£1.7 billion UK migrant health surcharge set to be recouped

Published: 04/04/2015

According to latest NHS statistics, the burden of giving medical care to temporary migrants too much and so new legislation, coming into effect on 6 April 2015 is designed to plug the financial shortfall. At the moment, migrants who enter the country to work, study or join family members receive free treatment through the NHS as though they were permanent residents. All nationals from outside the EEA who seek to enter the UK for longer than six months after 6 April 2015 will be required to pay a mandatory NHS health surcharge upon making their application. These changes will affect partners and spouses of UK citizens and permanent residents applying for a settlement visa. It will also be levied against non-EEA nationals who are already in the UK applying to extend their stay under the 5-year partner route. This change is part of the Immigration Act of 2014.

The surcharge will defray NHS shortfall

The cost per year to treat overseas visitors and migrants can only be estimated but is believed to be around £2 billion per year – of this, £950 million is spent on temporary, non-EEA workers and students. The surcharge, which will be £200 per annum per person, £150 for students, will be payable upfront and for the total time the migrant is applying to stay. If there is an extension in time, the extra surcharge will be payable before it is granted. The surcharge is not intended to put off genuine migrants and as it represents just 1% of the cost of a student’s tuition fees over three years it is unlikely to deter students from coming to the UK. But it is essential that the costs to the struggling NHS do not rise further.

Maintaining quality of care

James Brokenshire, the minister for Immigration and Social Security, is keen to explain that the surcharge is kept at a competitive level to recognise the contribution temporary migrants make to the economy of the UK. Monies collected through the surcharge will be passed to the health departments in England, Wales, Scotland and Northern Ireland. Many countries who require medical insurance to be taken out by migrants charge far greater sums, so the minister is confident that genuine migrants will not be put off by the surcharge but will see it for what it is, a genuine contribution to keep the NHS solvent. Those entering on tourist visas will not be required to pay the mandatory NHS surcharge but will continue to be charged for care received, as billed by individual providers.

Increased fees also being considered

As well as the surcharge, the Department of Health is considering proposals which will mean non-EEA visitors will pay 150% of the cost of their treatment, instead of cost price as at present. This will also reflect the fact that UK citizens and permanent residents pay taxes towards the NHS. Foreign nationals will be required to pay the surcharge at the same time they submit their visa application to come to the UK, or to extend their stay, as part of a two stage online process. The Immigration Act 2014 is part of the government’s ongoing reforms to make the immigration system work in the interests of the country as a whole. Its main aim is to prevent illegal migrants accessing public services to which they are not entitled and reducing the ‘pull factors’ which encourage them here in the first place.

How is the surcharge paid and can it be refunded?

The surcharge is calculated to cover the entire proposed stay but if the application is denied, the surcharge will be refunded. However, if you apply and then change your mind, no money is paid back, nor is part of it refunded if you choose to cut your visit short or the UK government ask you to leave. The surcharge must be paid ahead of any application and is calculated depending on length of stay. There is also no refund if the NHS is not used – this surcharge is designed to spread the onus on NHS use across all visa applicants and whilst some may not use the service at all, others will cost the NHS far more than their £200 (£150 for students) surcharge. Working out pro-rata refunds would cost far more than the total cost, which would be counter-productive.

Exemptions to paying the surcharge

There are some exemptions to this charge. Australian and New Zealand citizens and any British Overseas Territory Citizen from the Falkland Islands are exempt, as are those seeking asylum. Some intra-company migrants are not charged but instead of being classed ‘exempt’ have a nil charge, for which they receive a unique code. Other exemptions include dependents of the British Armed Forces and those who remain in the UK because of domestic violence. If an applicant has an appointment with a Premium Service Centre in the UK, the surcharge must have been processed before the date of the appointment.

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