Immigration Health Surcharge: £1,035 a Year Explained

What Is the Immigration Health Surcharge?

The immigration health surcharge is £1,035 a year for most UK visa applicants, and £776 a year for students, their dependants, people applying under the Youth Mobility Scheme, and anyone under 18 at the time of application. It is a compulsory charge paid as part of an online immigration application, and it is what gives visa holders access to the National Health Service. It was introduced in April 2015 and has risen several times since.

The surcharge is separate from the visa application fee. You pay it when you apply, and it covers the whole length of the visa you are given. If the visa is for 3 years, you pay 3 years of surcharge at the point of application.

The charge applies to most visa routes, including Skilled Worker visas, Spouse Visas, Student visas, and most other categories that last more than 6 months.

The Two Rates

• £1,035 a year for all other visa and immigration applications, including Skilled Worker, partner and other work and family visas.
• £776 a year for students, their dependants, people applying under the Youth Mobility Scheme, and anyone who is under 18 at the time of application.

How Part-Years Are Charged

GOV.UK sets out how a visa that is not a whole number of years is charged:

• 6 months or less: nothing if you are applying from outside the UK. If you are applying from inside the UK, half the yearly cost — £517.50 at the standard rate, £388 at the reduced rate.
• More than 6 months but less than a year: the cost of a full year, wherever you apply from.
• More than a year, up to 18 months: the yearly cost plus half the yearly cost.
• More than 18 months but less than 2 years: the cost of 2 full years.

GOV.UK also notes that the visa may last longer than the course of study or the period of employment, and it is the length of the visa that the charge follows.

Example Calculations

• Partner visa, first grant (2 years 9 months): 2 full years plus a further part-year of more than 6 months, charged as a full year — £1,035 x 3 = £3,105
• Partner visa, extension (2 years 6 months): £1,035 x 2 plus £517.50 = £2,587.50
• Skilled Worker (3 years): £1,035 x 3 = £3,105
• Skilled Worker (5 years): £1,035 x 5 = £5,175
• Student visa (3 years): £776 x 3 = £2,328
• Youth Mobility Scheme (2 years): £776 x 2 = £1,552

Who Does Not Pay

GOV.UK publishes a list of applications where you can use the NHS without paying the surcharge or getting a reference number. It includes people who are:

• applying for indefinite leave to enter or remain (settlement);
• a health and care worker eligible for a Health and Care Worker visa, or their dependant;
• applying to the EU Settlement Scheme;
• a diplomat or member of a visiting armed force not subject to immigration control;
• a dependant of a member of the UK's armed forces, or of another country's armed forces where that member is exempt from immigration control;
• a British Overseas Territory citizen resident in the Falkland Islands;
• an asylum seeker or applying for humanitarian protection, or their dependant;
• a domestic worker identified as a victim of slavery or human trafficking, or applying for discretionary leave or to stay on that basis, or their dependant;
• covered by the Home Office's domestic violence concession, or their dependant;
• in a position where being made to leave the UK would breach their rights under Article 3 of the European Convention on Human Rights, or their dependant;
• an S2 Healthcare Visitor, or eligible for a Frontier Worker permit and holding an S1 certificate;
• a child under 18 taken into care by a local authority;
• a relevant civilian employee at NATO or the Australian Department of Defence in the UK, or their dependant;
• applying to stay in the UK as a stateless person;
• applying for the Ukraine Extension Scheme or a visa under the Homes for Ukraine Sponsorship Scheme.

Visitor visas and short visas are outside the charge as well. You do not pay for a Standard Visitor visa or for a visa of 6 months or less applied for from outside the UK, and you do not pay for a visa for the Isle of Man or the Channel Islands. In each of those cases GOV.UK says you pay for any NHS care you get at the point you use it, unless it is a service that is free.

One point that catches people out: GOV.UK says you do have to pay the surcharge if you apply for indefinite leave to remain but are only given limited leave, and you must pay before that leave is given.

Having private health insurance does not take you out of the charge. GOV.UK says in terms: "You still need to pay even if you have private medical insurance."

How to Pay

You pay the surcharge when you apply for the visa, by debit or credit card. GOV.UK says you will be asked for the start and end dates on your certificate of sponsorship, if you have one, and your course dates if you are applying as a student.

