The Immigration Health Surcharge represents a compulsory payment for most individuals applying for UK visas lasting longer than six months. Established under the Immigration Act 2014, this charge ensures that temporary migrants contribute financially toward NHS services during their stay in the United Kingdom.
When you pay the IHS, you gain the right to access NHS healthcare on equivalent terms to permanent UK residents throughout your visa period. This means you can register with a general practitioner, receive hospital treatment, and utilize NHS services without additional charges at the point of care. However, like British citizens, you remain responsible for prescription fees, dental treatment costs, and optical services charges in England, which fall outside IHS coverage.
Since its introduction in 2015, the Immigration Health Surcharge has generated substantial revenue for the National Health Service, with government figures indicating collections in the hundreds of millions of pounds.
Who is required to pay the Immigration Health Surcharge?
Nearly all applicants for time-limited UK visas must pay the surcharge during their online application process. The requirement applies whether you are applying from overseas for entry clearance exceeding six months, or from within the UK to extend or switch your immigration status.
Each individual named on a visa application must pay separately, including all dependants. For instance, a primary applicant on a Skilled Worker visa bringing a spouse and one child would need to make three distinct IHS payments.
Short-duration visas of six months or less do not require IHS payment. This exemption includes Standard Visitor visas and UK FiancΓ© visas. However, holders of these short-term permissions cannot access free NHS care except for limited services such as general practitioner consultations and minor injury treatment.
When extending your existing leave, you must pay the surcharge again for the additional time requested. Similarly, switching to a different long-term visa category triggers a new IHS payment obligation for the fresh grant of leave.
The surcharge payment forms an essential component of a valid application. You cannot submit your visa application without a confirmed IHS payment and reference number. If you attempt to submit without payment, UK Visas and Immigration will contact you by email, typically allowing 10 working days for UK-based applicants or 7 days for overseas applicants to complete the payment. Failure to pay within this timeframe results in your application being rejected as invalid.
Importantly, holding private medical insurance or making UK National Insurance contributions does not exempt you from paying the Immigration Health Surcharge, payment remains mandatory regardless of alternative coverage.
Which applicants are exempt from the Immigration Health Surcharge?
A limited set of immigration categories qualify for exemption from IHS payment while retaining full NHS access rights.
Health and care sector professionals applying under the Health and Care Worker visa route are exempt, as are their dependants. This exemption recognizes their direct contribution to the healthcare system.
EU Settlement Scheme applicants do not pay the surcharge, nor do Frontier Worker Permit holders who possess a valid S1 certificate.
Diplomatic personnel, visiting military members, and their qualified dependants are exempt, along with individuals covered by specific international agreements, including certain NATO staff and Australian Defence Department employees stationed in the UK.
Protection categories receive automatic exemption: asylum seekers, refugees, humanitarian protection applicants, trafficking and modern slavery victims, domestic violence victims under Home Office concessions, individuals granted Article 3 ECHR relief, stateless persons, and beneficiaries of Ukraine visa schemes. Children under 18 in UK local authority care are similarly exempt.
Applications for indefinite leave to remain and other permanent settlement routes do not require IHS payment. Additionally, individuals granted full or partial fee waivers automatically receive IHS payment waivers.
Exempt individuals maintain complete NHS access without needing an IHS reference number. However, short-term visitors who are exempt from payment may still be directly charged for NHS services they use, except for the limited free services available to all UK residents.
Current Immigration Health Surcharge rates
The surcharge is calculated per person, per year of leave requested. The Home Office applies fixed annual rates and charges in six-month increments, rounding upward for any partial year. A nine-month visa incurs twelve months of charges, while a sixteen-month visa incurs eighteen months of charges.
The standard annual rate stands at Β£1,035 per person. A reduced rate of Β£776 per year applies to specific categories: full-time students and their dependants, Youth Mobility Scheme participants, and any applicant under 18 years of age on the application date.
The entire surcharge amount must be paid upfront during the application process; installment payments or deferred payment options are not available.
Calculating and paying your Immigration Health Surcharge
The online visa application system automatically calculates your IHS obligation and directs you to the payment portal. You must complete payment before submitting your visa application, using either a debit or credit card.
