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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:

  • You are a national from a country which is outside of the European Economic Area (EEA).
  • Your visa application is to study, work, or to join your family in the UK for more than 6 months. This applies only if you are not applying to remain ‘permanently‘ in the United Kingdom.

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

  • You are a national from a country which is outside of the European Economic Area (EEA).
  • Your immigration application is for any length of time. This applies to applications for 6 months or less if you are not applying to remain ‘permanently‘ in the United Kingdom.

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:

  • You are a child below 18 years old and get taken into care by a local authority.
  • You are a relevant civilian employee at NATO or the Australian Department of Defence in the UK. The same applies to their dependants.

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).


No 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:

  • Applying for indefinite leave to enter or remain.
  • A diplomat (or member of a visiting armed forces) and you are not subject to immigration control.
  • A dependant of a member of the United Kingdom armed forces. That also applies to a dependant of a member of another country’s armed forces if they are exempt from immigration control.
  • A family member of a European national having European Union treaty rights.
  • Applying for a visa to the Channel Islands or the Isle of Man.
  • A British Overseas Territory (BOT) citizen who is resident in the Falkland Islands.
  • Applying for discretionary leave to remain in the United Kingdom as someone who got identified as a victim of slavery or human trafficking (or a dependant of theirs).
  • A domestic worker (if you’re a victim of slavery or human trafficking).
  • An asylum seeker or applying for humanitarian protection (or a dependant of theirs).
  • Accepted in the Home Office ‘Destitution Domestic Violence (DDV) concession‘ (or you are their dependant).
  • Being made to leave the UK and it would be against your rights under Article 3 of the European Convention of Human Rights (or you a dependant of theirs).

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:

  • One of the types of visit visa.
  • A 6 month visa (or less) if you apply from outside the United Kingdom.

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