2. Who needs to pay
For visa applications made outside the UK, you need to pay if:
- you’re a national of a country outside the European Economic Area (EEA)
- you’re applying for a visa to work, study or join your family in the UK for more than 6 months (but you’re not applying to remain in the UK permanently)
For immigration applications made from within the UK, you need to pay if:
- you’re a national of a country outside the EEA
- you’re making an immigration application for any length of time, including applications for 6 months or less (but you’re not applying 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 won’t 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 don’t 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 doesn’t 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 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 a family member of a European national with European Union treaty rights
- 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 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 don’t 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.