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Most people need to pay the immigration health surcharge (IHS) as part of their online immigration application.

Whether you need to pay depends on the immigration status you鈥檙e applying for.

When you can start to use the NHS free of charge

You can start using the NHS free of charge from the date your visa starts. You must have already paid the IHS if you need to. Find out who needs to pay the IHS.

You鈥檒l still need to pay for certain types of services, and assisted conception.

When you access healthcare in the UK, you may need to prove your status online using a share code, if you have a digital immigration status.

You usually need to pay the healthcare surcharge if you鈥檙e applying for a visa or immigration application:

• for more than 6 months, if you鈥檙e applying outside the UK

• for any length of time, if you鈥檙e applying inside the UK

You do not need to pay if you鈥檙e applying for a visitor visa or to remain in the UK permanently.

Who does not need to pay

You鈥檒l be able to use the NHS without paying the surcharge or getting a reference number if:

• you鈥檙e applying for indefinite leave to enter or remain

• you鈥檙e a health and care worker who is eligible for a Health and Care Worker visa (or you鈥檙e their dependant)

• you鈥檙e applying to the EU Settlement Scheme

• you鈥檙e a diplomat or a member of a visiting armed forces and not subject to immigration control聽

• you鈥檙e a dependant of a member of the UK鈥檚 armed forces聽

• you鈥檙e the dependant of a member of another country鈥檚 armed forces who is exempt from immigration control听听

• you鈥檙e a British Overseas Territory citizen resident in the Falkland Islands聽

• you鈥檙e an asylum seeker or applying for humanitarian protection (or you鈥檙e their dependant)

• you鈥檙e a domestic worker who has been identified as a victim of slavery or human trafficking听听

• you鈥檙e 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鈥檙e their dependant)听听

• the Home Office鈥檚 domestic violence concession applies to you (or you鈥檙e 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鈥檙e their dependant)

• you鈥檙e an S2 Healthcare Visitor

• you鈥檙e eligible for a Frontier Worker permit and have an S1 certificate

• you鈥檙e a child under 18 who has been taken into care by a local authority

• you鈥檙e a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you鈥檙e their dependant)

• you鈥檙e applying to stay in the UK as a victim of human trafficking or slavery (or you鈥檙e the dependant of someone who is)

• you鈥檙e applying to stay in the UK as a stateless person

• you鈥檙e applying for the Ukraine Extension Scheme or for a visa under the Homes for Ukraine Sponsorship Scheme

Visitor visas and short-term visas

You do not need to pay the surcharge if you鈥檙e 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鈥檚 a service that鈥檚 free.

If you鈥檙e applying for a visa for the Isle of Man or Channel Islands

You do not need to pay the IHS.

You will need to pay for any NHS care you get at the point you use it.

The exact amount you pay depends on the length of your visa.

A visa may last longer than your course of study or period of employment.

Cost for a year

You鈥檒l have to pay:

• 拢776 per year for students, their dependants, and those on a Youth Mobility Scheme visa, for example 拢1,552 for a 2-year visa
• 拢776 per year for visa and immigration applicants who are under the age of 18 at time of application
• 拢1,035 per year for all other visa and immigration applications, for example 拢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鈥檙e given and where you apply from.

6 months or less

You do not need to pay the surcharge if you鈥檙e applying from outside the UK for 6 months or less.

If you鈥檙e applying from inside the UK, you鈥檒l have to pay half the yearly cost. For example:

• 拢388 for students, their dependants or under-18 applications
• 拢517.50 for any other application

More than 6 months but less than one year

Wherever you apply from, you鈥檒l 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鈥檒l have to pay:

• the yearly cost plus half the yearly cost, if it鈥檚 for 18 months or less
• the cost of 2 full years, if it鈥檚 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.

If you do not pay

You鈥檒l get an email from UK Visas and Immigration if you do not pay the surcharge (or do not pay enough).

The email will explain how to pay. It will go to the email address given in your visa application.

Once you get the email, you must pay the surcharge within:

• 10 working days if you鈥檙e inside the UK
• 7 working days if you鈥檙e outside the UK

You鈥檒l pay the immigration healthcare surcharge (IHS) when you apply for your visa.

You鈥檒l be asked for:

• the start and end dates on your certificate of sponsorship, if you have one
• your course dates, if you鈥檙e applying as a student

Family members

When you apply, you鈥檒l need to give your own details and those of your dependants, if they鈥檙e applying at the same time.

You鈥檒l also need the details of anyone you鈥檙e applying to join or remain with in the UK who is already here, unless:

• they鈥檙e a UK citizen

• they have EU settled status

• they have permission to stay in the UK permanently

You鈥檒l need their visa expiry date if you鈥檙e joining someone in the UK (or IHS reference number if they have one).

Finish your visa or immigration application

1. You鈥檒l be sent an email with an IHS reference number. This will also be shown on screen when you鈥檝e paid. You can only use this number once - you鈥檒l need to get another one if you reapply.

2. Finish your application form and pay your visa or immigration application fee.

You鈥檒l get a full immigration health surcharge (IHS) refund if:

• you paid the IHS twice for the same visa application
• your visa application is refused
• you withdraw your visa application before a decision is made

You鈥檒l get a partial IHS refund if your visa application鈥檚 successful but:

• you get less time on your visa than you asked for
• any dependants on your visa application are refused a visa - you鈥檒l only get their IHS back
• you鈥檙e applying to extend or switch your visa in the UK and have paid the IHS twice for the same period

If you鈥檝e paid twice for the same period and that period is 6 months or more, you鈥檒l get a partial refund rounded down to the nearest 6 months. For example, if you鈥檝e paid twice for a 15 month period, you will get a refund for 12 months of IHS.

How you鈥檒l be refunded

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 paid to the account or card you paid with.

When you will not get a refund

You will not get a refund if:

• you withdraw your visa application after your visa is granted
• 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鈥檙e told to leave the UK before your visa expires
• you鈥檙e applying for indefinite leave to remain
• you鈥檙e switching to another visa which is exempt from the IHS

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鈥檙e a student

You can apply for a full or partial IHS refund if all of the following are true:

• you鈥檙e 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 and you do not plan to work while you study

If you鈥檙e 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鈥檙e refunded will depend on the date your 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 or care and you have a visa

You and your dependants may be able to get a refund of the IHS.

You鈥檒l only get a refund for periods you worked in health or care for 6 months or more. If you worked in health or care for less than 6 months you will not get any money back.

You will only get a refund for your dependants if their visa covers the same period as yours.

Check if you鈥檙e eligible for a refund as a health or care worker.

How long it takes

You usually get your refund within 28 days 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鈥檒l get your refund up to 28 days after your appeal or administrative review is dismissed
• outside the UK - you鈥檒l get your refund up to 28 days after your visa application is refused

You鈥檒l have to repay the IHS if your appeal or administrative review is successful and you鈥檝e 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