The Immigration Health Surcharge (“IHS”) is a fee which most visa applicants will need to pay when applying for a UK visa. The healthcare charge has been controversial since it was first introduced in 2015 as many argue that it is a form of double taxation since migrants already contribute to the NHS through taxes in the same way as British citizens do.
Alongside other immigration costs, IHS has risen steeply over the years from £200 per year of visa in 2015 to £1,035 per year in 2024. Application fees and IHS are paid upfront for the duration of a visa which means that a large sum has to be paid upfront regardless of the visa outcome – so what happens when an application is refused or withdrawn, or an applicant leaves the UK early or switches visa category?
Who has to pay IHS?
You will usually need to pay the IHS if you are applying for a visa. There are a few exemptions, for example:
- Anyone applying for a visa of 6 months or less from outside the UK e.g. fiancé and visitor visas
- Health and Care Workers and their dependents
- EUSS applicants
- Ukraine scheme applicants
- Indefinite Leave to Remain applicants
- Those who have been granted a ‘fee waiver’ in respect of Immigration Health Surcharge
- Academic visitors coming to the UK for up to 12 months
- Children who have been taken into the care of a local authority
- Protected applicants including but not limited to asylum seekers and people who are stateless
- Diplomats and members of overseas armed forces who are exempt from immigration control
Others have to pay IHS upfront, but may be entitled to apply for a refund, for example:
- Those working in health and social care and their dependents (even if they were not exempt at the point of application)
- Those who moved to the UK on or after 1 January 2021 and have an S1 form issued by an EU country, Switzerland, Norway, Iceland or Liechtenstein registered with the NHS Business Services Authority
- Full time students in UK higher education on or after 1 January 2021 who have an EHIC and do not work/plan to work while studying
How much does it cost?
The exact amount you need to pay will depend on the type and duration of the visa you are applying for.
The current rates are set out below:
Adult | £1,035 per year of visa |
Student or Youth Mobility Scheme | £776 per year of visa |
Child (under 18) | £776 per year of visa |
You will pay for a full year if your application includes part of a year that is more than six months, but half of a year if your visa includes any period which is less than six months. For example, a spouse visa submitted from outside the UK will be for granted for two years and nine months. The IHS due will therefore be £1,035 x 3 = £3,105 (plus currency conversion fees) because the visa is for more than 2.5 years and rounded up.
Payment is made when the application is submitted, which means that a significant amount of funds must be paid upfront – regardless of the visa outcome or if your plans change.
What if I can’t afford it?
It is possible to request a ‘fee waiver’ to waive either the visa application fee, Immigration Health Surcharge or both for certain human rights-based and other specified applications.
See our previous post and Home Office guidance on fee waivers for more information.
When am I entitled to an IHS refund?
In some circumstances a full or partial IHS refund may be due.
Full refund due:
- You paid the IHS twice
- Your visa application is refused (and you have exhausted appeal rights if applicable)
- You withdraw your application before a decision is made
Partial refund due:
- You paid ‘overlapping’ IHS – more on this below
- You were granted less time than you applied for
- Any dependents are refused permission
No refund will be due if:
- You withdraw your application after it is approved
- Your application is successful but you do not come to the UK
- You leave the UK before your visa ends (even if this is to make a new application from outside the UK)
- You are told to leave the UK before your visa expires
- You applied for a visa extension or are switching into another category and have less than six months remaining on your existing visa
- You are applying for Indefinite Leave to Remain or another an IHS-exempt category, even if you have more than six months remaining on your visa
Overlapping IHS and calculating the refund due
If you have paid twice for the same period, and that period is at least six months, you will get a partial refund rounded down to the nearest six months. For example, if you have a visa with one year and five months left and you apply to switch into another visa category, you will get a refund for one year’s IHS. Note that this is calculated from the date a decision is made – rather than the date of application. You therefore need at least six months remaining on your visa on the date of decision to be eligible for overlapping IHS refund.
If the initial visa was an entry clearance visa submitted from outside the UK, the partial refund is processed based on the exchange rate applicable on the date the IHS was paid.
How you will be refunded
If you are due a full or partial refund, you should be refunded automatically to the account you paid with. This means that if someone else (such as your employer, partner or lawyer) paid IHS on your behalf, they will receive the refund instead of you.
You should receive the refund within 28 days of the relevant decision or within 28 days of your appeal rights being exhausted. The refund will not be processed until any deadline to appeal/apply for administrative review has elapsed. Unfortunately it is not unusual for refunds to take longer than this. If a refund is late, you may consider contacting the Home Office to escalate the request.
Contact our friendly team for advice and assistance.