Immigration health surcharge reimbursement scheme

In 2015, government introduced an ‘immigration health surcharge’ on certain UK visas, paid in addition to existing application fees. The Home Office stated that the aim of the surcharge was to ‘ensure that migrants make a proper financial contribution to the cost of their NHS care’. It applied to people coming from outside the European Economic Area (EEA) to work, study or join family in the UK for more than 6 months, but not for those applying to stay permanently.

Calls to exempt health and care staff

In March 2020, government confirmed plans to increase the surcharge from October. In the context of COVID-19 pandemic pressures on the health and social care system, this announcement led to calls from the public and members of parliament to exempt migrants working in the NHS from paying the surcharge. 

On 21 May 2020, Prime Minister Boris Johnson announced that government would exempt health and social care staff from the immigration health surcharge and refund those who had paid the surcharge during the pandemic.

Implementing the reimbursement scheme and exemption

In August 2020, government introduced an exemption from the surcharge for migrant staff coming to work in the UK on its new Health and Care visa. Introduced as part of the post-Brexit immigration system, the Health and Care visa offered reduced visa application fees and expedited entry to the UK for certain medical professionals. Government announced that it had also begun automatically refunding health care professionals on long-term work visas who had paid the surcharge since 31 March 2020. At the same time, government stated that the Department of Health and Social Care was developing arrangements for refunding and exempting migrant health and care workers who were ineligible for the Health and Care visa and long-term work visas, which included most social care staff.

From 1 October 2020, government ‘opened’ an immigration health surcharge reimbursement scheme for health and social care workers. This expanded eligibility for reimbursement, enabling all migrants who had paid the visa surcharge and worked continuously in health and social care for at least 6 months on or after 31 March 2020 to apply for refunds. A new online portal was introduced for staff to apply for reimbursement.

Regarding surcharge exemptions for new migrants, it was confirmed that only workers who were eligible for the Health and Care visa were automatically exempt. Health and care workers who arrived on other visas had to apply retrospectively for reimbursement.

Later developments

The end of the Brexit transition period on 31 December 2020 meant that all visa applicants coming to the UK for 6 months or longer became subject to the immigration health surcharge, including people from the EEA.

In December 2021, government announced that it would make key roles in social care eligible for the Health and Care visa for at least 12 months, following a recommendation from its Migration Advisory Committee. The expanded Health and Care Worker visa meant that people applying for visas to work as care workers, care assistants and home care workers in the UK became automatically exempt from the surcharge, rather than having to apply for reimbursement.