Who needs to pay
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.
You still need to pay even if you have private medical insurance.
Who only needs an IHS reference number
You still need to use the payment service to get an immigration health surcharge (IHS) reference number but you will not need to pay if:
- you’re a child under 18 who has been taken into care by a local authority
- you’re a relevant civilian employee at NATO or the Australian Department of Defence in the UK (or you’re their dependant)
The service will tell you that you do not have to pay anything and will give you your healthcare surcharge reference number for your application.
You’ll be able to use the National Health Service (NHS) even if you’re exempt from paying.
Who does not need to pay or get an IHS reference number
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’re a diplomat or a member of a visiting armed forces and not subject to immigration control
- you’re a dependant of a member of the UK’s armed forces
- you’re the dependant of a member of another country’s armed forces who is exempt from immigration control
- you’re applying for a visa for the Isle of Man or Channel Islands
- you’re a British Overseas Territory citizen resident in the Falkland Islands
- you’re an asylum seeker or applying for humanitarian protection (or you’re their dependant)
- you’re a domestic worker who has been identified as a victim of slavery or human trafficking
- you’re applying for discretionary leave to remain in the UK as someone who has been identified as a victim of slavery or human trafficking (or you’re their dependant)
- the Home Office’s domestic violence concession applies to you (or you’re their dependant)
- being made to leave the UK would be against your rights under Article 3 of the European Convention of Human Rights (or you’re their dependant)
- you’re an S2 Healthcare Visitor
- you’re eligible for a Frontier Worker permit and have an S1 certificate
You need to pay the healthcare surcharge if you apply for indefinite leave to remain but are only given limited leave. You’ll need to pay before you’re given the leave.
Visitor visas and short-term visas
You do not need to pay the surcharge or get an IHS reference number if you’re applying for a:
- visitor visa
- visa for 6 months or less from outside the UK
You will need to pay for any NHS care you get at the point you use it - unless it’s a service that’s free.