Helena Sheizon
Helena Sheizon

NHS Surcharge for Migrants from 6 April 2015

Immigration (Health Charge) Order 2015 introduces a mandatory NHS surcharge for migrants applying for entry clearance to the UK and for extension of limited leave to remain. The Order has effect from 6 April 2015.

The requirement is mandatory independently of whether the migrants have or do not have a private medical insurance and whether or not they intend to use the NHS.

The amount of annual surcharge is £200, with the exception of students and their dependants who will pay £150 per year.

Who is exempt from the requirement to pay the NHS surcharge?

  • Applicants for a visitor visa to the UK are not required to pay the NHS surcharge;
  • Applicants for Tier 2(Intra-Company Transfer) and their dependants;
  • Applicants for a entry clearance where leave to enter will have effect for not more than six months (apart from some student categories, this exemption does not seem to apply to any immigration category);
  • Asylum seekers and those who seek humanitarian protection; victims of human trafficking; beneficiaries of “Destitution Domestic Violence Concession” will be exempt;
  • dependants of a member of HM Forces;
  • EU nationals and their family members applying for an EEA family permit or residence documentation;
  • Applicants for indefinite leave to remain (ILR);
  • Applicants for indefinite leave to enter (a very rare category these days which only covers dependent parents and in some cases children of persons settled in the UK);
  • Citizens of Australia and New Zealand

How much does one have to pay?

Migrants will have to pay for the maximum duration of leave that can be granted in the given category. Where this leave includes part of a year, the amount payable is either half of the annual charge if the period in question is up to six months, or a full annual charge if the relevant part of the year is longer than six months. For example, an applicant for entry clearance as a partner of a UK citizen will be charged £600 NHS surcharge: the visa will be granted for 33 months, so it will be three annual amounts. The application for extension of leave in this category will be accompanied by a fee of £500 (grant of leave for 30 months, 2.5 annual charges).

How does it work?

You must make a payment before you submit your immigration application or book an appointment at a premium service centre.

The payment is made online and an IHC (Immigration Health Charge) payment number is issued once you are registered online. The immigration authorities will check against the IHS reference number if the payment has been made.

The payment is made with each immigration application. Payment cannot be transferred if the migrant applies for variation of status. Thus a person with a five year leave as a Tier 2 General migrant will have to pay the health surcharge again if he applies for a new visa to reflect a changed role with the employer or change of sponsor (employer).


Refunds are expected to be issued if the application is refused. However, the Secretary of State has discretion to reduce, waive or refund all or part of a charge. It is not yet clear how if a guidance will follow on how this discretion is to be exercised.

Who is affected most?

Migrants who need to extend their leave for a short period of time or after a short period of stay appear to be affected most unfairly. This is particularly palpable when the migrant has a family of dependants. For instance, an applicant for an extension of ancestry visa will be required to pay a full five year NHS charge (£1000) even if the extension is only required for a short period of time after which the migrant will qualify to apply for ILR. A family of four would face an overall charge of £4000. It is not clear if the Secretary of State will exercise discretion in circumstances where the charge appears to have been raised unfairly.


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