Immigration Health Surcharge Refunds: Who Qualifies and How to Claim

You may receive an Immigration Health Surcharge refund if your visa application is refused or withdrawn, you paid twice for the same application, or a new in-country visa overlaps with at least six months of your previous permission.

Some refunds are issued automatically. Others—including reimbursements for eligible health and care workers, students with a qualifying EHIC and registered S1 holders—must be claimed.

The rules are narrow. Leaving the UK early, deciding not to travel or obtaining indefinite leave to remain does not normally entitle you to recover the unused portion of the surcharge.

Key points

• Refusals, pre-decision withdrawals and duplicate payments can result in full refunds.

  
  

• Shorter visa grants and qualifying overlapping visas can produce partial refunds.

  
  

• Changing employer does not itself create an IHS refund.

  
  

• A refund may arise where a new in-country application creates at least six months for which the IHS has been paid twice.

  
  

• Overlapping periods are rounded down to complete six-month blocks.

  
  

• Eligible health and care workers can claim reimbursement for completed six-month work periods.

  
  

• Refunds normally return to the original payment method, including where an employer paid the surcharge.

  
  

• Leaving the UK early or switching to an IHS-exempt route does not itself generate a refund.

  
  

• EHIC and S1 reimbursements operate under separate eligibility and claim processes.

  
  

What is the Immigration Health Surcharge?

The Immigration Health Surcharge, commonly called the IHS, is normally paid as part of a UK visa application.

Applicants outside the UK generally pay it when applying for a visa lasting more than six months. Those applying from inside the UK will usually need to pay it even where the period requested is six months or less, unless an exemption applies.

Payment gives the visa holder access to NHS services broadly on the same basis as a person ordinarily resident in the UK. It does not make every service free: charges that also apply to UK residents, such as certain prescription, dental and optical charges, may still apply.

The IHS is generally paid upfront for the full length of the immigration permission being requested.

When is an IHS refund issued automatically?

The Home Office normally processes the following refunds without a separate claim.

The refund is normally returned to the account or card used to make the payment. If an employer, relative, adviser or another third party paid the IHS, that payer will normally receive the money.

These circumstances are explained in the current GOV.UK IHS refund guidance.

How employment can affect an IHS refund

Employment does not ordinarily change the amount of IHS payable. It becomes relevant where a change of employer requires a new immigration application, where an employer paid the original surcharge, or where the individual undertakes eligible health or social care work.

Employers and sponsored workers should therefore distinguish between a change in employment and the immigration or payment consequences created by that change.

Changing sponsor or employer

Changing employer does not automatically produce an IHS refund.

A Skilled Worker changing sponsor from inside the UK will usually need to make a new visa application and pay the IHS again, unless an exemption applies. A refund may then arise if the new permission creates a qualifying period for which the surcharge has been paid twice.

The refund is based on the periods of immigration permission—not the worker’s final day with the previous employer or the date the new application was submitted.

Overlapping visa periods and double payment

A partial refund may arise where someone:

1. holds valid temporary immigration permission;

2. applies from inside the UK to extend or switch their visa;

3. pays the IHS again; and

4. receives their new permission while at least six complete months remain on their previous permission.

   
   

The overlap is measured from the date the new permission is granted to the expiry date of the previous permission.

Refunds are calculated in six-month blocks and rounded down. An overlap of less than six complete months will not produce a refund.

Example: switching employer from inside the UK

Marco holds a Skilled Worker visa expiring on 30 June 2027. He changes sponsors and is granted a new Skilled Worker visa on 15 December 2025.

The overlap between the new grant date and the expiry of his previous visa is slightly more than 18 months. The qualifying refundable period is therefore 18 months.

If only five months remained when his new visa was granted, he would not receive an overlapping-period refund.

The refund arises because the new in-country application creates a qualifying period for which the IHS has been paid twice. It does not arise simply because Marco changed employer.

The Home Office’s detailed IHS caseworker guidance explains how overlapping payments are treated.

Two separate applications made outside the UK do not ordinarily create an overlapping-permission refund, even where the visa dates overlap.

Eligible health and social care employment

A person applying directly under the Health and Care Worker route does not normally pay the IHS.

A separate reimbursement scheme may, however, apply to someone who:

• paid the IHS under another visa;

• has permission to work in the UK;

• undertakes eligible health or social care work;

• works an average of at least 16 hours per week; and

• completes at least six months of eligible work.

  
  

Claims are made retrospectively for completed six-month periods. Working for fewer than six months does not normally produce a reimbursement.

Eligibility depends on the work undertaken, the employer and the available evidence. A healthcare-related job title alone does not establish eligibility.

The current criteria are set out in the health and care reimbursement guidance.

Example: eligible healthcare employment

Amara is in the UK on a visa that permits work and for which the IHS was paid. She later begins eligible employment with an NHS trust, working 37.5 hours per week.

After completing six months of eligible work, she may submit a reimbursement claim supported by evidence such as her employment contract and payslips.

If she remains eligible, she can make further claims after each subsequent six-month period. She cannot normally claim future periods in advance merely because her employment contract continues beyond the first six months.

Employment interruptions and changing jobs

A six-month health and care reimbursement period may include certain statutory or paid absences, including:

• maternity leave;

• paternity leave;

• sickness absence; and

• jury service.

  
  

The individual should remain employed during the relevant statutory absence and retain evidence of the employment and leave.

Eligible hours may also include up to four weeks—28 days—of justified unpaid leave or breaks in service. Someone who changes jobs can remain eligible where:

• each role meets the eligible-work criteria;

• the person continues to satisfy the average-hours requirement; and

• breaks in employment do not exceed 28 days in total during the six-month period.

  
  

Evidence or an explanation may be required for any gaps between employers.

Refunds where the employer paid the IHS

Employers sometimes pay the IHS on behalf of sponsored workers as part of the recruitment or relocation package.

Employers that make these payments should retain:

• the IHS reference number;

• the payment confirmation;

• evidence identifying the sponsored worker;

• the relevant visa application details; and

• details of the payment method used.

  
  

Any automatic refund will normally return to the original payment method. This may belong to the employer rather than the employee.

The employer and worker should therefore establish who made the original payment before assuming who will receive the refund.

Dependants of eligible health and care workers

A qualifying health or care worker may also be able to claim reimbursement for dependants who:

• paid the IHS or had it paid on their behalf;

• are living in the UK;

• hold visas covering the relevant period; and

• meet the applicable dependant requirements.

  
  

Dependants may also qualify independently where they themselves undertake eligible health or social care work.

The position will depend on the main applicant’s eligibility, the dependant’s immigration permission, the periods being claimed and who originally paid the surcharge.

When will you not receive an IHS refund?

You will not normally receive a refund merely because:

• you decide not to travel after your visa is granted;

• you leave the UK before your visa expires;

• the Home Office tells you to leave before your visa ends;

• your visa is curtailed after your sponsor stops sponsoring you;

• you withdraw your application after permission has been granted;

• you apply for indefinite leave to remain;

• you become a British citizen;

• you switch to a visa route that is exempt from the IHS; or

• part of your visa remains unused.

  
  

A visa holder’s use—or non-use—of NHS services does not determine whether one of the defined refund rules applies.