Post edited on 31/12/2018 following the increase of the immigration health surcharge. 

In recent years, the British Government has put into place a series of measures aiming to discourage “medical tourism”: non-European visitors staying for more than six months in the UK must pay an immigration health surcharge before they arrive in order to access the NHS. Additionally, tourists must pay a higher amount when receiving care from the NHS. Thus, now, for all non-European visitors, one must pay to access the benefits of the NHS. This does not apply to foreigners who settle in the UK with resident status. If you are not a national of the European Economic Area, here is what will change for you.

NHS immigration health surcharge Visa Royaume Uni Surcharge médicale pour les étrangers au Royaume-Uni

The financial contribution to access the NHS, called the immigration health surcharge, came into effect on 6th April 2015. It is intended for temporary residents from countries outside the European Economic Area (EEA), who stay in the UK for more than 6 months: employees, students, or visitors. Australians and New Zealanders are exempt from paying this contribution as they have special agreements with the UK. This “right to access” surcharge must be paid for before entering British territory, at the same time as when you apply for your visa.

Previously, some NHS care was offered to non-EEA nationals for free, whilst other treatments were payable. But it seems that the NHS had difficultly being reimbursed retrospectively for the services provided. The new charge will raise around £200 million a year and help offset the estimated £2 billion cost of providing free healthcare to overseas visitors, temporary non-EU workers and foreign students, the Home Office says.

Now, with the surcharge, migrants all pay a fixed amount and their access to care is the same as it is for UK residents: free public care except for medication, dental and optical care.

This payment initially amounted to £200 per year for temporary migrants and £150 per year for students and those on the Youth Mobility Scheme. This payment will double on 8 January 2019. The fee paid by temporary migrants to fund the NHS will rise to £400 a year and to £300 a year for students. The payment must be made when you apply for a visa, If your visa application is refused or cancelled you can request a refund of the immigration health surcharge.

The amount of the contribution to the NHS is calculated based on the length of your stay in the UK. Here is an online tool to help you accurately calculate the amount of your medical surcharge.

This measure is also aimed at visitors who are already in the UK and who would like to extend their visa.

If you decide to take out international health insurance, you are not exempt from paying the surcharge, as it is mandatory.

If you are a tourist, you will be subject to different conditions

If you are a non-EU citizen and you visit the UK on a tourist visa, you are not affected by the mandatory NHS health surcharge, but a different rule applies to you: since April, tourists who come from outside of the European Economic Area must pay 150% of the cost of the health care they receive, 50% more than what it was previously. “This reflects the additional cost burden that the NHS carries when managing the administration for visitors to the UK”, explains the British government on its website, while stressing that “for this group, possession of adequate travel and health insurance is highly recommended”. 

As a reminder, European residents travelling to the UK are not subject to this “right to access” surcharge and can benefit from the NHS using their European Health Insurance Card (at least until Britain is still part of the EU). However, British expatriates who have been outside of the European Economic Area for more than six months relinquish their residential right of access to the NHS and will also be asked to pay the 150% tariff if they are travelling in a touristic capacity.

The Home office states that “the intended effect of the surcharge is that a person’s access to healthcare should be in line with their immigration status in the UK. Temporary migrants have not built up the long-term contribution to the UK that a British Citizen will have built up and will build up over the course of their lifetime.”


Read also: 

An expat guide on healthcare and health insurance in the UK

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