Immigration Specialists London

Immigration Health Surcharge UK Visa 2024: If you are planning to apply for a UK visa, it’s essential to understand the Immigration Health Surcharge (IHS) rates: students, their dependents, and Youth Mobility Scheme visa holders pay £776 per year, such as £1,552 for a 2-year visa. Applicants under 18 years old at the time of application also pay £776 annually. For all other visa types, the charge is £1,035 per year, which amounts to £3,105 for a 3-year visa. These fees contribute to the funding of the National Health Service (NHS), ensuring that migrants have access to healthcare during their stay.

Published On:


Last Updated:

Immigration Health Surcharge UK Visa 2024

1. Introduction


What is the Immigration Health Surcharge?

The Immigration Health Surcharge (IHS) is a fee required from most foreign nationals applying for temporary permission to live in the UK. It is charged in addition to the visa application fee to cover some of the costs of NHS services used by migrants.

Why was the IHS introduced?

The IHS was introduced in April 2015 under the Immigration Act 2014 with an initial rate of £200 per year. The government’s goal was to ensure that migrants contribute to the cost of the NHS care they use, in addition to any taxes they pay as residents of the UK. This measure was in response to the previous policy that allowed temporary migrants access to free NHS care shortly after their arrival, which was deemed overly generous by the Coalition Government.

Changes in the Immigration Health Surcharge Rate

What are the current and future rates of the IHS?

As of now, the surcharge is £624 per year but will increase to £1,035 per year from 6 February 2024. This increase was legislated after both Houses of Parliament approved changes to the surcharge rate, reflecting the Department of Health and Social Care’s estimation that £1,036 is the average annual cost of healthcare per migrant.

Who Needs to Pay the IHS?

Who is required to pay the IHS?

Applicants for work, family, and student visas must pay the surcharge in full when applying for their visa or any extensions. There is no option to opt out by obtaining private health insurance, but exemptions are available for certain groups.

Who is exempt from paying the IHS?

Visitor visa holders, asylum seekers, and healthcare workers are exempt from the surcharge. Healthcare workers may also receive refunds under policies introduced during the coronavirus pandemic. Additionally, individuals applying for certain family and humanitarian visas might be exempt if they demonstrate financial hardship.

Financial Impact and Public Reaction

How much has the IHS raised for the NHS?

Since its inception, the IHS has generated over £5 billion, significantly contributing to healthcare funding. In the fiscal year 2022/23 alone, it raised £1.7 billion.

Why is the IHS controversial?

The surcharge is often viewed as a form of double taxation since migrants already contribute to the NHS through regular taxes. Criticisms also focus on the application of the surcharge, including the scope of exemptions and the inability to pay in instalments. Despite these controversies, successive ministers have defended the surcharge as providing good value compared to private insurance and as a crucial source of NHS funding.

2. IHS Charges


Immigration Health Surcharge (IHS) for Various UK Visas

  • General Visa and Visa Extensions
    • For most general visas, including extensions, the IHS is set at £1,035 per year.
    • This rate applies to non-EU nationals staying in the UK for longer than six months and covers a comprehensive range of NHS services.
  • Student and Graduate Visas
    • Students and children are charged a reduced IHS rate of £776 per year, reflecting the government’s policy to support educational pursuits in the UK.
    • Graduate visas, designed to retain international students who have completed their studies in the UK, also attract the standard rate of £1,035 per year.
  • Ancestry, Partner, and Fiancé Visas
    • Individuals applying for Ancestry, Partner, or Fiancé visas are subject to the standard IHS rate of £1,035.
    • These visas facilitate family reunification and heritage-based residency in the UK, underlining the need for access to health services during their stay.
  • Youth Mobility and Skilled Worker Visas
    • Youth Mobility visas, which allow young people from participating countries to live and work in the UK for up to two years, also incur the standard IHS fee of £1,035 per year.
    • Similarly, Skilled Worker visas, essential for individuals filling the shortage occupations list or changing employers, require the same surcharge, ensuring these workers have health coverage during their employment in the UK.
  • Healthcare Workers and Waivers
    • Healthcare workers are often exempt from the IHS, especially if they are on Health and Care visas, in recognition of their contributions to the NHS.
    • Waivers and exemptions are also available for applicants on family or human rights grounds, who demonstrate that they cannot afford to pay the surcharge.
  • Visitor Visas and Short Stays
  • Indefinite Leave to Remain
    • Applicants for Indefinite Leave to Remain are exempt from the IHS, as they are considered settled and have likely already contributed to the NHS through previous surcharges or taxes.
  • Costs for Families and Children
    • For families applying together, the surcharge for each child is £776 per year, ensuring that all family members have health coverage.
    • Spouse visas also carry the standard IHS rate of £1,035, consistent across most long-term immigration routes.

