA nationals visiting the UK on a tourist visa will not pay the health surcharge, but will continue to be fully liable for the costs of any NHS treatment at the point they receive it.

The Department of Health is also working on proposals that will mean from April non-EEA visitors who use the NHS will be charged 150% of the cost of their treatment. This means that for a £100 procedure, they could be billed £150. This reflects the additional cost burden the NHS carries when managing the administration for visitors to the UK.

A question to consider…who will actually pay the surcharge?

For a migrant worker with 3 dependents, the charge will be £800 payable when they make their immigration application.

Will this cost fall to the Sponsor – with possible claw back in the employee’s contract?

A point to note……migrants entering the UK under the Tier 2 categories must also meet the “Maintenance” requirement. Sponsors must “tick that box” when assigning the Certificate of Sponsorship to confirm that either they as an A-Rated Sponsor certifies that they will support the main applicant and their dependents for their first month in the UK as Tier 2 visa holders – or the applicants themselves are required to provide evidence of having available funds of £945 for the main applicant and £630 for each dependent.

These funds must be held for a consecutive 90 day period ending no more than 1 month before the application is submitted.

The purpose of this maintenance requirement is to ensure that migrants do not require access to public funds.

Will we see an amendment to the Certificate of Sponsorship:

  • Tick to confirm the sponsor certifies maintenance for the migrant: Y
  • Tick to confirm that the sponsor is responsible for the health surcharge: Y


(Previous post from 7th November 2014)

The much debated NHS health surcharge  for migrants provision of the May 2014 Immigration Act is expected to come into effect in April 2015. Secondary legislation under the Immigration Act as regards the NHS surcharge is expected to be passed later this year.

This will take the shape of a payment made as part of the UK visa application process. The annual NHS surcharge for migrants will be applicable to all non-EEA citizens who are applying for a Tier 1, Tier 2 (excluding Intra-Company Transfers), Tier 4 or Tier 5 visas which are longer than 6 months in duration.

The NHS surcharge for migrants will affect all new out of country and in country applications. The fee is expected to be £200 per year. Contrary to the indications during the consultation period for the Immigration Bill 2014, the amount will be payable in full upfront at the point of application – this is applicable for main applicant and dependant applications. Previous understanding was that the surcharge would be paid annually, but it appears this will not be the case when the provision comes into effect and practice next year.

The total amount payable will depend on the length of the visa which is being applied: for example, a Tier 2 (General) migrant making a five-year visa application would need to pay the annual amount for all five years upfront, equalling a total of £1,000 in addition to Home Office visa Application fees. When added to the visa application fee and any maintenance requirements, this becomes a very significant, substantial and completely crazily burdensome amount required to be paid by migrants (or employers, if that is the arrangement and understanding).

The surcharge will also apply to any dependent applications. So, for example, for a main applicant with a dependant spouse and two dependant children, the cost in NHS surcharge alone will be £4000, excluding visa application and maintenance requirement costs.

Students will be subject to a lesser charge of £150 for each year expected to stay in the UK.

Tier 2 (Intra-Company Transfer) migrants will be exempt from the surcharge and will continue to access NHS care free of charge.

As a part of this new incentive, all EU migrants and visitors will be required to show a European Health Insurance Card in order to avoid being charged.

GP services and nurse consultations at primary care level will remain free of charge for all.


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 500and 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.

Legal Disclaimer

The matters contained in this article are intended to be for general information purposes only. This article does not constitute legal advice, nor is it a complete or authoritative statement of the law, and should not be treated as such. Whilst every effort is made to ensure that the information is correct at the time of writing, no warranty, express or implied, is given as to its accuracy and no liability is accepted for any error or omission. Before acting on any of the information contained herein, expert legal advice should be sought.

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