Immigration Health Surcharge Explained (IHS Fee)

What is the IHS?

As part of your immigration application, there is a fee known as the Immigration Health Surcharge or IHS that may be required to be paid if you plan to stay in the UK. You will still be required to pay even with private medical insurance.

Paying the surcharge only gives you access to the UK’s National Health Service (NHS) provides. Paying the surcharge does not mean you are treated faster. Doctors will assess the urgency of your condition the same way. Ordinarily, resident patients are assessed and will be placed on a waiting list if necessary.

Migrants already pay for the NHS through taxes, so the surcharge represents a tax on UK visas. It is levied in addition to Home Office administration fees.

Who needs to pay the IHS fee?

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

• for more than six months, if you’re applying outside the UK
• for any length of time, if you’re applying inside the UK
• If you’re from the EU, Switzerland, Norway, Iceland or Liechtenstein, you only need to pay if you’re applying to come to the UK from 1 January 2021.

Who does not need to pay the IHS fee?

You’ll be able to use the NHS without paying the surcharge or getting a reference number if:

• you’re applying for indefinite leave to enter or remain
• you’re a health and care worker who is eligible for a Tier 2 Health and Care visa (or you’re their dependant)
• you’re a diplomat or a member of visiting armed forces and not subject to immigration control
• you’re a dependent 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 a family member of a European national with European Union treaty rights
• you’re applying for a visa for the Isle of Man or the Channel Islands
• 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 of 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’re 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).

Do visitors need to pay the IHS?

You do not need to pay the surcharge or get an IHS reference number if you’re applying for a:

• visitor visa
• visa for 6 months or less from outside the UK

You will need to pay for any NHS care you get at the point you use it – unless it’s a free service.

How do I pay the Immigration healthcare surcharge?

You must make the payment before you submit or send your visa or book an appointment at a premium service centre.

There are five 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 are 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 the screen when you’ve paid. You’ll need to include this reference number with your visa application
• Finish your application form and pay your visa or immigration application fee

You need this reference number even if you’re exempt from paying the healthcare surcharge.

You must pay by cash at an embassy or visa application centre if you’re in Bangladesh, Myanmar or the Democratic People’s Republic of Nepal.

When can I start using the NHS?

You can start using the National Health Service (NHS) when both:

• you’ve paid the healthcare surcharge (or are exempt from paying it)
• your visa or immigration application is granted.

Which NHS services can I use?

Primary care services such as GP and nurse consultations. You’ll need to pay for certain services, such as prescriptions, dental treatment, eye tests and assisted conception. For more information, visit the government website here.

How much do I need to pay for the Immigration Health Surcharge?

As per the Immigration (Health Charge) (Amendment) Order 2020 (SI 2020 No. 1086) made on 6th October 2020, the Immigration Health Surcharge will increase from £400 a year to £624 a year on 27 October 2020. As a result, UK immigration applications sent in before the 27th will be hundreds of pounds cheaper than those completed after that date.

The order also provides that applicants for a Health and Care visa are exempt from paying the surcharge. 

A reduced rate of £470 will apply to students, dependants of students, Youth Mobility visa holders and anyone under 18.

What information do I need for the IHS payment?

There is certain information you will need to provide when paying for IHS, this includes;

• dependents applying for a visa
• or a family member in the UK you are planning to join. Included should be their immigration health surcharge reference number or leave expiry date.

Is IHS fee refundable?

The surcharge is expected to be paid at the beginning of every visa application process, and applicants whose visa application processes were unsuccessful will be refunded. Refunds are done within six weeks of getting a decision on your visa. Otherwise, you will get a full refund if:

• you paid twice, or 
• you withdraw your visa application

You’ll get a partial IHS 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.

What happens if I do not pay the IHS?

You’ll get an email from UK Visas and Immigration if you do not pay the surcharge (or do not pay enough) as part of your visa or immigration application.

Check your junk folder if you cannot see the email in your inbox.

Once you get the email, you must pay the surcharge within the following

• Ten working days if you’re inside the UK
• Seven working days if you’re outside the UK

Your visa or immigration application will be turned down if you do not pay the total amount at this time.