Immigration Health Surcharge (IHS): Costs, Refunds and Reimbursements 

What is the Immigration Health Surcharge? 

The Immigration Health Surcharge (IHS) is a fee that most eligible visa applicants pay as part of their immigration application to access NHS healthcare in the UK. The IHS is necessary to ensure that those who come to the UK and require healthcare services adequately contribute to their use of the publicly funded NHS.

Who needs to pay the Immigration Health Surcharge? 

Most visa applicants need to pay the IHS if they are applying for: 

• A visa for more than 6 months when applying from outside the UK, unless they are applying to stay permanently; or 
• Any length of time when applying from inside the UK. 

Dependants applying to join or stay with a main visa holder will normally also need to pay the IHS, unless an exemption applies.

Who does not need to pay the Immigration Health Surcharge? 

However, some applicants do not need to pay the IHS, including: 

• Visitors coming to the UK for 6 months or less 
• Holders of indefinite leave to remain (ILR) or UK citizenship 
• Applicants who are granted ILR 
• EU Settlement Scheme (EUSS) applicants 
• Health and care worker visa applicants 
• Isle of Man or Channel Islands visa applicants, and 
• People covered by the Home Office’s domestic violence concession applies 

A full list of all of those who do not need to pay the IHS can be found on the Home Office website¹. 

How much is the Immigration Health Surcharge? 

The Immigration Healthcare Surcharge (IHS) is £1,035 per person per year. For dependent children under 18, Youth Mobility Scheme visa applicants, Student visa applicants and their dependants, the IHS is £776 annually.  

The amount of IHS you pay depends on the length of the visa you are granted for and whether you apply from inside or outside the UK. 

• 6 months or less: No IHS is payable if you apply from outside the UK. Half of the annual IHS cost is payable if you apply from inside the UK. 
• More than 6 months but less than a year: You must pay the IHS for a full year. 
• More than 1 year but no more than 18 months: You must pay the full IHS cost plus half the yearly cost. 
• More than 18 months but no more than 2 years: You must pay the full annual IHS cost for 2 years. 

If you do not pay the IHS, or you do not pay the correct amount, your visa may be refused or delayed.  

When can you get an Immigration Health Surcharge refund? 

You may get a full IHS refund if: 

• you paid the IHS more than once in error 
• your visa application is refused by the Home Office 
• you decide to withdraw your application before a decision is made. 

A partial IHS refund is available where: 

• the visa holder is granted less time on their visa by the Home Office than they applied for, or 
• a member of your family (i.e., your spouse/partner or dependant child) has their UK visa refused. 

The Home Office will not normally offer an IHS refund if: 

• your visa application is approved by the Home Office, but for some reason, you do not come to the UK as planned 
• you decide to leave the UK before the expiry of your visa 
• you are required to leave the UK by the Home Office before your visa expires 
• you are applying for ILR 

For the standard full and partial refund circumstances above, you do not normally need to apply. Immigration Health Surcharge refunds are normally received within 6 weeks of a final decision being made on your visa application. UKVI advises that you should contact them directly if you have not received a refund of your IHS within 6 weeks².  

Who can apply for an IHS refund or reimbursement in other circumstances? 

Some applicants can also apply for an IHS refund or reimbursement based on their healthcare cover, studies or work in health and care. These include: 

• People with an eligible S1 certificate: You may get a full or partial IHS refund if your healthcare is paid for by an EU country, Switzerland, Norway, Iceland or Liechtenstein and you have an S1 certificate registered with the NHS Business Services Authority. 
• Eligible students with an EHIC: You can apply for a full or partial refund if you are a full-time higher-education student in the UK, hold an eligible EHIC issued by an EU country, Switzerland, Norway, Iceland or Liechtenstein, and do not work or intend to work while studying. The period that can be refunded depends partly on when and where the EHIC was issued. 
• Eligible health and care workers³: You may be able to apply for an IHS refund if you paid the IHS and work in an eligible health or care role for an eligible organisation. Under the general reimbursement route, this normally requires at least 6 months’ work averaging at least 16 hours per week. 

Unlike the standard IHS refunds described above, these refund or reimbursements are not generally automatic. Eligible applicants need to apply through the relevant process.

References

¹ GOV.UK: Who needs to pay

² GOV.UK: Contacting UKVI from outside UK

³ GOV.UK: Get an immigration health surcharge refund if you work in health and care