Immigration health surcharge on a Skilled Worker visa: who pays, and who is exempt?

Who pays the immigration health surcharge?

When you apply for a Skilled Worker visa, you’ll need to have enough money to: pay the application fee - the standard fee ranges from £819 to £1,865 depending on your circumstances pay the healthcare surcharge - this is usually £1,035 per year

You usually need to pay the healthcare surcharge if you’re applying for a visa or immigration application: for more than 6 months, if you’re applying outside the UK for any length of time, if you’re applying inside the UK You do not need to pay if you’re applying for a visitor visa or to remain in the UK permanently.

In short: from outside the UK you usually pay if the visa is for more than 6 months. From inside the UK, for example when switching from a Graduate visa, you usually pay whatever the length. GOV.UK’s refunds page also covers a payment made by someone else:

If someone else paid the IHS on your behalf, they’ll receive your refund.

Do I pay the surcharge? Your situation

Who does not pay the surcharge?

You’ll be able to use the NHS without paying the surcharge or getting a reference number if: you’re applying for indefinite leave to enter or remain you’re a health and care worker who is eligible for a Health and Care Worker visa (or you’re their dependant) you’re applying to the EU Settlement Scheme

You - and your partner or children - will not have to pay the healthcare surcharge.

To qualify for a Health and Care Worker visa, you must: be a qualified doctor, nurse, health professional or adult social care professional work in an eligible health or social care job work for a UK employer that’s been approved by the Home Office have a ‘certificate of sponsorship’ from your employer with information about the role you’ve been offered in the UK be paid a minimum salary - how much depends on the type of work you do

In short: someone eligible for the Health and Care Worker visa does not pay the surcharge, and nor do their partner and children. The other two lines are for indefinite leave to enter or remain (settlement) and EU Settlement Scheme applications. GOV.UK lists more groups who do not pay on its ‘Who needs to pay’ page. The Skilled Worker visa is not on the list. Health and care staff on it who paid may get money back: see ‘Health and care staff who paid: getting it back’.

How much is the immigration health surcharge (NHS surcharge) per year?

£776 per year for students, their dependants, and those on a Youth Mobility Scheme visa, for example £1,552 for a 2-year visa £776 per year for visa and immigration applicants who are under the age of 18 at time of application £1,035 per year for all other visa and immigration applications, for example £3,105 for a 3-year visa

What if the visa is not a whole number of years?

6 months or less You do not need to pay the surcharge if you’re applying from outside the UK for 6 months or less. If you’re applying from inside the UK, you’ll have to pay half the yearly cost. For example: £388 for students, their dependants or under-18 applications £517.50 for any other application More than 6 months but less than one year Wherever you apply from, you’ll have to pay the cost of a full year. Cost for more than one year If your visa is for more than a year, you’ll have to pay: the yearly cost plus half the yearly cost, if it’s for 18 months or less the cost of 2 full years, if it’s for more than 18 months but less than 2 years

In short: for 6 months or less, there is nothing to pay from outside the UK and half the yearly cost from inside the UK. Over 6 months but under a year costs a full year. Over a year: up to 18 months is the yearly cost plus half the yearly cost, and over 18 months but under 2 years is the cost of 2 full years.

Health and care staff who paid: getting it back

If you work in health or care and paid the surcharge, GOV.UK gives two ways to get money back. The first is a refund for Skilled Worker visa holders in listed jobs:

You’ll be eligible to apply for a refund if you both: have a Skilled Worker visa work in an eligible job

You can get a refund if you’re a: biological scientist biochemist dental practitioner doctor midwife medical radiographer nurse ophthalmic optician paramedic pharmacist physiotherapist physical scientist podiatrist psychologist social worker speech and language therapist therapy professional

You’ll get a full refund if you paid the IHS on or after 31 March 2020. If you paid the IHS before 31 March 2020, you’ll get a partial refund. You’ll be refunded for any periods of 6 months that your IHS payment covered after this date.

Dependants If you’re eligible, your dependants can also get a refund. Apply for a refund If you’re eligible, you’ll need to contact UKVI with the following details: the IHS reference numbers for you and any dependants the date you and any dependants paid the IHS your Certificate of Sponsorship (CoS) number your employer’s name

You’ll only get a refund for periods you worked in health or care for 6 months or more. If you worked in health or care for less than 6 months you will not get any money back. You will only get a refund for your dependants if their visa covers the same period as yours.

