Immigration Health Surcharge for Spouse Visas: Full Guide

What the Surcharge Is

The immigration health surcharge is a compulsory charge paid as part of an online immigration application. GOV.UK says you can start using the NHS free of charge from the date your visa starts, provided you have paid it where you needed to. It was introduced in April 2015, and the standard rate has been £1,035 a year since February 2024.

Paying it does not make every NHS service free. GOV.UK lists services you still pay for in the same way UK residents do: prescriptions, dental treatment, eye tests and assisted conception. It also notes that you may have to pay for NHS treatment while the Home Office has not yet decided your application. Having private medical insurance does not take you out of the charge: GOV.UK says "you still need to pay even if you have private medical insurance". For the full cost picture, see our visa fees guide.

The Two Rates

• £1,035 a year for most applicants.
• £776 a year for anyone who is under 18 at the time of application, and for students, their dependants and Youth Mobility Scheme applicants.

GOV.UK adds that dependants aged 18 or over usually pay the same amount as the main applicant. So a family total is not simply the adult rate multiplied by the number of people: children under 18 come in at the lower rate.

What It Comes To at Each Stage

The partner route grants permission in fixed lengths, and the surcharge follows the length of the visa. GOV.UK charges a part-year of more than 6 months as a full year, and a part-year of 6 months or less as half a year.

• First partner visa (2 years 9 months): 2 full years plus a 9-month part-year charged as a full year, so 3 years. £3,105 at the standard rate, or £2,328 for an applicant under 18.
• Extension (2 years 6 months): 2 full years plus half a year. £2,587.50 at the standard rate (£1,035 × 2 plus £517.50), or £1,940 for an applicant under 18 (£776 × 2 plus £388).
• Settlement application: no surcharge. GOV.UK lists people applying for indefinite leave to enter or remain among those who can use the NHS without paying it or getting a reference number.

One trap worth naming: GOV.UK says you do have to pay the surcharge if you apply for indefinite leave to remain but are only given limited permission, and that you must pay before that permission is given.

For a full breakdown of partner visa costs, see our cost breakdown guide.

How to Pay

You pay the surcharge when you apply for the visa, on GOV.UK, by debit or credit card. You give your own details and those of any dependants applying at the same time, plus details of the person you are joining or remaining with in the UK — unless that person is a UK citizen, has EU settled status, or has permission to stay permanently. On a partner application the sponsor is usually a British citizen or settled, so that last part often does not arise.

You are then sent a reference number by email, and it is shown on screen once you have paid. GOV.UK says the number can only be used once: a new application needs a new one.

If you do not pay, or do not pay enough, UK Visas and Immigration emails the address given in the application explaining how to pay. You must then pay within 10 working days if you are inside the UK, or 7 working days if you are outside it, and GOV.UK says the application will be turned down if the full amount is not paid in that time. It suggests checking your junk folder. If you need to reach the department, see our Home Office contact guide.

Dependants

Each dependant pays their own surcharge, at the rate for their age. Two examples at the standard and reduced rates, on a first partner visa of 2 years 9 months:

• Applicant plus one child under 18: £3,105 + £2,328 = £5,433.
• Applicant plus two children under 18: £3,105 + (£2,328 × 2) = £7,761.

The same family at the extension stage, over 2 years 6 months: £2,587.50 + £1,940 = £4,527.50 for the applicant and one child, or £2,587.50 + (£1,940 × 2) = £6,467.50 with two.

Across both stages, an applicant with one child pays £9,960.50 in health surcharge alone, before any application fee. See our hidden costs guide.

Refunds

The refund rules are narrower than most people expect, and the ones that apply are automatic — you do not have to claim them.

GOV.UK gives a full refund where:

• you paid the surcharge twice for the same visa application;
• the application is refused;
• you withdraw the application before a decision is made.

And a partial refund where:

• the application succeeds but you get less time on your visa than you asked for;
• a dependant on the application is refused;
• you are extending or switching in the UK and have paid twice for the same period. Where that period is 6 months or more, the refund is rounded down to the nearest 6 months; where it is less than 6 months, there is no refund.

GOV.UK is explicit that there is no refund where:

• you are applying for indefinite leave to remain;
• you leave the UK before your visa ends, for example to make a new application;
• the application succeeds but you do not come to the UK;
• you withdraw the application after the visa is granted;
• you are told to leave the UK before your visa expires.

Where a refund is due, GOV.UK says it is paid to the account or card you paid with, usually within 6 weeks of the decision on the application, and that if someone else paid on your behalf they receive it. Contact UK Visas and Immigration if it has not arrived within 6 weeks. For the wider rules, see our refund guide.

Who Does Not Pay

Most partner visa applicants pay. GOV.UK's list of applications outside the charge includes, among others:

• people applying for indefinite leave to enter or remain (settlement);
• health and care workers eligible for a Health and Care Worker visa, and their dependants;
• people applying to the EU Settlement Scheme;
• people to whom the Home Office's domestic violence concession applies, and their dependants;
• people whose removal from the UK would breach their rights under Article 3 of the European Convention on Human Rights, and their dependants;
• asylum seekers and people applying for humanitarian protection, and their dependants;
• people applying to stay as a victim of human trafficking or slavery, or as a stateless person.

Where the charge does apply but cannot be afforded, the route is a fee waiver rather than an exemption. GOV.UK says you can apply for a fee waiver on a family visa if you do not have a place to live and cannot afford one, have a place to live but cannot afford essential living costs like food or heating, or have a very low income and paying the fee would harm your child's wellbeing. The Home Office guidance says that where a full or partial fee waiver is granted, payment of the health surcharge is waived, and that the fee waiver application must be made before the immigration application.

The full list is on the GOV.UK page on who needs to pay.

Questions and answers