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NHS health surcharge to be extended in April 2016

Since April 2015, nationals from outside the European Economic Area (EEA) have been required to pay a ‘health surcharge’ when making UK immigration applications, allowing them equivalent rights of access to the NHS as UK residents. Australian and New Zealand nationals were initially exempt from making this payment on the basis that there was a reciprocal healthcare agreement in place with those nations. However, the Government has announced that from April 2016, the surcharge will also apply to Australians and New Zealanders planning to spend more than six months in the UK.

The reaction from the New Zealand Prime Minister was somewhat damning when he accused Britain of being “pretty cheap” and not acting “in keeping with the history of the two countries” after it revealed its plans.

We summarise below some of the main issues the health surcharge poses for migrants and employers of non-EEA workers.

1. When does the surcharge apply?

a. Applying to enter: Non-EEA nationals applying to enter the UK for more than six months must pay the surcharge when making their online application. The surcharge must be paid before the application is submitted or before any appointment at a Premium Service Centre.
b. Renewing an existing permission: Those renewing an existing entitlement to stay in the UK will have to pay the surcharge, even if this was not required with their initial application.

2. How much is it?

a. £200 (£150 for students) per annum, for both dependants and main applicants.
b. The surcharge is payable up-front for the ‘entire period’ of the immigration permission being applied for i.e. the maximum period that could be granted under the relevant application route.
c. Up-front payments for the ‘entire period’ often result in the health surcharge being higher than the fees required for the actual applications. For example, a family of four travelling to the UK for an initial three-year period under Tier 2 (General) would have to pay an additional £2,400 surcharge, on top of the cost of the visa application.

3. What happens if the surcharge is not paid?

Failure to pay will not only delay an application but may lead to it being refused altogether. Once payment has been requested, it must be made within seven working days of the request (or 10 working days for a renewal).

4. Are there any exceptions?

a. Visitor visa holders are exempt from the surcharge, but may still have to pay for NHS care at the point of use.
b. Those transferring within a company (“Tier 2 – Intra-Company Transfer” (ICT)) are also exempt, but must complete the surcharge process to be given a reference number.
c. Babies born in the UK to an exempted person will also be exempt until they reach three months. However, the exemption will no longer apply if they leave the UK.

Unless you fall within one of these exempted categories, which will also include Australian and New Zealand nationals until April 2016, the NHS surcharge cannot be avoided. This will be the case even if a family has private healthcare.

5. What should employers do?

Employers seeking to bring an employee into the UK from an overseas office should consider applying under Tier 2 (ICT) rather than Tier 2 (general), if they satisfy the ITC eligibility requirements. Using the example referred to above, a saving of £2,400 could be made for a family of four, applying under Tier 2 (ICT).

6. What is the impact?

Paying the surcharge means that non-EEA nationals (to include Australians and New Zealanders from April 2016) are entitled to treatment in the NHS as if they are a permanent UK resident.

This replaces the previous system under which individuals were charged for non-emergency NHS care at the point of use, if they were ‘not ordinarily resident’ in the UK. It is worth noting, however, that this more complex system remains relevant to those entering the UK for six months or less and those without permission altogether.

The surcharge, which promises to simplify access to healthcare, has raised more than £100m in its first six months for the NHS and Britain’s Immigration Minister, James Brockenshire, said that it was “only fair” that the surcharge was extended to Australians and New Zealanders. He also remarked that “by keeping the surcharge at a competitive level, we are recognising the contribution temporary migrants make to the wider economy”.


This briefing is for guidance purposes only. RadcliffesLeBrasseur LLP accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.

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