Guidance

Immigration health surcharge for EU and Swiss students in the UK

From 1 January 2022, EU and Swiss full-time students studying in the UK can apply for a reimbursement of the immigration health surcharge (IHS).

About the IHS

If you begin a course of study in the UK that is longer than 6 months, you must pay the IHS as part of your visa application.

Find out more about paying for UK healthcare as part of your immigration application.

If your course of study is 6 months or less, you do not need to pay the IHS.

IHS reimbursement for students

You’ll be able to apply for an IHS reimbursement from 1 January 2022.

If you’re a student from the EU, your reimbursement will be backdated to include any surcharge payments made for a visa starting on or after 1 January 2021.

If you’re a student from Switzerland, your reimbursement will be backdated from 1 November 2021 at the earliest, even if your visa started between 1 January 2021 and 31 October 2021.

Who can apply

You may be entitled to a full or partial reimbursement of your IHS payment if all of the following are true:

  • you’re a full-time student in UK higher education
  • your visa started on or after 1 January 2021
  • you have a European Health Insurance Card (EHIC) issued in an EU country or Switzerland
  • you do not work or do not intend to work in the UK

Higher education is:

  • level 4 and above in England, Wales and Northern Ireland

  • level 7 and above in Scotland

Your family members can also apply for an IHS reimbursement if they:

  • are in the UK on a visa that started on or after 1 January 2021

  • hold a valid EHIC

  • do not work or intend to work in the UK

How much IHS reimbursement you’ll get

You’ll get an IHS reimbursement that covers the period that your EHIC is valid in the UK. In order to be eligible for a full reimbursement, you should ensure that you hold a valid EHIC for the duration of your stay.

If you work or plan to work in the UK

A student is only eligible for an IHS reimbursement if they do not work during the time the IHS covers.

This is because if you work in the UK, your EHIC will no longer be valid as your home country will no longer be responsible for your healthcare while you’re in the UK.

When the student IHS reimbursement scheme goes live on 1 January 2022, you’ll be asked to declare if you:

  • currently work in the UK

  • have worked in the UK during your visa period

  • intend to work in the UK during your visa period

If you answer ‘yes’ to any of the above, you will not be able to apply for an IHS reimbursement.

Answering ‘yes’ does not affect your right to work under the conditions of your visa – only your eligibility for an IHS reimbursement.

What counts as ‘work’

‘Work’ is defined as any paid employment or self-employment that is liable for National Insurance.

This includes any work where the minimum earnings threshold for owing National Insurance is not met.

If you have a contract of employment with your university (for example, as a PhD student to teach), this will count as work.

What does not count as work

You can apply for an IHS reimbursement if you:

  • do unpaid work (including unpaid work placements)

  • volunteer

You can also apply for an IHS reimbursement if you get scholarship income (such as a bursary). This income is not considered taxable income.

Accessing UK healthcare during your studies

You should carefully consider your healthcare needs before deciding whether to apply for an IHS reimbursement.

The IHS entitles you to free NHS hospital treatment in the UK on the same basis as someone who is ordinarily resident (except for NHS-funded assisted conception services in England).

You can access treatment from the date your visa is granted until it expires.

For more information about accessing NHS services in different parts of the UK see:

Accessing UK healthcare after getting an IHS reimbursement

If you or your family members get an IHS reimbursement, you can only use your EHIC to access ‘medically necessary treatment’ during your stay.

Medically necessary treatment means healthcare that cannot reasonably wait until you or your family members return home.

The healthcare provider providing the treatment decides whether any treatment is necessary.

If you intend to apply for a reimbursement, you should show your EU or Swiss EHIC when accessing medically necessary treatment during your stay in the UK.

You may have to pay for any NHS healthcare you get that is not deemed medically necessary. This includes ‘elective’ treatment such as planned, non-urgent surgery that is not covered by EHIC.

If you require such treatment you may be able to apply to your home country for support under the planned treatment (S2) route.

For more information see:

Published 14 September 2021
Last updated 1 November 2021 + show all updates
  1. Updated to reflect the UK-Switzerland Convention on Social Security Coordination coming into effect. Eligible students from Switzerland will be able to apply for a refund of their immigration health surcharge payment from 1 January 2022, backdated to 1 November 2021.

  2. First published.