You give your own details and those of any dependants applying at the same time, plus details of anyone you are applying to join or remain with who is already in the UK — unless that person is a UK citizen, has EU settled status, or has permission to stay permanently. If you are joining someone in the UK you need their visa expiry date, or their surcharge reference number if they have one.

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

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. GOV.UK says you must then pay within 10 working days if you are inside the UK, or 7 working days if you are outside it, and that the application will be turned down if the full amount is not paid in that time. It suggests checking your junk folder if you cannot see the email.

Dependants

Each dependant pays their own surcharge. GOV.UK says dependants aged 18 or over usually pay the same amount as the main applicant. Applicants who are under 18 at the time of application pay the £776 rate, so a family total is not simply the adult rate multiplied by the number of people.

Two adults and two children under 18, all on a 3-year visa at the standard rate:

(2 x £1,035 x 3) + (2 x £776 x 3) = £6,210 + £4,656 = £10,866.

That is on top of the visa application fees. For the full picture of family visa costs, see our hidden costs of immigration guide.

Refunds

The refund rules are narrower than people often expect, and the refunds that do apply are automatic.

Full refund

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

Partial refund

• the application succeeds but you get less time on your visa than you asked for;
• a dependant on the application is refused — you get their share back;
• you are applying to extend or switch 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 (GOV.UK's example: paying twice for 15 months gives back 12 months). Where it is less than 6 months, there is no refund.

No refund

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

GOV.UK also says that if an applicant dies, in the UK or before arriving, the surcharge is not refunded.

How the refund reaches you

For the reasons above you do not have to do anything. GOV.UK says the refund is paid to the account or card you paid with, and that if someone else paid on your behalf, they receive it. It usually arrives within 6 weeks of the decision on the visa application. If you appeal or ask for an administrative review, it can take longer: up to 6 weeks after the appeal or review is dismissed if you applied inside the UK, or up to 6 weeks after the refusal if you applied outside it. If the appeal or review succeeds and the refund has already been paid, it has to be repaid.

The refunds you do have to apply for

Three separate schemes work differently and need an application:

• Health and care workers: you and your dependants may be able to get a refund for periods worked in health or care of 6 months or more. Less than 6 months gets nothing back, and a dependant's refund only covers a visa period matching yours.
• Full-time students with a European Health Insurance Card: a refund may be available where you are a full-time student in UK higher education, your visa started on or after 1 January 2021, you hold a card issued in an EU country, Switzerland, Norway, Iceland or Liechtenstein, and you do not work and do not plan to while you study.
• People with an S1 certificate registered with the NHS Business Services Authority.

The details are on GOV.UK. Contact UK Visas and Immigration if an automatic refund has not been paid within 6 weeks.

What the Surcharge Covers

GOV.UK says you can start using the NHS free of charge from the date your visa starts, provided you have already paid the surcharge where you needed to. It also notes that you may have to pay for NHS treatment while the Home Office has not yet decided your visa application.

Paying the surcharge 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;
• assisted conception.

Prescription charges apply in England; prescriptions are free in Wales, Scotland and Northern Ireland. The current England charge is published by the NHS.

When you use healthcare in the UK, GOV.UK says you may need to prove your status online with a share code if you have a digital immigration status.

How the Rate Has Changed

The standard rate has risen several times since it was created:

• April 2015: introduced at £200 a year (£150 for students).
• January 2019: £400 a year (£300 for students and Youth Mobility Scheme applicants).
• October 2020: £624 a year (£470 for students, their dependants and Youth Mobility Scheme applicants).
• February 2024: £1,035 a year (£776 for students, their dependants, under-18s and Youth Mobility Scheme applicants).

The February 2024 change was the largest single rise, and it is the rate in force now. For a complete view of all visa costs, see our UK visa fees guide.

The Shape of the Cost

On a longer visa the surcharge often comes to more than the application fee. Three things determine the figure:

• The length of the visa, not the length of the course or job, and charged in whole and half years by the rules set out above.
• Which rate applies to each person: £1,035 a year, or £776 for students, their dependants, Youth Mobility Scheme applicants and under-18s.
• How many people are on the application, since each dependant pays their own.

It is paid when you apply, so it lands alongside the application fee rather than later. Our financial requirement guide covers the separate income rules on the family route, and our immigration solicitor costs guide covers what regulated advice costs, if you want it.

Questions and answers