Our Guide to the Immigration Health Surcharge (IHS)

The UK’s National Health Service (NHS) provides free publicly funded healthcare to UK nationals, permanent residents, and EEA nationals. Non-EEA nationals applying for a visa to come to or remain in the UK may need to pay a fee to use the NHS; this is referred to as the Immigration Health Surcharge (IHS).

What is Immigration Health Surcharge (IHS)?

The IHS is a fee added to most immigration applications to enable those coming to the UK to access the NHS. While not all health services in the UK are included within the IHS, (prescriptions, dental treatment, and eye tests are not included), GP, hospital, and emergency services can be accessed. The IHS fee is still payable whether you have private medical insurance or not.

Who is required to pay the IHS?

The IHS is paid by the majority of UK non-EEA visa applicants and dependant family members, including those applying for a visa to work, study or join family members (including spouses) in the UK for:

• more than six months - if applying from outside the UK
• any length of time if applying from within the UK (i.e. if you are applying for limited leave to remain)

The IHS is not paid by:

• indefinite leave to remain (ILR) applicants, as you will be eligible to access the NHS if ILR is granted
• short-term visitors to the UK
• fiancé(e) visa applicants
• nationals of the European Union (EU) exercising their treaty rights of free movement in the UK
• family members of a European national exercising EU treaty rights
• EU nationals with pre-settled or settled status

As defined by the Home Office, there are a range of specific scenarios under which you may not be required to pay the IHS, including if you are:

• a diplomat or a member of visiting armed forces and not subject to immigration control
• a dependant of a member of the UK’s armed forces
• the dependant of a member of another country’s armed forces who is exempt from immigration control
• applying for a visa for the Isle of Man or the Channel Islands
• a British Overseas Territory citizen resident in the Falkland Islands
• an asylum seeker or applying for humanitarian protection (or you’re their dependant)
• a domestic worker who has been identified as a victim of slavery or human trafficking
• an applicant seeking 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)
• subject to the Home Office’s domestic violence concession (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)

How much is the IHS?

Under the current immigration rules, as set out in the Immigration (Health Charge) (Amendment) Order 2018, the fee for students or Tier 5 (Youth Mobility Scheme) visa is £300 per year. All other applicants will pay £400 per year.

It is important to remember that the full cost of the IHS is payable when you submit your application online. If you are applying for a multi-year visa, you will need to pay the IHS for the whole period upfront.

Calculating IHS if the period is not a round number of years

If applying for a visa of fewer than six months, you will pay half of the applicable yearly IHS fee. If the total amount of leave you are applying for includes part of a year (e.g. as in the case of spouse visa of two years and nine months), you will need to round the period to the nearest half-year; hence, two years and nine months would be rounded to three years, whereas two years and six months would remain as is.

If you need help calculating the amount of IHS you will need to pay, the Government provides an online IHS calculator for visa applicants.

If your visa application includes dependants, you will need to pay their IHS at the same time. For example, if you, your spouse, and a dependant child are applying for a Visa lasting three years, the IHS fee will be £400 x 3 years x 3 people = £3,600.

Paying the IHS

There is little choice but to pay at the point of submitting your online application by debit or credit card. If you are applying by post, you will be required to pay the IHS online before posting your forms.

Under which circumstances will the Home Office refund the IHS?

The Home Office website confirms that you will receive an automatic IHS refund if you paid twice (in error), you withdraw your application, or your application is declined.

If you are given less time on your visa than requested or a dependent included on your application is refused a visa, you will receive a partial refund of the IHS you have paid.

Refunds are not provided if your visa application is successful, but you then do not come to the UK, you leave the UK before your visa period expires, you are told to leave the UK prior to the expiry of your visa, or you are applying for ILR or changing to another visa which does not require payment of the IHS.

Final words

There is no escaping the fact that IHS fees can become quite costly, especially if you are paying for multiple years and for a number of dependants. It will, however, provide you with peace of mind that at any point in your time in the UK, you and your dependents will be able to receive routine and urgent healthcare.

Related article: Read also 'The new Health Surcharge fee set to increase October 2020'