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NHS surcharge for immigration applications


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A new “health surcharge” was introduced for all new applications for entry clearance or leave to remain made on or after 6 April 2015. The charge is £150 per year for students and £200 per year for all other types of application. A charge is payable for each dependent as well as the main applicant.

An applicant for a five year Tier 2 General visa with a spouse and two children will need to pay a health surcharge of £4,000 (4 applicants x £200 x 5 years) on top of application fees of £4,512. That is £8,512 in total. Plus any lawyer costs.

Information about the charge is available on the gov.uk website and there is also a specific mini site, Immigration Health Surcharge, where payment can be made and the “IHS reference number” required for making immigration applications can be generated.

Liability for the charge is as follows:

  • All applications for entry clearance other than visits of 6 months or less
  • All applications from within the UK for any period of time other than indefinite leave to remain

If an application is made for ILR but limited leave is granted, the surcharge will become payable and the Home Office will contact the applicant, presumably before the visa is issued.

The exemptions are as follows:

  • Nationals of EEA countries and their family members exercising treaty rights
  • Nationals of Australia and New Zealand
  • Tier 2 (Intra-company Transfer) visa (and dependants)
  • Children under 18 who has been taken into care by a local authority
  • Dependants of a member of the UK’s armed forces
  • Diplomat or a member of a visiting armed forces and not subject to immigration control
  • Dependant of a member of another country’s forces who is exempt from immigration control
  • Relevant civilian employee employed by North Atlantic Treaty Organisation (NATO) or the Australian Department of Defence in the UK (or their dependant)
  • applying for a visa for the Isle of Man or Channel Islands
  • British Overseas Territory citizen resident in the Falkland Islands
  • Asylum seeker or applying for humanitarian protection (or you’re their dependant)
  • Identified as a victim of human trafficking (or their dependant)
  • Home Office’s domestic violence concession applies (or their dependant))
  • Article 3 protection cases and their dependents
  • Where destitute and within the policy on being exempt from paying the fee for an immigration application

Some of those exempt still have to register and obtain a reference number and others do not: check the Immigration Health Surcharge at the date of application for the latest updates.

Visitors will have to pay for NHS care at the point of need.

Those who have paid the charge are permitted to access free NHS care to the same extent as permanent residents during the period of their leave. A power is retained to exclude “certain expensive, discretionary treatments” but it was stated there were no plans to make use of this provision (Lord Taylor of Holbeach, Hansard 12 March 2014 : Col 1806).

This post is based on material from the second edition of my Immigration Act 2014 ebook.

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Colin Yeo

Immigration and asylum barrister, blogger, writer and consultant at Garden Court Chambers in London and founder of the Free Movement immigration law website.


4 Responses

  1. Hi Colin

    I read the Order as applying a health service charge to an application for limited leave. You say, “If an application is made for ILR but limited leave is granted, the surcharge will become payable and the Home Office will contact the applicant, presumably before the visa is issued”. I’m sure that’s right, but where does it say that?


  2. Hi guys,

    What about those applying under family reunion? I presume they would be exempt under the “•Asylum seeker or applying for humanitarian protection (or you’re their dependant)”?

    If not this is crazy…well its crazy anyway but it would be more crazy…


  3. Hi Guys,

    Wondered if you could ‘confirm’ my views on this, especially for out of country applications for settlement. On my reading, it appears that if the application is for indefinite leave, then there is no surcharge payment, however if the application is for limited leave then the surcharge applies. For example, if there is an application for child settlement (which would be for ILE) then no surcharge is applicable, however for a spouse application, because this will only allow an initial 30 month entry (and therefore limited leave), the surcharge is applicable.

    I would really appreciate comments as I have one of each type of application and I am slightly puzzled as I know the children settlements are always ILE.

    Look forward to responses please.


  4. Hi Colin/Guys,

    I would appreciate if somebody could direct me to the policy where is states that those who have Immigration Fee Exemption are also exempt from IHS fee. I have read IHS guidance recently and this wasn’t mentioned but I assumed it would be the case. The only argument I could logically cpome up with im my head was that the policy states those who have applied for and paid for the application after 6th April. Given that a fee exempt person hasn’t paid, they would not have to pay fee????

    Any comments would be appreciated. I have such a case ongoing now.