The much debated health surcharge for migrants who are coming to the UK for more than 6 months to work, study or join family members has now been implemented. It also applies to those applying for leave to remain from inside the UK.

What is it for?

This is a mandatory surcharge which is payable upfront at the time of applying for leave. By paying this surcharge the applicant will be able to use the National Health Service free of charge to the same extent as permanent residents during the validity of their leave. Certain types of services such as prescriptions in England, eye tests and dental treatment will still be chargeable.

How much is it?

The fee is £150 per year for students and £200 per year for everyone else. It is payable upfront for the duration of leave applied for at the time of application. For example, a person applying for a 5-year entry clearance work visa will have to pay a £1,000 health surcharge (£200 x 5 years). Anyone applying for leave that includes less than 6 months of a year will pay half of the annual charge. The full annual charge will apply to those applying for leave, which includes more than 6 months of a year.

Who has to pay?

Anyone making an immigration application for entry clearance or leave to remain in the UK for 6 months or more after the 6^th April 2015 has to pay. Each dependant family member will also have to pay this fee before submitting his or her application.

Exemptions – those who require an IHS reference number

The following migrant’s will not need to pay the surcharge but will be required to obtain an Immigration Health Surcharge (IHS) reference number for their application: 

• Nationals of Australia or New Zealand (due to the reciprocal healthcare agreements that the UK has with these countries)

• Tier 2 (Intra-Company Transfer) applicants and their dependants

• Children under 18 who have been taken into care by a local authority

• Dependants of a member of the UK’s armed forces

• Dependants of a member of another country’s forces who is exempt from immigration control

• A relevant civilian employee employed by NATO or the Australian Department of Defence in the UK and their dependants

Applicants who fall under the above exemptions will be required to go through the online process for the health surcharge. The service will state that no payment is required and will provide an IHS reference number, which will be needed for the application.

Exemptions – those who do not require an IHS reference number

The following migrant’s will not need to pay the surcharge and will not be required to obtain an IHS reference number:

• Visitors are not required to pay this fee. However, they will be charged 150% of the cost of treatment if they use the NHS

• EEA Nationals (although they will need to show a European Health Insurance Card)

• Family members of EEA Nationals who are exercising EU Treaty Rights

• Those applying for Indefinite Leave to Remain (ILR) in the UK. *Those who apply for ILR but are only granted limited leave will need to pay the surcharge and will be informed by UKVI if this happens

• Diplomats or members of visiting armed forces who are not subject to immigration control

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

• Citizens of a British Overseas Territory who are resident in the Falkland Islands 

• Asylum seekers or those applying for humanitarian protection and any dependant

• Those who have been identified as a victim of human trafficking and their dependant

• Those who the Home Office’s domestic violence concession applies to and their dependant

• Any applicant or their dependant where under Article 3 of the European Convention of Human Rights being made to leave the UK would be against their rights 

All migrants who are exempt from paying the health surcharge will still be able to use the NHS.

Other Information

The surcharge is refundable if the visa is refused. UK Visas & Immigration will refund the surcharge automatically in this case. If a visa is issued but the applicant decides not to travel to the UK, the fee will not be refunded.

In the event that the applicant holds Private Health Insurance for the UK, they will still be required to pay the full health surcharge.

The surcharge or any part of it will not be refunded if the person does not use the NHS or departs the UK prior to their leave expiring

Migrants will be required to show their Biometric Residence Permit when accessing the NHS.

How to pay the surcharge

All of the information is available on the government Immigration Health surcharge website: https://www.immigration-health-surcharge.service.gov.uk/payment/start.

Applicants will first need to register to use the service, enter their details then make the payment online. They will be given an IHS reference number, which will be required for the application.

Those who are applying from Bangladesh, Myanmar or the Democratic People’s Republic of Korea will need to pay by cash at an embassy or visa application centre.

Those who are applying from Nepal can either pay in cash or use the online service.