Pay for UK healthcare as part of your immigration application
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1. Overview
You might need to pay a healthcare surcharge (called the ‘immigration health surcharge’ or IHS) as part of your immigration application.
Whether you need to pay depends on the immigration status you’re applying for.
When you must pay
If you’re making your immigration application online, you pay the surcharge as part of your application or when you book an appointment.
If you’re applying by post, you pay the surcharge online before you send your application. You’ll need to include the IHS reference number on your application form.
When you can start to use the NHS
You can start using the National Health Service (NHS) when both:
- you’ve paid the healthcare surcharge (or are exempt from paying it)
- your visa or immigration application is granted
You’ll still need to pay for certain types of services, such as prescriptions, dental treatment, eye tests and assisted conception.
When you access healthcare in the UK, you may need to:
- provide your biometric residence permit, if you have one
- prove your status online using a share code, if you have a digital immigration status
2. Who needs to pay
You usually need to pay the healthcare surcharge if you’re applying for a visa or immigration application:
- for more than 6 months, if you’re applying outside the UK
- for any length of time, if you’re applying inside the UK
You do not need to pay if you’re applying for a visitor visa or to remain in the UK permanently.
You still need to pay even if you have private medical insurance.
Who only needs an IHS reference number
You still need to use the payment service to get an immigration health surcharge (IHS) reference number but you will not need to pay if:
- you’re a child under 18 who has been taken into care by a local authority
- you’re a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you’re their dependant)
The service will tell you that you do not have to pay anything and will give you your healthcare surcharge reference number for your application.
You’ll be able to use the National Health Service (NHS) even if you’re exempt from paying.
Who does not need to pay or get an IHS reference number
You’ll be able to use the NHS without paying the surcharge or getting a reference number if:
- you’re applying for indefinite leave to enter or remain
- 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’re a diplomat or a member of a visiting armed forces and not subject to immigration control
- you’re a dependant of a member of the UK’s armed forces
- you’re the dependant of a member of another country’s armed forces who is exempt from immigration control
- you’re applying for a visa for the Isle of Man or Channel Islands
- you’re a British Overseas Territory citizen resident in the Falkland Islands
- you’re an asylum seeker or applying for humanitarian protection (or you’re their dependant)
- you’re a domestic worker who has been identified as a victim of slavery or human trafficking
- you’re 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’re their dependant)
- the Home Office’s domestic violence concession applies to you (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)
- you’re an S2 Healthcare Visitor
- you’re eligible for a Frontier Worker permit and have an S1 certificate
You need to pay the healthcare surcharge if you apply for indefinite leave to remain but are only given limited leave. You’ll need to pay before you’re given the leave.
Visitor visas and short-term visas
You do not need to pay the surcharge or get an IHS reference number if you’re applying for a:
- visitor visa
- visa for 6 months or less from outside the UK
You will need to pay for any NHS care you get at the point you use it - unless it’s a service that’s free.
3. How much you have to pay
The exact amount you pay depends on the length of the visa you’re given.
A visa may last longer than your course of study or period of employment.
Cost for a year
You’ll have to pay:
- £776 per year for students, their dependants, and those on a Youth Mobility Scheme visa, for example £1,552 for a 2-year visa
- £776 per year for visa and immigration applicants who are under the age of 18 at time of application
- £1,035 per year for all other visa and immigration applications, for example £3,105 for a 3-year visa
Cost for part of a year
The amount you have to pay depends on the length of the visa you’re given and where you apply from.
6 months or less
You do not need to pay the surcharge if you’re applying from outside the UK for 6 months or less.
If you’re applying from inside the UK, you’ll have to pay half the yearly cost. For example:
- £388 for students, their dependants, Youth Mobility Scheme or under-18 applications
- £517.50 for any other application
More than 6 months but less than one year
Wherever you apply from, you’ll have to pay the cost of a full year.
Cost for more than one year
If your visa is for more than a year, you’ll have to pay:
- the yearly cost plus half the yearly cost, if it’s for 18 months or less
- the cost of 2 full years, if it’s for more than 18 months but less than 2 years
Paying for dependants
Dependants aged 18 or over usually need to pay the same amount as you.
Calculate the cost
Calculate how much you’ll have to pay before you apply.
The exact amount you pay depends on the length of the visa you’re given, which may last longer than your course of study or period of employment.
This may mean your actual payment is more than the calculator shows.
Refunds
You’ll automatically get a partial refund if you paid the healthcare surcharge for more years than you were granted leave.
