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IHS: Immigration Health Surcharge

Last Date of Content Review: 16 September 2024

When applying for a UK visa, individuals will likely have to pay a healthcare surcharge as part of the visa application. This will enable access to the National Health Service (NHS). This article summarises the who, what, why, where and when surrounding the IHS.

Who needs to pay the IHS?

You will need to pay the healthcare surcharge if you’re applying for a visa or immigration application:

for more than 6 months, if you’re applying outside the UK

for any length of time, if you’re applying inside the UK

You do not need to pay if you’re applying for a visitor visa or to remain in the UK permanently.

N.B. You still need to pay even if you have private medical insurance

Who does not need to pay?

Those requiring an IHS Reference Number

Some individuals will only need an IHS reference number; they need to use the payment service to get an IHS reference number but will not need to pay. The service will state there is no need to pay anything and will provide a healthcare surcharge reference number for the application. These individuals are able to use the NHS even if they are exempt from paying:

a child under 18 who has been taken into care by a local authority

a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you’re their dependant)

Those not requiring an IHS reference number:

Individuals able to use the NHS without paying the surcharge or getting a reference number are those who are:

applying for indefinite leave to enter or remain.

* N.B. An individual will need to pay the healthcare surcharge if they apply for indefinite leave to remain but are only granted limited leave. They will need to pay before the leave is approved.

a health and care worker who is eligible for a Health and Care Worker visa (or their dependant)

applying to the EU Settlement Scheme

a diplomat or a member of a visiting armed forces and not subject to immigration control

a dependant of a member of the UK’s armed forces

the dependant of a member of another country’s armed forces who is exempt from immigration control

a applying for a visa for the Isle of Man or Channel Islands

a British Overseas Territory citizen resident in the Falkland Islands

an asylum seeker or applying for humanitarian protection (or their dependant)

a domestic worker who has been identified as a victim of slavery or human trafficking

applying for discretionary leave to remain in the UK as someone who has been identified as a victim of slavery or human trafficking (or their dependant)

someone to whom the Home Office’s domestic violence concession applies (or their dependant)

being made to leave the UK would be against their rights under Article 3 of the European Convention of Human Rights (or their dependant)

an S2 Healthcare Visitor

eligible for a Frontier Worker permit and have an S1 certificate

There is no need to pay the surcharge or get an IHS reference number for those applying for a:

visitor visa

visa for 6 months or less from outside the UK

N.B. These indivdiuals will need to pay for any NHS care they get at the point they use it - unless it is a service that is free.

Why does the IHS need to be paid?

The Immigration Health Surcharge enables visa individuals to access healthcare within the UK. Individuals can start using the National Health Service (NHS) when they have both paid the surcharge (unless exempt from paying it), and had their visa or immigration application granted. Individuals should be willing to provide their biometric residence permit (if they have one), or prove their status online using a share code (if they have a digital immigration status) when accessing healthcare in the UK.

Please note that visa individuals will still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and assisted conception.

When to pay

The surcharge is calculated and paid as part of the application submission. It is calculated based on the information you provide within your visa application.

What to pay

The immigration health surcharge is:

£1,035 per year for all other visa and immigration applications, for example £3,105 for a 3-year visa, or £5,175 for a 5-year visa.

£776 per year for students, their dependants, children and those on the Youth Mobility Scheme. For example £1,552 for a 2-year visa.

Adult dependants usually need to pay the same amount as the main applicant. The rate for dependent children under the age of 18 is £776 per year.

The exact amount to pay depends on how much leave the applicant is granted. Applicants pay half of the yearly amount if their application includes part of a year that is less than 6 months. Conversely, applicants pay for a whole year if their application includes part of a year that is more than 6 months.

There is an online calculator available to work out the amount to be paid.

How to get a refund

There are a number of circumstances where you will automatically receive a full or partial refund for the immigration health surcharge, depending on your circumstances.

Full Refund

You should automatically receive a refund of the full amount paid if:

you paid twice

your visa application is refused

you withdraw your visa application

Partial Refund

You will get a partial refund if your visa application is successful but:

you get less time on your visa than you asked for

any dependants on your visa application are refused

Useful Tip: Refunds are paid to the account or card that was used to submit the visa application. For those individuals who request a representative submit their application, the refund will be paid to the representative. This can be hard to trace as there is no reference number; it is simply a payment from the Home Office. If you are expecting a refund and used a representative, do keep in contact with them.

Do be aware that you will not get a refund if:

your visa application is successful but you do not come to the UK

you leave the UK before your visa ends, for example to make a new application

you’re told to leave the UK before your visa expires

you’re applying for indefinite leave to remain.

USEFUL REFERENCES

UKVI Online IHS Calculator

IHS Refunds