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Overview

You might need to pay a healthcare surcharge (called the ‘immigration health surcharge’ or IHS) as part of your immigration application.

Whether you need to pay depends on the immigration status you’re applying for.

When you must pay

If you’re making your immigration application online or through a premium service centre, you pay the surcharge as part of your application or when you book an appointment.

If you’re applying by post, you pay the surcharge online before you send your application. You’ll need to include the IHS reference number on your application form.

When you can start to use 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

You’ll still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and assisted conception.

You should bring your biometric residence permit with you when you access healthcare in the UK.

Who needs to pay

For visa applications made outside the UK, you need to pay if:

  • you’re a national of a country outside the European Economic Area (EEA)
  • you’re 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 remain in the UK permanently)

For immigration applications made from within the UK, you need to pay if:

  • you’re a national of a country outside the EEA
  • you’re making an immigration application for any length of time, including applications for 6 months or less (but you’re not applying to remain in the UK permanently)

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

Who only needs an IHS reference number

You still need to use the payment service to get an immigration health surcharge (IHS) reference number but you will not need to pay if:

  • you’re a child under 18 who has been taken into care by a local authority
  • you’re a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you’re their dependant)

The service will tell you that you do not have to pay anything and will give you your healthcare surcharge reference number for your application.

You’ll be able to use the National Health Service (NHS) even if you’re exempt from paying.

Who does not need to pay or get an IHS reference number

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 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 a family member of a European national with European Union treaty rights
  • you’re applying for a visa for the Isle of Man or 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)

You need to pay the healthcare surcharge if you apply for indefinite leave to remain but are only given limited leave. You’ll need to pay before you’re given the leave.

Visitor visas and short-term visas

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 service that’s free.

How much you have to pay

You’ll have to pay:

  • £150 per year for a student or Tier 5 (Youth Mobility Scheme) visa, for example £300 for a 2-year visa
  • £200 per year for all other visa and immigration applications, for example £1,000 for a 5-year visa

Dependants usually need to pay the same amount as you.

The exact amount you have to pay depends on how much leave you’re granted.

You’ll pay half of the yearly amount if your application includes part of a year that is less than 6 months.

You’ll pay for a whole year if your application includes part of a year that is more than 6 months.

You’ll automatically get a partial refund if you paid the healthcare surcharge for more years than you were granted leave. 

If you do not pay

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:

  • 10 working days if you’re inside the UK
  • 7 working days if you’re outside the UK

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

Refunds

You do not need to do anything to get an IHS refund – it’s automatically paid to the account or card you paid with.

You’ll get a full IHS refund if:

  • you paid twice
  • your visa application is refused
  • you withdraw your visa application

You’ll get a partial IHS refund if your visa application’s successful but:

  • you get less time on your visa than you asked for
  • any dependants on your visa application are refused

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 or changing to another visa where you do not need to pay the IHS

How long it takes

You usually get your refund within 6 weeks of getting a decision on your visa application. It can take longer if you appeal or ask for an administrative review after your visa application is refused.

If you appeal or ask for an administrative review

If you applied from:

  • inside the UK – you’ll get your refund up to 6 weeks after your appeal or administrative review is dismissed
  • outside the UK – you’ll get your refund up to 6 weeks after your visa application is refused

You’ll have to repay the IHS if your appeal or administrative review is successful and you’ve already got your IHS refund.

You might have to repay a different amount if:

  • the length of your stay changes
  • you get less time on your visa than you asked for

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