Immigration Health Surcharge (IHS) Reimbursement Guidance

This guidance covers the candidate’s eligibility criteria and the process for applying IHS reimbursements for candidates who do not have a granted visa through the health and care visa (a sub-category of the current Tier 2 (General) immigration route) and whose reimbursement will be administered by the NHS Business Services Authority (NHSBSA).

This process (the scheme) is operated on a UK-wide basis by NHSBSA on behalf of the Department of Health and Social Care (DHSC). 

If you are an applicant in the UK on Tier 2 (General) visa, working in an eligible health or social care occupation, you would benefit from exemption under the health and care visa offer, but you should not claim reimbursement through this scheme. Instead, you should contact the Home Office at [email protected] to claim a refund, for any time remaining on their visa after 31 March 2020.

Eligibility Criteria

Anyone holding a relevant visa, who has worked in the health and social care continuously for at least 6 months commencing on or after 31 March 2020 and has paid the IHS may be eligible for reimbursement.

Their dependents may also be eligible for reimbursement if they have paid the IHS or the IHS has been paid for them.

Applicants must have paid the IHS for the period covered by their claim. For instance, they must hold visas, for which they have paid the IHS, covering the period between 1 April and 30 September 2020, if they claim on 1 October 2020.

Applicants will need to apply for reimbursements on a 6-monthly basis when they have worked for an average of at least 16 hours per week over the full 6 months. These reimbursements will be processed in six-month installments in arrears. 

Example 1

If an applicant paid the IHS in 2019, for a period of 3 years, they will be able to claim 6 months’ worth of IHS reimbursement on 1 October 2020.

This can be repeated on 31 March 2021 and for any additional 6-month periods, as long as they have met the eligibility criteria for each period.

Any period of time or work an applicant has completed before 31 March 2020 cannot be claimed for. 

The reimbursement scheme is designed for applicants who are in the UK on visas that give them a generic right to work. Examples of this may include:

Dependant of a UK national or another migrant

Someone on a Tier 4 student visa who can undertake up to 20 hours of work a week during term time.

Someone on the Tier 5 youth mobility scheme

These examples are not exhaustive.

Eligibility criteria & Eligible hours

If that your visa is not a Tier 2 (General) visa, the applicant is entitled to claim reimbursement of the IHS, if you have provided the required evidence to demonstrate that you have completed the eligible hours of eligible work.

Eligible hours must total at least an average of 16 hours per week calculated over a 6-month period which began on or after 31 March 2020.

The calculation of hours can include periods of statutory leave from ongoing employment (including contracted hours during jury service, maternity leave, and sickness leave). It may also include eligible work for one or more employers and can include up to 4 weeks (28 days) unpaid leave with justification, such as changing employers or personal circumstances. Applicants may be asked to explain any unpaid leave or breaks of service as part of their application.

If an applicant has changed jobs in the 6-month period, they will remain eligible so long as breaks within the relevant 6-month period do not total longer than 4 weeks (28 days) in any 6-month period. Each job must meet the criteria specified under eligible work.

Example 2

If an applicant started working in a care home on 1 May 2020, leaving that role on 14 June and starting in a new, eligible post on 1 July, they would be able to claim a reimbursement from 1 November.

Eligible work

  1. Providing a service which is related to the delivery of health or social care
  1. The applicant is employed or engaged to do the work by:

A recognised health or care provider (for example, NHS trusts, national NHS bodies)

An employer which is registered with an appropriate health or social care services regulator to provide health or care services. For instance, this includes care homes or independent sector healthcare providers, which would be registered with the Care Quality Commission (CQC) in England, or a pharmacy, which would be regulated by the General Pharmaceutical Council

An employer delivering services that directly support health and social care services, such as facilities management services within a hospital, as long as this work is undertaken within a health and care setting


If the applicant has dependants who have also paid the IHS, they will be able to claim a reimbursement for each of their dependants. A dependant is any of the following:

a husband, wife or partner

a child under 18 years of age

a child over 18 years of age, if they are currently in the UK as a dependant

If the applicant is in the UK on Tier 2 (General) visa, working in an eligible occupation, or health and care visa and has dependants who have paid the IHS, they should contact the Home Office to seek a refund.

Dependants may be eligible for a reimbursement in their own right, for instance if they work in a health or social care setting for an average of at least 16 hours per week. If they are the dependant of a person who is in the UK on a work or study visa but who does not work in health or social care, they would only be able to claim a reimbursement for themselves and any further dependants (such as children). 

Example 3

An engineer is in the UK working in the energy sector on a General Work Visa (Tier 2) and has brought a partner as a dependant, who works as a care home manager. They have brought one dependent child.

In this instance, the dependant and their child would qualify for a reimbursement, but the engineer would not.

Dependants of UK nationals, where the UK national works in the health or care sector, will not be eligible for a reimbursement, unless the dependant is eligible in their own right.

Tier 2 (General) Visa holders

If the applicant is in the UK on Tier 2 (General) visa, working in an eligible occupation, or a health and care visa, they should not claim reimbursement through this scheme. Instead, they should contact the Home Office at [email protected] to claim a refund, for any time remaining on their visa after 31 March 2020.

From 4 August 2020, anyone applying for a health and care visa does not need to pay the IHS upfront.

Reimbursement process

The NHSBSA works with the UKVI, which is part of the Home Office, to process reimbursement applications.

Link: Apply for your immigration health surcharge reimbursement

Where help is needed, applicants should call the NHSBSA helpline on 0300 330 7693. Call +44 191 283 8937 if you’re outside the UK. 

This helpline is available Monday to Friday 8am to 6pm and Saturday 9am to 3pm.

Required evidence: hours worked and claims for dependents (if applicable)

Applicants should ensure they have all relevant documentation to hand before beginning their application, including:

the applicant’s IHS number, and that of any dependants who are also being claimed for

payslips covering the 6-month period of the reimbursement claim. The applicant should ensure that this includes the:
A) name of the employer
B) applicant’s job role
C) number of hours worked throughout the period

details of any dependants that the applicant is also claiming for and relevant evidence (where applicable) such as:
A) payslips (where applicable)
B) supporting letter from the employer outlining the sector of work and applicant’s role

Applicants are reminded that:

if they submit false or misleading information, they may not receive their payment and could be liable to criminal prosecution and/or civil proceedings

information given may be shared with other departments for the purposes of fraud prevention, detection and investigations

information applicants give may be shared as part of the Cabinet Office National Fraud Initiative (NFI) exercise to prevent and detect fraud

NHSBSA provides data to the NHS Counter Fraud Authority when referrals of alleged fraud, bribery and corruption are received


Applicants should receive a decision via email and payment to the bank account associated with paying the immigration health surcharge within 6 weeks from submission to NHSBSA of all evidence information required. Please be aware that in some instances NHSBSA will need to contact the applicant for more information or to conduct a more thorough check. In these cases, it may take longer to process.

The applicant may make another claim for reimbursement when they have worked a further 6 months in an eligible role.

Link: Apply for your immigration health surcharge reimbursement