Immigration health surcharge for students from the EU, Norway, Iceland, Liechtenstein and Switzerland in the UK
Full-time students from the EU, Norway, Iceland, Liechtenstein or Switzerland studying in the UK can apply for a reimbursement of the immigration health surcharge (IHS).
About the IHS
If you begin a course of study in the UK that is longer than 6 months, you must pay the immigration health surcharge (IHS) as part of your visa application.
Find out more about paying for UK healthcare as part of your immigration application.
If your course of study is 6 months or less, you do not need to pay the IHS.
IHS reimbursement for students
You can apply to get back the money you paid for the IHS. This is called an IHS reimbursement.
If you get a reimbursement, you will not be able to get as much free healthcare in the UK. You should carefully consider all the information on this page before deciding whether to apply for a reimbursement.
Once you’ve received a reimbursement, you must present your European Health Insurance Card (EHIC) in order to get urgent medically necessarily healthcare in the UK during the period covered. Medically necessary treatment is defined by the medical provider and you are likely to be charged for state healthcare if it is not considered medically necessary.
You cannot repay the reimbursement if you change your mind, or if your circumstances change.
If you’re a student from Norway and are applying for a reimbursement for between 1 January 2021 and 31 December 2023, you should contact the Overseas Healthcare Team at the NHS Business Services Authority directly to process any IHS reimbursement.
If you are a student from Iceland or Liechtenstein, your IHS reimbursement will be backdated to 1 January 2024 even if your visa started earlier.
Who can apply
You may be entitled to a full or partial reimbursement of your IHS payment if:
- you’re a full-time student in UK higher education
- your UK visa started on or after 1 January 2021
- you have an EHIC issued from an EU country, Norway, Iceland, Liechtenstein or Switzerland
- you do not work or do not intend to work in the UK
Higher education is:
- level 4 and above in England, Wales and Northern Ireland
- level 7 and above in Scotland
Your family members, including your spouse, civil partner and dependent children, can also get an IHS reimbursement if they:
- are in the UK on a visa that started on or after 1 January 2021 (1 November 2021 for Swiss students and 1 January 2024 for students from Iceland and Liechtenstein)
- hold a valid EHIC
- do not work and do not intend to work in the UK
You can only make an application if you’re the student eligible for reimbursement.
You can apply for family members as part of your application. If a family member needs to make a separate application – for example, because they arrive in the UK at a later date – they should contact the NHS Business Services Authority by email at: [email protected].
How much IHS reimbursement you’ll get
To get a full IHS reimbursement, make sure that your EHIC is valid for the length of your visa. If your EHIC only covers part of your stay in the UK, you’ll receive a partial reimbursement for the duration of the validity of the EHIC, rounded down to the nearest 6 months. For example, an EHIC valid for 8 months of the IHS payment period would result in the applicant receiving a 6-month reimbursement.
If your EHIC does not cover the whole of your stay, you can make an application for the amount of IHS covered by your EHIC. If you renew your EHIC, you can then apply for a further reimbursement. To make your first application, you must have had at least 6 months left on your EHIC when your visa started.
You will not be able to get an IHS reimbursement for any periods in which you didn’t have a valid EHIC.
How to apply
The application takes about 30 minutes to complete.
To make an application, you need your:
- full name as it appears on your passport
- date of birth
- 9-digit IHS number, which you can find in your confirmation email from WorldPay – the number starts with ‘IHS’, for example, IHS123456789
- visa share code – this code lets you prove your visa status to others
- UK address
- email address
- scanned copy or photo of your European Health Insurance Card (EHIC)
- scanned copy or photo of your Confirmation of Acceptance for Studies (CAS) statement or university acceptance letter
You will also need the same details for any family members you are applying for, barring the CAS letter.
The type of visa you are on does not affect your eligibility for the UK scheme.
However, it’s possible that your country may not consider your EHIC to be valid if you move to the UK on certain types of visas – for example, as a dependent of another visa holder.
If you apply to the scheme and you’re not on a student visa, you’ll need to show evidence that your EHIC is still valid. For example, this could be confirmation from your country’s health authority.
- Start the application on this page.
- Answer the questions. Upload scans or photos of documents as evidence to support your application.
- Complete and submit your application. Then we’ll send you an email with your application reference number to confirm that you’ve applied.
Deadlines for applying
You should apply for your reimbursement as soon as possible and within 12 months of arriving in the UK. This will help you to have all the relevant documents you need to make an application. It also means we can give you important information about using your EHIC to get medical treatment.
Your application may not be accepted if you do not apply within 12 months of arriving in the UK.
After you apply
We’ll send you an email to let you know if we’ll repay your IHS or not.
We’ll pay the money back to the original payment card or bank account used to pay the IHS fee. If someone else paid the IHS for you (such as your university), we’ll repay the money to their bank account.
