The UK Rules
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Who Needs to Pay IHS

Check Who Needs to Pay IHS in UK

Whether you need to pay immigration health surcharge depends on where you make the visa application. Check how visa applications made inside or outside the United Kingdom affect who needs to pay for IHS.

IHS RULES: Making a visa application from outside the UK means you need to pay IHS if:

Making a visa application from inside the UK means you would need to pay IHS if:

Note: Anyone with private medical insurance still needs to pay the 'immigration health surcharge cost'.

Cases Requiring an IHS Reference Number (only)

There are some situations to use the IHS payment service even if you do not need to pay. This is the method of getting an immigration health surcharge reference number. But, you will be exempt from paying if:


The IHS payment service will inform you that there is nothing to pay. It will also provide you with a healthcare surcharge reference number. You will need this number for your application. That means those who are exempt from paying can use the National Health Service (NHS).

Check Who Needs to Pay Immigration Health SurchargeNo Need to Pay or Get IHS Reference Number

Some situations allow you to use the NHS without getting a reference number. You may also not need to pay the surcharge if you are:

Note: You must pay the IHS surcharge if you apply for indefinite leave to remain but only get limited leave. You would need to pay before you get the leave.

Visitor Visas Rules (and short-term visas)

There are several other circumstances where you do not need to pay a surcharge or get an IHS reference number. Neither would be a requirement if your application is for:

You may need to pay for any NHS care that you get at the point you use it. An exception would be in cases where a particular service entitlement is free of charge.

Who Needs to Pay Immigration Health Surcharge in the United Kingdom