Immigration Health Surcharge (IHS)

Visa Rules

When you make a visa application to the UK you may have to pay an extra charge, called an ‘Immigration Health Surcharge (IHS)’, in order to use the National Health Service (NHS).

However, services like prescriptions, eye tests and dental treatment will still have to be paid for.


You are entitled to free NHS hospital treatment just like an ordinarily resident person in the UK, from the date your visa is granted, so long as you have paid the IHS or you don’t have to pay it because you are exempt.

Also, your visa must allow you to stay in the UK for more than 6 months.

If the Home Office decides to end your visa early then any NHS treatment from then on will become chargeable, even if you have already paid the IHS.

Any non-exempt treatment received before your visa started will also be chargeable.

Any extension of visa applications may lead to another IHS having to be paid. You will not have to pay for the IHS if you apply for Indefinite Leave to Remain and it is granted.

By paying the IHS you will not get any preferential treatment from the NHS as the IHS only gives you access to NHS services and you will be treated in the same way as patients who are ordinarily resident in the UK.

Who has to pay the Immigration Health Surcharge (IHS)?

You will have to pay the IHS if you are applying from OUTSIDE the UK and you:

  • are from a country that is not in the European Economic Area
  • made your application and paid the visa fee on 6 April 2015 or after
  • are applying for a visa for more than 6 months in order to study or work or join your family in the UK (but not to permanently remain in the UK)

You will have to pay the IHS if you are applying from INSIDE the UK and you:

  • are from a country that is not in the European Economic Area
  • made your application and paid the visa fee on 6 April 2015 or after
  • are making an immigration application for any length of time (but not to permanently remain in the UK)

Who does not have to pay the Immigration Health Surcharge (IHS)?

You won’t have to pay if you:

  • are under 18 and have been taken into local authority care; or
  • are a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or their dependant)

You will, however, still have to use the service in order to get a IHS reference number.

The online IHS system will recognise that you are exempt from paying the IHS fee and you will be issued an IHS reference number.

You can access NHS services even if you are exempt from paying the IHS.

Who does not need an IHS reference number?

You will not have to pay the IHS or get an IHS reference number if:

  • you have applied for a visitor visa – instead, you’ll have to pay for any NHS services that you use.
  • you have a family member who is a European national and they have European Union treaty rights
  • you have applied for indefinite leave to remain (ILR) – if you applied for ILR but the UKVI decide to grant you limited leave you will have to pay the immigration health surcharge.
  • you have applied for a visa to the Channel Islands or to the Isle of Man.
  • you have applied for humanitarian protection or you are an asylum seeker (or you’re their dependant)
  • you are resident in the Falkland Islands as a British Overseas Territory citizen
  • you are a dependant of a member of the UK’s armed forces
  • you are the dependant of a member of another country’s armed forces who is exempt from immigration control
  • you are a member of a visiting armed forces or you are a diplomat and you are not subject to immigration control
  • you are a domestic worker and you have been identified as a victim of human trafficking or slavery
  • you have been identified as a victim of slavery or human trafficking and you have applied for discretionary leave to remain in the UK on these grounds (or you’re their dependant)
  • you are subject to the Home Office’s domestic violence concession (or you are their dependant)
  • it would be against your rights under Article 3 of the European Convention of Human Rights to make you leave the country (or you’re their dependant)

If you are exempt from paying then you can still use the NHS but if you have a visitor visa then you will have to pay for any NHS services that you use.

How much will you have to pay?

From 8 January 2019, the IHS Fee is:

  • £150 – £300 per year as a student (youth mobility)
  • £400 per year for all other visa applications

If, when you apply, there are more than 6 months left in the year then you will have to pay for the whole year.

If there are less than 6 months left in the year you pay half of the yearly amount.

Normally, any dependants will have to pay the same fee that you do. You can calculate how much you will have to pay for the IHS using this handy calculator.

Your application can be delayed if you don’t pay the right IHS fee or even refused if you fail to pay at all.

When do you have to pay?

Before you submit your application or book an appointment at a premium service centre you will have to pay the Immigration Health Surcharge for you and any dependants.

If you don’t pay the Immigration Health Surcharge, or you didn’t pay the right amount, then UK Visas and Immigration will contact you to find out why this has not been paid.

Failing to pay the right amount could lead to your visa application being refused. If you are INSIDE the UK, you must pay within 10 working days.

If you are OUTSIDE the UK, you must pay within 7 working days.

How do you make payment?

Paying the immigration health surcharge is relatively straightforward. Here are the steps to follow:

  • First, you must register in order to use the service.
  • Then, you will have to answer the questions. This will determine whether you have to pay the Immigration Health Surcharge or if you are exempt from it.
  • Then you will be prompted to make payment providing you are not exempt. Payment will be made in the same currency as your visa application fee.
  • You should receive an email which will have your IHS reference number. The IHS reference number should also come up on the main screen once you have made payment. It’s important that you save this number because you will need to add this reference number to your visa application.  
  • Complete the rest of your visa application and pay the relevant visa fee.

Information you will need when you make payment

You will need the following information:

  • your full name
  • your date of birth
  • your email address
  • your nationality
  • your passport number or your travel document number
  • the visa you are applying for
  • if you are applying from outside the UK, you will need the name of your visa application centre

You must provide all of the above details for:

  • anyone who is applying for a visa with you like a dependant
  • anyone who is already in the UK who you are applying to join or remain with (unless they are a British citizen or EEA citizen). You will also need the expiry date of their leave or IHS reference number.


