Immigration Health Surcharge (IHS)

GOV.UK calls it the immigration health surcharge and says most people need to pay it as part of their online immigration application. Once your visa starts you can use the NHS free of charge, provided you have paid the surcharge if you needed to. Charges that apply to everyone, such as prescriptions or dental treatment where those charges apply, still apply.

Whether you pay depends on the immigration status you are applying for. GOV.UK says you usually pay if you apply for more than 6 months from outside the UK, or for any length of time from inside the UK. Visitors do not pay.

Most work, study and family visa applicants pay. GOV.UK lists groups who do not, including:

• a health and care worker who is eligible for a Health and Care Worker visa, or their dependant
• people applying for indefinite leave to enter or remain
• applicants to the EU Settlement Scheme
• people applying for asylum or humanitarian protection, and certain other protected groups

GOV.UK states that you still need to pay even if you have private medical insurance. This is why the Health and Care Worker visa costs far less overall than a Skilled Worker visa for the same job: a nurse or doctor on that route, and their partner and children, pay no surcharge.

1. Start your online visa application.
2. The service calculates the surcharge from the length of the visa you are applying for.
3. Pay it as part of the application, before the visa is granted.
4. If you are asked to pay separately, pay within the deadline GOV.UK gives: 10 working days if you are inside the UK or 7 working days if outside, or the application is rejected.

GOV.UK sets these yearly rates:

• £1,035 per year for most visa and immigration applications, including work visas
• £776 per year for students and their dependants, Youth Mobility Scheme applicants, and applicants under 18

For part years, GOV.UK says that if you apply from outside the UK for 6 months or less you pay nothing, while from inside the UK you pay half the yearly amount. For more than 6 months but less than 12, you pay a full year. Longer periods are charged in half-year and full-year steps, so the total is paid up front for the whole visa.

• Applying on the wrong route. If your job and employer qualify for the Health and Care Worker visa but you apply as a Skilled Worker, you may pay the surcharge you could have avoided.
• Dependants on other routes. The exemption covers dependants of eligible health and care workers; other family routes have their own rules.
• Expecting all NHS care free. Everyday charges that apply to residents still apply to you.

See our Health and Care Worker visa guide for the full cost comparison.