You cannot repay the reimbursement if you change your mind or your circumstances change. You should carefully consider all the information on this page before deciding whether to apply for a reimbursement.
If you work or plan to work in the UK
A student is only eligible for an IHS reimbursement if they do not work during the time the IHS covers.
You need to carefully consider whether you intend to work in the UK before deciding whether to apply for a reimbursement.
This is because, if you work in the UK, your EHIC will no longer be valid as your home country will no longer be responsible for your healthcare while you’re in the UK.
When applying for the student IHS reimbursement scheme, you’ll be asked to declare if you:
- currently work in the UK
- have worked in the UK during your visa period
- intend to work in the UK during your visa period
If you declare any of these, you will not be able to apply for an IHS reimbursement.
Answering ‘yes’ does not affect your right to work under the conditions of your visa – only your eligibility for an IHS reimbursement.
If you start work after getting an IHS reimbursement, you’ll need to contact the health authority in your home country to confirm what healthcare you are covered for and consider buying insurance to cover any additional healthcare you may need.
What counts as ‘work’
‘Work’ is defined as any paid employment or self-employment that is liable for National Insurance.
This includes any work where the minimum earnings threshold for owing National Insurance is not met.
If you have a contract of employment with your university (for example, as a PhD student to teach) or as a part of a ‘sandwich year’ (where you are paid for your work beyond travel costs), this will count as work.
What does not count as work
You can apply for an IHS reimbursement if you:
- do unpaid work (including unpaid work placements or ‘sandwich years’ as a part of your course that pay a travel stipend only, as opposed to a salary)
- volunteer
You can also apply for an IHS reimbursement if you get scholarship income (such as a bursary). This income is not considered taxable income.
Accessing UK healthcare during your studies
You should carefully consider your healthcare needs before deciding whether to apply for an IHS reimbursement.
Accessing UK healthcare when you’ve paid the IHS
The IHS entitles you to NHS hospital treatment at no additional cost in the UK on the same basis as someone who is ordinarily resident (except for NHS-funded assisted conception services in England).
You can access treatment from the date your visa is granted until it expires.
For more information about accessing NHS services in different parts of the UK, see:
- How to access NHS services in England if you are visiting from abroad
- EU, overseas and visitors policy (Northern Ireland)
- Healthcare for overseas visitors (Scotland)
- Cover your healthcare abroad (Wales)
Accessing UK healthcare after getting an IHS reimbursement
If you or your family members get an IHS reimbursement, you can only use your EHIC to access ‘medically necessary treatment’ during your stay.
Medically necessary treatment means healthcare that cannot reasonably wait until you or your family members return home.
Medically necessary healthcare can include:
- emergency treatment and visits to A&E
- treatment for a long-term or pre-existing medical condition
- routine medical care for pre-existing conditions that need monitoring
- routine maternity care, as long as you’re not going abroad to give birth
- oxygen therapy and kidney dialysis
Whether or not a treatment is classed as ‘medically necessary’ can be influenced by the duration of your planned stay in the UK. For example, if you broke your leg while on holiday you would likely be entitled to an operation to treat your leg. If you’re studying for 6 months in the UK with no plans to visit home, you would likely be entitled to the operation as well as any necessary follow-up treatments, such as physiotherapy.
Students will therefore typically be covered on a more comprehensive basis than a tourist under the EHIC scheme. However, the decision on whether or not a treatment is medically necessary is always made by the individual healthcare provider.
If you intend to apply for a reimbursement, you should show your EHIC when accessing medically necessary treatment during your stay in the UK.
You may have to pay for any NHS healthcare you receive that is not deemed medically necessary. This includes ‘elective’ treatment such as planned non-urgent surgery that is not covered by EHIC.
If you need this type of treatment, you may be able to apply to your home country for support under the planned treatment (S2) route.
You should consider buying insurance to cover any healthcare requirements not covered by your EHIC, such as medical repatriation should you become too ill to travel home.
For more information, see:
Updates to this page
Published 14 September 2021Last updated 22 February 2024 + show all updates
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Various changes to the text to reflect EEA and EFTA changes that came into force on 1 January 2024.
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Updated email address for family members to contact NHSBSA.
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Updated to highlight that, once a reimbursement is received, the EHIC must be presented in order to get urgent medically necessary healthcare in the UK.
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Updated to clarify you cannot repay the reimbursement if you change your mind or your circumstances change.
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Updated to reflect that the application process for the IHS reimbursement scheme for students is now open. Added more guidance on the application process and updated guidance on medically necessary healthcare.
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Updated to reflect the UK-Switzerland Convention on Social Security Coordination coming into effect. Eligible students from Switzerland will be able to apply for a refund of their immigration health surcharge payment from 1 January 2022, backdated to 1 November 2021.
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First published.