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Overview of the Immigration Health Surcharge

The Immigration Health Surcharge (IHS) is a compulsory fee that certain visa applicants must pay to access the National Health Service (NHS) in the United Kingdom. The IHS was introduced on 6th April 2015 as part of the Immigration Act 2014. It was designed to ensure that migrants who come to the UK for more than six months contribute to the cost of their healthcare, similar to how UK citizens and permanent residents pay for healthcare through taxes.

The funds generated from the IHS are allocated to the NHS and are meant to cover the healthcare costs of the visa holder during their stay in the UK. This includes general healthcare services, such as doctor’s appointments and hospital treatment. However, the IHS does not cover services such as prescriptions or dental care, which typically require separate payments.

Who needs to pay the Immigration Health Surcharge?

The Immigration Health Surcharge (IHS) is payable by the main applicant and any dependants in the following scenarios:

  • When submitting a visa or immigration application from overseas for durations exceeding six months
  • When applying from within the UK, regardless of the visa duration

There are several notable exceptions to this criteria. There is no obligation to pay the IHS fee when applying for a visitor visa or for Indefinite Leave to Remain in the UK. However, you must pay the healthcare surcharge if you apply for ILR but are only given limited leave to remain instead. In this situation, you must pay before you are given further leave to remain.

Once you have paid the IHS amount due for your visa, you will be allocated an IHS Reference Number. This number essentially acts as confirmation of your payment and means you can access NHS healthcare.

It’s important to note that you must still pay the NHS Surcharge even if you have private medical insurance.

Who does not need to pay or get an IHS Reference Number?

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

  • You are applying for an Indefinite Leave to Enter or Remain (ILR) Visa;
  • you’re a health and care worker who is eligible for a Health and Care Worker visa (or you’re their dependant);
  • you’re applying to the EU Settlement Scheme;
  • You are a diplomat or a member of a visiting armed forces and not subject to immigration control;
  • you’re a dependent of a member of the UK’s armed forces;
  • you are the dependant of a member of another country’s armed forces who is exempt from immigration control;
  • you are applying for a visa for the Isle of Man or the Channel Islands;
  • You are a British Overseas Territory citizen resident in the Falkland Islands;
  • You are an asylum seeker or applying for humanitarian protection (or you are their dependant);
  • You are a domestic worker who has been identified as a victim of slavery or human trafficking;
  • You are 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 are their dependant);
  • The Home Office’s domestic violence concession applies to you (or you are their dependant);
  • being made to leave the United Kingdom would be against your rights under Article 3 of the European Convention on Human Rights (or you are their dependant);
  • you’re an S2 Healthcare Visitor;
  • you’re eligible for a Frontier Worker permit and have an S1 certificate;


It’s important to highlight that, despite not needing to pay the IHS fee, you will retain access to the services offered by the National Health Service (NHS).

Who only needs an IHS Reference Number?

In some instances, it is necessary to obtain an IHS Reference Number, even though the applicant doesn’t need to pay the IHS fee. In such cases, you must still utilise the online payment service to obtain an Immigration Health Surcharge (IHS) reference number. However, you will not be required to make a payment if:

  • You are a minor under 18 years of age who is under the care of a local authority.
  • You are an eligible civilian employee affiliated with NATO or the Australian Department of Defence working in the UK, or you are a dependent of such an employee.

In these cases, the service will inform you that no payment is necessary and will provide you with your healthcare surcharge reference number for your application.

It’s worth noting that even if you are exempt from making a payment, you will still have full access to the services provided by the National Health Service (NHS).

UK Visitor Visas and UK Short-term Visas

You are not required to make a payment or obtain an IHS Reference Number in the following instances:

  1. If you are applying for a UK Visitor Visa.
  2. If you are applying for a UK Visa for a duration of six months or less from outside the UK.

However, please be aware that you will be responsible for covering the cost of any NHS care you receive when you use it unless the service is free. If you’re visiting the UK, it’s recommended that you take out comprehensive travel insurance to cover you for any medical emergencies.

How Much is the Immigration Health Surcharge?

The Immigration Health Surcharge is currently set at a standard rate of £624 per adult per year and £470 per child under the age of 18 per year. The only exception to this policy is for students and youth mobility visa scheme applicants. Both visa categories will benefit from paying the lower fee of £470 per year. However, in July 2023, the UK Government announced plans for the IHS fee to rise by 66%, meaning adults would now pay £1,035 and children under 18 would pay £776 per year.  While these fee increases have not yet been implemented, they will likely be in place from 2024 onwards.

The Immigration Health Surcharge fee is payable upfront for the duration of your visa. This means that you will need to pay the following:

Visa Duration (Years)Full Fee (£624)Reduced Fee £470)
2.5 £1,560£1,175

The fee is charged in 6-month increments, so if your visa is for 2 years and 9 months, you must pay the fee for 3 years (£1,560 / £1,175). Likewise, if you receive a 3-month extension to your visa in the UK, you will need to pay the IHS for 6 months (£312 / £235).

The IHS fee is not refundable if you leave the UK early. The only instances where the IHS fees are refunded to you are:

  • If you have paid IHS fees for a period longer than the length of the visa issued to you
  • If your visa application is declined or if you withdraw your application

In both of these instances, you will automatically receive a refund.


When and how do I Pay the Immigration Health Surcharge?

The Immigration Health Surcharge is payable at the point of application. As all visa applications are now made online, you cannot submit your application without paying the visa application fee and the relevant IHS fee. All fee payments must be made online via a debit or credit card.

When am I Able to Use the NHS?

You can commence utilising the services offered by the National Health Service (NHS) when two conditions are met:

  1. You have paid the applicable IHS Fee in full or are exempt from it.
  2. Your visa or immigration application has been approved.

While you can access the NHS, it’s important to note that specific services, like prescriptions, dental treatment, and eye examinations still require separate payments. It’s also important to fully disclose any pre-existing health conditions in your visa application where appropriate.

When seeking healthcare in the UK, you may be asked to:

  • Present your biometric residence permit if you possess one.
  • Verify your immigration status electronically using a share code, should you have a digital immigration status.