The second is an online reimbursement. GOV.UK says:

You can apply online for a refund (‘reimbursement’) if either: you’re a medical professional and you’re not eligible to apply for a refund

for example because you do not have a Skilled Worker visa you work in another role in a healthcare setting Healthcare settings include hospitals, GP practices, care homes and community healthcare facilities.

You must have paid the immigration health surcharge

and both: work for an eligible company or organisation, for example the NHS or the Care Quality Commission (CQC) - read ‘Annex A’ of the detailed guidance to check eligibility have worked in your role for at least 6 months, for an average of at least 16 hours a week The 6 months can include paid leave, such as maternity or statutory sick leave. You will not be eligible if you were unemployed or had unpaid leave for more than 28 days during the last 6 months.

You can apply for a refund for one 6-month period at a time, starting on or after 31 March 2020.

In short: the reimbursement is for medical professionals who cannot apply for the Skilled Worker refund, and for other roles in a healthcare setting. You must have paid the surcharge, work for an eligible organisation (GOV.UK points to ‘Annex A’ of its detailed guidance), and have worked in the role for at least 6 months, at an average of at least 16 hours a week. More than 28 days unemployed or on unpaid leave in the last 6 months rules a claim out. You claim one 6-month period at a time, from 31 March 2020.

Do a partner and children pay their own surcharge?

Dependants aged 18 or over usually need to pay the same amount as you.

When and how do you pay it?

You must pay the healthcare surcharge by debit or credit card. You’ll be asked for: the start and end dates on your certificate of sponsorship, if you have one

You’ll get an email from UK Visas and Immigration if you do not pay the surcharge (or do not pay enough). The email will explain how to pay. It will go to the email address given in your visa application. Check your junk folder if you cannot see the email in your inbox. Once you get the email, you must pay the surcharge within: 10 working days if you’re inside the UK 7 working days if you’re outside the UK Your visa or immigration application will be turned down if you do not pay the full amount in this time.

In short: you pay by card, and you are asked for the start and end dates on your certificate of sponsorship, if you have one. If you do not pay, or do not pay enough, UK Visas and Immigration emails you. You then have 10 working days (inside the UK) or 7 (outside) to pay the full amount, or the application is turned down.

When do you get the surcharge back?

GOV.UK’s list for a full refund:

you paid the IHS twice for the same visa application your visa application is refused you withdraw your visa application before a decision is made

You’ll get a partial IHS refund if your visa application’s successful but: you get less time on your visa than you asked for any dependants on your visa application are refused a visa - you’ll only get their IHS back you’re applying to extend or switch your visa in the UK and have paid the IHS twice for the same period If you’ve paid twice for the same period and that period is 6 months or more, you’ll get a partial refund rounded down to the nearest 6 months. For example, if you’ve paid twice for a 15 month period, you will get a refund for 12 months of IHS . If you have paid twice for the same period of less than 6 months, you will not get a refund.

You will not get a refund if: you withdraw your visa application after your visa is granted your visa application is successful but you do not come to the UK you leave the UK before your visa ends, for example to make a new application you’re told to leave the UK before your visa expires you’re applying for indefinite leave to remain you’re switching to another visa which is exempt from the IHS

In short: a full refund if you paid twice for the same application, the application is refused, or you withdraw it before a decision. A partial refund if the visa is granted but for less time than you asked for, if a dependant is refused (only that dependant’s surcharge comes back), or if you paid twice for the same period when extending or switching. For a double payment, the refund is rounded down to the nearest 6 months. Under 6 months, nothing comes back. No refund for the cases in the last list.

What to check next

• Work out the amount for each person: the per-year rate for the length of the visa, using ‘What if the visa is not a whole number of years?’. The visa fee and the full budget are in our Skilled Worker visa cost guide.
• Check where you apply from (inside or outside the UK) and the dates GOV.UK asks for (see ‘When and how do you pay it?’).
• Switching from a Graduate visa: compare the period your current surcharge covers with the new visa. If the two overlap, see ‘When do you get the surcharge back?’.
• Check whether the Health and Care Worker visa fits your job and offer. GOV.UK lists the eligible jobs on its ‘Your job’ page.
• If you work in health or care and paid: check the Skilled Worker refund list and the reimbursement conditions quoted above, including ‘Annex A’ for employers.
• Note how old each child is on the day they apply, for the under-18 rate.

Jobs at UK employers on the Home Office register of licensed sponsors

Common questions