When applying for a Visa in the UK you will have to pay the IHS, this will give you the rights to use the UK's National Health Service (NHS).
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’ll pay
If you’re making your immigration application online or through a premium service centre, 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’ll still need to pay for certain types of services, such as prescriptions, dental treatment and eye tests.
You should bring your biometric residence permit with you when you access healthcare in the UK.
Who needs to pay?
For visa applications made outside the UK, you need to pay if:
You’re a national of a country outside the European Economic Area (EEA)
You’re applying for a visa to work, study or join your family in the UK for more than 6 months (but you’re not applying to remain in the UK permanently)
For immigration applications made from within the UK, you need to pay if:
You’re a national of a country outside the EEA
You’re making an immigration application for any length of time, including applications for 6 months or less (but you’re not applying 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 won’t need to pay if:
The service will tell you that you don’t 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 doesn’t 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 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 a family member of a European national with European Union treaty rights
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 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 don’t need to pay the surcharge or get an IHS reference number if you’re applying for a:
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.
How much you have to pay
You’ll have to pay:
£150 per year for a student or Tier 5 (Youth Mobility Scheme) visa, for example: £300 for a 2-year visa
£200 per year for all other visa and immigration applications, for example: £1,000 for a 5-year visa
Dependants usually need to pay the same amount as you.
The exact amount you have to pay depends on how much leave you’re granted. Calculate how much you’ll have to pay before you apply.
You’ll pay half of the yearly amount if your application includes part of a year that is less than 6 months.
You’ll pay for a whole year if you’re application includes part of a year that is more than 6 months.
Your visa or immigration application won’t be granted if you don’t pay the healthcare surcharge or your application will be delayed if you don’t pay the right amount.
You’ll automatically get a partial refund if you paid the healthcare surcharge for more years than you were granted leave.
When you have to pay
If you’re applying for a visa online or through the premium service centre, you’ll pay the surcharge as part of your application or when you book an appointment.
If you’re applying for a visa by post, you must pay the healthcare surcharge online before you send your application - you’ll need to include the IHS reference number on your application form.
You’ll be contacted by UK Visas and Immigration if you didn’t pay the surcharge (or didn’t pay enough) as part of your visa or immigration application.
Your visa or immigration application will be turned down if you don’t pay the full amount:
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 at a premium service centre, you pay the surcharge when you book an appointment.
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 or through the premium service centre, you’ll be asked for:
If you’re applying by post, you’ll also be asked for:
You need to pay by cash at the UK embassy if you’re in the Democratic People’s Republic of Korea.
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 don’t 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
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
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.
Finish your application form and pay your visa or immigration application fee.
You don’t need to do anything to get an IHS refund - it’s automatically paid to the account or card you paid with.
You’ll get a full IHS refund if:
You’ll get a partial IHS refund if your visa application’s successful but:
You won’t get a refund if:
Your visa application is successful but you don’t 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 or changing to another visa where you don’t need to pay the IHS
How long it takes
You usually get your refund within 90 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’ll get your refund up to 90 days after your appeal or administrative review is dismissed
Outside the UK - you’ll get your refund up to 90 days 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:
Contact UK Visas and Immigration (UKVI) if your refund isn’t paid within 90 days.
This was originally published on Gov.uk