Instead of paying the Immigration Health Surcharge, can I get private health insurance?

No, you will have to pay the Immigration Health Surcharge when you make your visa application.
You can take out private healthcare insurance if you wish but the Home Office will not waive the Immigration Health Surcharge just because you have your own private healthcare insurance.

If I don’t use the NHS can the Immigration Health Surcharge be refunded?

No, even if you do not use any NHS services, you will not be refunded the IHS fee.

I have paid the Immigration Health Surcharge but my visa application was refused. What happens now?

Whilst your visa application fee will not be refunded, the IHS fee will be refunded to you.

What is a ‘partial refund’ of the Immigration Health Surcharge?

If you paid for a period which was longer than the leave you were granted then you will automatically get a partial refund of the IHS fee that you paid.

Josh Lindsey
Josh Lindsey

Immigration lawyer with more than 20 years of consulting experience

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VisaHelpUK - UK Immigration and Visa Application Advice Service
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  1. Avatar photo
    Roy Mercer

    Hello not to sure if you can assist my wife and my daughter both paid IHS about 4 years ago and I was only made aware recently that you can apply for a partial Refund. My wife works for the NHS and has done so for 6 years. but unfortunately i cant locate the IHS number for either of them. I have searched my e mails but cant find the e mail when I paid for both of them how can I find these numbers in order to apply for a refund. If you could assist I would be more than grateful.
    Regards Roy Mercer

    1. Josh Lindsey
      Josh Lindsey author

      Hello Roy,

      I’m more than happy to help you out with your query regarding the IHS (Immigration Health Surcharge) refund process. As you’ve mentioned, your wife and daughter both paid the IHS about four years ago, and you’re now looking to apply for a partial refund since your wife works for the NHS.

      Firstly, kudos to your wife for her dedication and service at the NHS! Now, let’s tackle the issue of locating their IHS reference numbers, which is essential for the refund application process.

      I understand that you’ve already tried searching through your emails but couldn’t find the one containing the IHS reference numbers. No worries, we can still explore a few other avenues to retrieve this information:

      1. Check visa application documents: When you initially applied for their visas, you should have received a document called a “biometric residence permit” (BRP) or a vignette (sticker) in their passports. The IHS reference number is usually printed on these documents. Take a close look at them, and you might find the elusive numbers.

      2. Contact UK Visas and Immigration (UKVI): If you still can’t locate the IHS numbers after checking their visa documents, your next step would be to reach out to UKVI. They should have a record of your wife’s and daughter’s IHS payments tied to their visa applications. You can contact UKVI via email or phone – here’s their helpline number: +44 (0)300 123 2241 (charges may apply).

      3. Seek assistance from an immigration adviser: In case the above options don’t work out, you may consider consulting a registered immigration adviser who can help you find the IHS reference numbers and guide you through the refund application process. You can search for a licensed immigration adviser using the Office of the Immigration Services Commissioner’s (OISC) online database:

      Once you have the IHS reference numbers, you can proceed with the refund application process, which typically involves filling out a form and providing supporting documents to prove your wife’s employment with the NHS. Keep in mind that there might be specific deadlines and other conditions for applying for a refund, so it’s essential to review the latest IHS refund guidance provided by the UK government:

  2. Avatar photo

    I have applied for family reunion for my child (Child of a person with Refugee leave to remain in the UK) during when filling the form for IHS I forgot to add my name as the person to join in UK hence she did not get an IHS refrence number although her application is completed and she’s got an appointment at the embassy. I need to know how this can affect her appointment and also how it can be sorted without applying for a new application.

    thank you

    1. Josh Lindsey
      Josh Lindsey author

      Hi Raperin,

      First of all, I’d like to commend you for taking the necessary steps to reunite your family in the UK. Navigating the immigration process can be quite challenging, especially when it comes to ensuring that all the required paperwork is completed accurately. But don’t worry – I’m here to help guide you through this situation and provide some advice on how to address the missing IHS reference number.

      To give you a brief background, the Immigration Health Surcharge (IHS) is a mandatory fee that non-EU nationals must pay when applying for a visa to stay in the UK for more than 6 months. This fee helps cover the costs of using the National Health Service (NHS) during their stay in the UK. When you fill out the IHS form, it’s essential to include all relevant information to receive an IHS reference number, which is needed for a successful visa application.

      Now, let’s address your concern about how the missing IHS reference number could affect your child’s appointment at the embassy and how you can rectify this issue without starting a new application.

      1. Contact UK Visas and Immigration (UKVI) – It’s important to get in touch with UKVI as soon as possible and inform them about the error in your IHS application. They may be able to provide guidance on how to correct the mistake without requiring a new application. You can reach UKVI via email or phone.

      2. Consider rescheduling the embassy appointment – If you’re unable to resolve the issue before your child’s scheduled embassy appointment, it may be wise to reschedule it. This will give you more time to sort out the IHS reference number and avoid any potential complications during the appointment.

      3. Gather supporting documents – It’s crucial to have all relevant documents, including proof of your refugee status, your child’s birth certificate, and any other required paperwork, readily available. This will help support your case when explaining the IHS error to the embassy or UKVI.

      4. Be prepared to explain the situation – During your child’s embassy appointment, be ready to explain the error in the IHS application and provide any correspondence you had with UKVI about the issue. Demonstrating that you’ve been proactive in addressing the problem can help your case.

      5. Stay calm and be patient – Remember that mistakes can happen, and it’s essential to remain calm and patient throughout the process. While rectifying the issue may take some time, being persistent