The NHS for newcomers: the surcharge and your GP

The surcharge in one paragraph

Most people who apply for a UK visa pay the Immigration Health Surcharge, the IHS, as part of the online application (gov.uk). It does not buy private cover. It is a fee that gives you access to the National Health Service, free of charge, from the date your visa starts.

What you pay

There are two yearly rates (gov.uk, how much you pay):

Who	Rate per year
Students, their dependants, Youth Mobility Scheme visa holders, and applicants under 18	GBP 776
Everyone else who must pay	GBP 1,035

The bill follows the length of your visa:

• six months or less, applying from outside the UK: no surcharge;
• six months or less, applying from inside the UK: half the yearly cost, GBP 388 or GBP 517.50;
• more than six months and less than a year: one full year;
• more than a year and up to 18 months: the yearly cost plus half of it;
• more than 18 months and under two years: two full years.

For a longer visa you pay the yearly rate for each year. Our arithmetic for a five-year visa at the standard rate: 5 x GBP 1,035 = GBP 5,175. Work out the total for everyone who is applying before you accept a job offer.

If you have not paid when the Home Office asks, you have 10 working days inside the UK, or 7 working days outside it, before the application is rejected.

What it covers, and what it does not

Once paid, you can use the NHS free of charge from the date your visa starts. The government says you will still pay for some services even after paying the surcharge: prescriptions, dental treatment, eye tests and assisted conception. Check the charges of the NHS nation you live in, which we did not research.

The government also warns that you may need to pay for NHS treatment if the Home Office has not yet made a decision on your visa. So do not book treatment on the assumption that the payment alone entitles you.

Registering with a GP

In England everyone can register with a GP surgery, and it costs nothing (NHS England). The NHS page is explicit on three points:

1. you do not need ID, proof of address or proof of immigration status;
2. you do not need an NHS number to register, although one can make it easier to find your records;
3. you can register online, in the NHS App, by paper form in person, or through some surgeries’ own websites.

The basic details a surgery asks for are your name, date of birth and address. Register in the first days after you arrive, not when you are ill. Our sources are for England; we did not check the other nations of the UK.

Private cover next to the NHS

The surcharge does not buy private cover, so private or international health insurance is an add-on if you want it. We did not research the private market for this guide, we did not find a verified figure on how many newcomers buy it, and ReloFinder gives no insurance advice. If you want private cover, ask an adviser regulated in the UK.

A first-month checklist

1. Check whether you pay the standard or the discounted rate, and for how many years.
2. Pay the surcharge with the visa application, not after it.
3. Register with a GP in your first days.
4. If your employer offers private cover, read what it adds on top of the NHS before you accept.

What we could not source

We did not find an official statement on how long GP registration takes, nor on waiting times for appointments, so this guide gives none. We also did not check the surcharge for visa types with special rules or for people who are exempt, beyond what the government’s pages say in the sections we read.