Upon successful payment, you receive a unique IHS reference number that links your payment to your visa application. This reference number is essential for any future refund claims, so retain your payment confirmation documentation carefully.
If you discover an error after payment, for example, if you entered an incorrect visa duration, you must pay any additional amount owed before your visa can be issued.
Consequences of non-payment
Visa applications cannot proceed without valid IHS payment. The immigration rules explicitly require the surcharge, making payment a fundamental validity requirement.
In practice, if you submit an application without completing IHS payment, UK Visas and Immigration will send an email notification. You must pay promptly, typically within 10 working days for UK applications or 7 days for overseas applications. Missing this deadline results in your application being rejected as invalid.
To avoid refusal, ensure you complete the full IHS payment when submitting your visa application.
When you qualify for an Immigration Health Surcharge refund
Because the surcharge is paid in advance, the Home Office provides automatic refunds in specific circumstances where payment exceeds actual requirements.
You receive a full refund if your visa application is refused and all appeal rights have been exhausted, or if your application is withdrawn, voided, or rejected before a decision is made. Since you did not receive the intended immigration permission, the payment is returned.
Accidental duplicate payments, such as system errors that charge the IHS twice for the same application, also result in full refunds.
Partial refunds apply in particular scenarios. If your visa is granted for a shorter period than you requested, you will receive a refund for the unused portion. For example, applying for three years but receiving two years results in one year’s IHS being refunded. When applying as a family, if a dependant’s application is refused while the main applicant succeeds, the IHS paid for that dependant is returned.
Full-time students from EU, EEA, or Switzerland who hold valid European Health Insurance Cards, do not work during their studies, and have visas starting on or after 1 January 2021 may claim partial refunds for periods covered by their EHIC.
Several situations do not qualify for refunds. If your visa is granted but you choose not to use it, perhaps you change plans and never travel to the UK, the surcharge is not refunded. Similarly, leaving the UK before your visa expires does not trigger a refund unless UK Visas and Immigration officially curtails your leave. Switching to an immigration status that does not require IHS payment also does not generate a refund.
Critically, the Home Office does not provide exceptions for IHS refunds in cases of an applicant’s death. Additionally, since indefinite leave to remain and settlement applications never require IHS payment initially, refund questions do not arise for these categories.
Immigration Health Surcharge refund processing timeframes
Automatic refunds are generally processed efficiently once final decisions are made. You do not typically need to apply for a refund for a UK Visas and Immigration returns the payment to the card used for the original transaction.
For straightforward refusals or withdrawals without appeals, expect to see your refund within approximately six weeks of the Home Office decision notification.
Appeals or administrative reviews complicate the timeline. Home Office guidance indicates that refunds are not issued until appeal rights are exhausted. For UK-based appeals, refunds are processed up to six weeks after the appeal is finally dismissed. For overseas applications, refunds are issued up to six weeks after the initial refusal decision.
If you are owed a refund and it has not arrived after six weeks following the relevant decision, contact the IHS refund team or submit an online query through the official channels.
How Lawsentis can assist with your UK visa application
Understanding UK immigration requirements, including the Immigration Health Surcharge, can be challenging, particularly when determining eligibility, exemptions, and calculating correct payment amounts. Errors in IHS payment can lead to application delays or invalidity, making professional guidance valuable.
Lawsentis is an Immigration Advice Authority (IAA) regulated firm, ensuring that you receive immigration advice from qualified professionals who meet rigorous regulatory standards. Our team can guide you through all aspects of your UK visa application, including IHS requirements specific to your visa category.
We can advise on whether you qualify for exemptions, calculate the correct surcharge amount for your circumstances, and ensure your application includes all necessary payments and documentation. If you have questions about refund eligibility or have experienced delays in receiving a refund you believe you are owed, we can assess your situation and advise on appropriate next steps.
Whether you are applying for a work visa, family visa, student visa, or any other UK immigration permission, our IAA-regulated immigration specialists provide tailored support based on your individual circumstances. As a regulated firm, Lawsentis maintains professional conduct standards and appropriate insurance coverage, giving you confidence in the quality and reliability of the advice you receive.
Contact Lawsentis today to discuss your UK visa application and ensure you meet all requirements, including the Immigration Health Surcharge, correctly and efficiently.