When you must pay
If you apply for a visa online, you pay the surcharge as part of the application.
If you apply for a visa by post, you must pay the surcharge online before you send your application. You’ll need to include your IHS reference number on the application form.
If you do not pay
You’ll get an email from UK Visas and Immigration if you do not pay the surcharge (or do not pay enough) as part of your visa or immigration application.
Check your junk folder if you cannot see the email in your inbox.
Once you get the email, you must pay the surcharge within:
- 10 working days if you’re inside the UK
- 7 working days if you’re outside the UK
Your visa or immigration application will be turned down if you do not pay the full amount in this time.
4. Pay the healthcare surcharge
If you’re making an immigration application online you pay the healthcare surcharge as part of the application process. You must complete the payment and return to the online immigration application in less than 30 minutes.
If you’re making an immigration application by post you must pay the healthcare surcharge before you complete your application.
You must pay the healthcare surcharge by debit or credit card.
If you’re applying online, you’ll be asked for:
- the start and end dates on your certificate of sponsorship, if you have one
- your course dates, if you’re applying as a student
If you’re applying by post, you’ll also be asked for:
- the type of visa you’re applying for
- your passport or travel document number
- an email address
You need to pay by cash at the UK embassy if you’re in the Democratic People’s Republic of Korea.
Family members
You’ll need the same information that you used to pay for:
- any person applying for a visa or other immigration application with you, for example a dependant
- any person you’re applying to join or remain who is already in the UK (you do not need to add this person’s details if they are a UK or EEA citizen)
You’ll also need their leave expiry date if you’re joining someone in the UK (or IHS reference number if they have one).
Finish your visa or immigration application
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You’ll be sent an email with an IHS reference number. This will also be shown on screen when you’ve paid. You can only use this number once - you’ll need to get another one if you reapply.
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You’ll need to write this on the cover of your visa application if you’re applying by post. You need this reference even if you’re exempt from paying the healthcare surcharge.
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Finish your application form and pay your visa or immigration application fee.
5. Refunds
You’ll get a full immigration health surcharge (IHS) refund if:
- you paid twice
- your visa application is refused
- you withdraw your visa application
You’ll get a partial IHS refund if your visa application’s successful but:
- you get less time on your visa than you asked for
- any dependants on your visa application are refused
If you are due a full or partial refund for these reasons, you do not have to do anything to get it. It will be automatically paid to the account or card you paid with.
You will not get a refund if:
- your visa application is successful but you do not come to the UK
- you leave the UK before your visa ends, for example to make a new application
- you’re told to leave the UK before your visa expires
- you’re applying for indefinite leave to remain
If your healthcare is paid for by an EU country, Switzerland, Norway, Iceland or Liechtenstein
If you have an S1 certificate
You may get a full or partial IHS refund if you have an S1 certificate registered with the NHS Business Services Authority.
Find out more about applying for a refund.
If you’re a student
You can apply for a full or partial IHS refund if all of the following are true:
- you’re a full-time student in UK higher education
- your visa started on or after 1 January 2021
- you have a European Healthcare Insurance Card (EHIC) issued in an EU country, Switzerland, Norway, Iceland or Liechtenstein
- you do not work
If you’re claiming as a full-time student with an EHIC, you can apply for a refund of the IHS you paid to cover any period starting on or after:
- 1 January 2021 - if your EHIC was issued in the EU or Norway
- 1 November 2021 - if your EHIC was issued in Switzerland
- 1 January 2024 - if your EHIC was issued in Iceland or Liechtenstein
Applications open from 1 January 2022.
The amount you’re refunded will depend on the date your S1 certificate or EHIC runs out.
Find out more about applying for a refund as an EU or Swiss student.
Apply for a refund as an EU or Swiss student.
If you work in health and care
You and your dependants may be able to get a refund of the IHS if you work in health and care.
Check if you’re eligible for a refund as a health or care worker.
How long it takes
You usually get your refund within 6 weeks of getting a decision on your visa application. It can take longer if you appeal or ask for an administrative review after your visa application is refused.
If you appeal or ask for an administrative review
If you applied from:
- inside the UK - you’ll get your refund up to 6 weeks after your appeal or administrative review is dismissed
- outside the UK - you’ll get your refund up to 6 weeks after your visa application is refused
You’ll have to repay the IHS if your appeal or administrative review is successful and you’ve already got your IHS refund.
You might have to repay a different amount if:
- the length of your stay changes
- you get less time on your visa than you asked for
Contact UK Visas and Immigration (UKVI) if your refund is not paid within 6 weeks.