If you’re applying for many types of UK visa, you’ll likely pay the Immigration Health Surcharge (IHS). For families, it can be one of the largest parts of the relocation budget. Yet many Africans aren’t sure what it actually covers once they arrive.
Here’s what you need to know.
What Is the Immigration Health Surcharge?
The IHS is a fee paid by many visa applicants coming to the UK for more than six months. It contributes to the cost of NHS services. You usually pay it upfront for the full length of your visa, as part of your application. The GOV.UK healthcare immigration page explains current rates and who needs to pay.
Who Usually Pays
- Skilled workers and their dependants
- Students and their dependants
- Family visa applicants
- Many other long-term visa holders
Some groups are exempt or eligible for reimbursement, such as certain health and care workers. Rules change, so always check the current list.
What the IHS Covers
Once you’ve paid and your visa is granted, you can generally use NHS services on broadly the same basis as a UK resident. This typically includes:
- GP appointments
- Hospital treatment
- Emergency care
- Maternity care
- Specialist referrals
- Mental health services
- Many diagnostic tests
What It Doesn’t Cover
Paying the IHS doesn’t make everything free. You may still pay for:
- Prescriptions in England: unless you qualify for an exemption
- Dental treatment: NHS dental charges apply for most adults
- Eye tests and glasses: for most adults
- Some fertility treatments
- Private healthcare if you choose it
Budget for these extra costs.
Paying for the Whole Family
Each dependant usually pays their own IHS. For a family of four on a multi-year visa, the total can be substantial. Factor this in early when planning relocation.
Refunds
You may get a full or partial refund if your visa application is refused, withdrawn, or in certain other situations. You usually won’t get a refund if you leave the UK early or your visa is cut short. Check the specific rules for your situation.
Visa Extensions
When extending your visa, you’ll usually pay the IHS again for the additional period. Include this in your budget for renewals.
After Settlement
Once you get Indefinite Leave to Remain or become a British citizen, you generally no longer need to pay the IHS.
Visitors Don’t Pay It, but Aren’t Covered
People on short visitor visas don’t pay the IHS, but they’re generally not entitled to free NHS hospital treatment. If your parents visit from Nigeria, buy comprehensive travel health insurance for them.
NHS Debts and Immigration
If you receive chargeable NHS treatment and leave bills unpaid, it may affect future immigration applications. Pay any NHS bills or agree a payment plan promptly.
Make the Most of Your Cover
Since you’ve paid for NHS access, use it wisely:
- Register with a GP immediately
- Attend preventive screenings when invited
- Get recommended vaccinations
- Seek help early for health concerns
Keep Proof of Payment
Keep your IHS reference number and payment confirmation with your visa documents. Hospitals may occasionally ask about your eligibility, and having the reference ready avoids confusion and unexpected bills.
Using Private Healthcare Alongside the NHS
Some immigrants use private healthcare for faster access to specialists or scans, especially when NHS waiting lists are long. Employers sometimes offer private medical insurance as a benefit. Private care can be useful, but it doesn’t replace your NHS entitlement, and costs can be high without insurance. Check what any private policy covers before relying on it.
Final Thoughts
The Immigration Health Surcharge gives you access to much of the NHS, but not everything is free. Understand what’s covered, budget for extra costs, check exemptions and refunds, and make full use of the care you’ve paid for.