How the Surcharge is Applied

The IHS is required to be paid upfront as part of the visa application process, with no option for installment payments. This upfront payment ensures that immigrants have immediate access to healthcare upon arriving in the UK, similar to permanent residents.

3. Legislation and Policy


Legal Basis for the Immigration Health Surcharge

What is the legal foundation for the IHS?

The Immigration Health Surcharge (IHS), often simply referred to as the immigration health charge, is mandated under Section 38 of the Immigration Act 2014. This legislation empowers the government to require temporary migrants to pay the surcharge as part of their visa application process, rather than when they access NHS services.

How is the surcharge regulated?

The specifics of the surcharge, including the amount, are determined by statutory instruments, specifically the Immigration (Health Charge) Order 2015, which initially came into effect on 6 April 2015. An amendment to this order, effective from 6 February 2024, increases the standard surcharge to £1,035 per year (£776 for students and children), up from the previous £624 per year (£470 for students and children).

Reasons for Introducing the Immigration Health Surcharge UK Visa

What prompted the introduction of the IHS?

The primary motive for introducing the IHS, as outlined in a Home Office press release from March 2015, was to ensure that migrants contribute financially to the NHS costs they incur. This was seen as a necessary step to align migrants’ contributions with those of UK residents, who fund the NHS through their taxes.

How have surcharge increases been justified?

Subsequent increases in the surcharge in 2019, 2020, and the planned 2024 adjustment have been justified on the grounds of covering the full cost of NHS services provided to migrants. According to an impact assessment from October 2020, the goal is to set the surcharge at a level that broadly reflects the actual cost of NHS services, thereby supporting the long-term sustainability of the health service.

Why was there a need for the surcharge?

Before the surcharge’s introduction, temporary migrants could access free NHS care shortly after their arrival in the UK. The Coalition Government deemed this policy overly generous and inconsistent with international norms and the UK’s policies on eligibility for welfare benefits and social housing.

4. Costs and Impact


What are the current and upcoming rates for the IHS?

As of now, the immigration health surcharge stands at £624 per year for most visas, with a reduced rate of £470 for student visas and children. From 6 February 2024, these rates will increase to £1,035 and £776, respectively. This marks a significant rise from the initial rates set in 2015, which were £200 per person per year and £150 for the reduced rate. Alongside these changes, visa application fees have also consistently risen above the rate of inflation.

How much do visa applicants have to pay upfront?

The Immigration (Health Charge) Order 2015 specifies the surcharge amount per person per year. Successive amendments have raised the rate from £200 in 2015 to £400 in January 2019, £624 in October 2020, and soon £1,035 in February 2024. The total amount paid depends on the visa type and its duration. For instance, a person applying for a five-year Skilled Worker visa will pay a surcharge of £5,175 plus application fees of £1,084, with the same amount applicable to a dependant partner. The surcharge must be paid in full at the point of application; installment payments are not an option.

Legislative Timeline, Approval, and Financial Outcomes

When and how was the rate increase approved?

In July 2023, the Chief Secretary to the Treasury announced the surcharge increase to fund a pay raise for doctors. The draft Immigration (Health Charge) (Amendment) Order 2023 was laid before Parliament in October 2023, requiring a positive vote from both Houses for approval. The House of Lords approved the order in December 2023, followed by the House of Commons on 15 January 2024. The order was officially signed into law on 16 January and will take effect from 6 February 2024.

How is the surcharge rate determined?

The Department of Health and Social Care sets the surcharge based on the average cost of public healthcare for migrants, estimated at £1,036 per person. The upcoming increase to £1,035 is intended to closely match these costs, despite migrants’ generally lower NHS usage due to their younger age demographics.

What is the financial impact of the surcharge?

From its inception in April 2015 until April 2023, the surcharge generated £5.1 billion. This revenue is intended to directly support the NHS, although it is actually distributed among the health departments of England, Scotland, Wales, and Northern Ireland, which may allocate funds to non-NHS purposes. The exact amount spent specifically on NHS services is not centrally recorded. The 2024 rate increase is projected to raise an additional £6.2 billion over five years.

How is the surcharge revenue used?

