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What is the Immigration Health Surcharge and Who Has to Pay?

The Immigration Health Surcharge (IHS) was introduced with the implementation of the Immigration (Health Charge) Order 2015. Its purpose is to prevent visitors and those staying for a limited period of time from accessing medical treatment by the National Health Service (NHS) without paying a fee. The NHS is available for free to British citizens and those "ordinarily resident" in the UK. You cannot be considered "ordinarily resident" unless you have indefinite leave to remain or settled/pre-settled status under the EU Settlement Scheme. NHS treatment includes urgent and emergency hospital care and GP consultations, but excludes dentistry, prescriptions, and assisted conception services. As part of the vast majority of immigration applications to the UK, applicants must pay the applicable IHS fee at the time their application is made. In other words, before their application is decided.

Who is exempt?

Applicants applying for a standard visitor visa or indefinite leave to remain do not have to pay the IHS.

Who must pay?

The IHS will be payable in most instances for applicants coming to the UK or extending their stay as students, dependants, or on business or work visas.

How Much?

The amount payable is dependent on which route an applicant is applying. The IHS generally corresponds to the length of your visa. For example, the fee will be different for an applicant who is seeking leave to remain for a period of 2 years, 3.5 years, or 5 years.

The latest fees are listed below:

Type of Application

Annual Fee

Application for entry clearance or leave to remain as a student, in accordance with the immigration rules.


Application for entry clearance or leave to remain as the dependant of a student, in accordance with the immigration rules.


Application for entry clearance as a Tier 5 (Youth Mobility Scheme) Temporary Migrant in accordance with the immigration rules.


All other applications for entry clearance or leave to remain, made in respect of a person aged 18 years or over at the date of the application.


All other applications for entry clearance or leave to remain, made in respect of a person aged under 18 years at the date of the application (whether that person is the applicant or the dependant of the applicant)


Applicants can check how much they will have to pay using the official IHS calculator.

When is NHS use permitted?

For applicants making an application from within the UK, use of NHS services will incur a fee until their application is granted. This means that applicants waiting for an outcome cannot rely on payment of the IHS to access NHS services for free.

It is important to note that there is no charge for certain types of treatment such as A&E outpatient treatment, treatment for some infectious diseases, or treatment of sexually transmitted infections. These exemptions apply regardless of eligibility, and are designed for vulnerable people who require urgent or immediate care.

How much will the NHS charge for treatment?

If you are in the UK for less than 6 months and receive NHS services to which you are not entitled, you will be liable to pay any invoice you receive (even if you leave the UK before you receive notification of a requirement to pay). Fees are calculated at a rate of 150% of the NHS base rate. It is, therefore, advisable to arrange private medical insurance to cover the duration of your trip.

What happens if payment is not made for NHS treatment?

Not paying an NHS invoice or a request from UKVI for additional IHS will have adverse consequences on your future immigration applications. Unpaid debts over £500.00 are reported to UKVI after 2 months.


The IHS fee will be refunded to applicants whose applications are unsuccessful or withdrawn, normally within 6 weeks of the date the decision was made. Applicants will not be eligible for a full or partial refund if they are granted a visa but chose not to travel to the UK, or they leave (or are told to leave) the UK before the end of their visa.


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