While the Home Office states that surcharge income directly supports the NHS, actual allocations are decided by regional health departments, which can choose to fund NHS or other health-related activities. The distribution among the UK regions follows the Barnett formula, with the Home Office retaining a portion of the gross revenue to cover administrative costs. Details on the exact administrative costs have not been disclosed, but it is known that a private company collecting the payments charges about 2% of the gross revenue.

5. Arguments For and Against


Case for the Immigration Health Surcharge UK Visa

Supporting the NHS Financially

Successive ministers have advocated for the surcharge as beneficial both for the NHS and for the migrants who pay it. Immigration Minister Kevin Foster highlighted in 2020 that the surcharge was “designed to benefit the NHS and support its long-term sustainability,” emphasizing that it is fair for those working in non-healthcare roles in the UK to contribute to the extensive NHS services they might use. The 2024 increase is specifically aimed at raising funds to enhance NHS doctors’ salaries.

Value for Money for Migrants

Health Minister Stephen Hammond stated in 2019 that the surcharge offers excellent value for money, providing comprehensive access to NHS services, including care for pre-existing conditions. This arrangement is positioned as superior to alternative healthcare options, ensuring that migrants do not have to worry about securing insurance or covering unexpected medical expenses while in the UK.

Case Against the Immigration Health Surcharge

Perceived Unfairness and Impact on Foreign Workers

Civil society and business groups have criticized the surcharge as being unfair and unjust, particularly before exemptions were made for NHS workers in 2020. There are concerns that the surcharge deters valuable foreign workers due to its perceived unfairness, especially when combined with high visa application fees.

Double Taxation Issue

One principal objection to the IHS is that it represents a form of double taxation, as temporary migrants already contribute to the NHS through their taxes, akin to permanent UK residents. This has been echoed by the Scottish Government, which has called the policy “morally wrong.”

Financial Burden on Families

Charities and advocacy groups point out that the combined costs of the surcharge and application fees can be prohibitive, especially for lower-paid foreign workers and those in immigration categories requiring them to pay these costs for ten years before becoming eligible for settlement. There is a call for more generous exemptions and waivers, particularly for groups like NHS workers and those on family or human rights visas.

Increasing the Cost of Hiring Overseas Labor

The financial implications of the surcharge, alongside visa application fees, also make it more costly for employers to hire from abroad. This could potentially reduce the attractiveness of the UK to foreign professionals, including scientists and researchers, as the overall expense of moving to the UK for work becomes a significant deterrent.

6. FAQs


Immigration Health Surcharge UK Visa

  1. What is the Immigration Health Surcharge (IHS)?

    The IHS is a fee charged to non-EU migrants applying to live in the UK for more than six months. It helps fund the National Health Service (NHS).

  2. How much will the IHS cost in 2024?

    From 6 February 2024, the surcharge will increase to £1,035 per year for most visas, and £776 per year for students and children.

  3. Who is required to pay the IHS?

    Most non-EU nationals applying for a visa to stay in the UK for longer than six months are required to pay the IHS. Exemptions apply to visitors, certain healthcare workers, and other specific groups.

  4. Are there any exemptions to paying the IHS?

    Yes, visitors, asylum seekers, children under the care of a local authority, and applicants for certain humanitarian protections are exempt. Healthcare workers also received exemptions during the COVID-19 pandemic.

  5. Can the surcharge be paid in installments?

    No, the full amount of the surcharge must be paid upfront when you submit your visa application.

  6. What does the IHS cover?

    The surcharge grants access to the NHS similar to that of a UK resident, covering all necessary treatments except for certain charges like prescriptions and dental care in England.

  7. Why was the IHS introduced?

    The IHS was introduced to ensure that migrants contribute to the cost of NHS services they are likely to use while in the UK. It was first implemented in 2015.

  8. What happens if I pay the IHS but my visa is refused?

    If your visa application is refused, you will be eligible for a full refund of the IHS.

  9. How does the increase in the IHS affect the UK visa appeal?

    While the increase might raise concerns about higher costs for migrants, the government believes it will not significantly impact the demand for UK visas. The surcharge is meant to reflect the cost of healthcare services provided to migrants.

  10. Will the IHS continue to increase?

    The rates have been subject to increases since its introduction, usually to align more closely with the actual cost of NHS services provided to migrants. Future increases depend on governmental assessments and healthcare costs.

For an in-depth analysis of the financial implications of the Immigration Health Surcharge UK visa, refer to the Commons Library briefing.