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Health and Care Worker vs Skilled Worker visa

The Health and Care Worker visa is a version of the Skilled Worker route for listed health and social care jobs with approved employers. It costs £324 for up to 3 years with no health surcharge, against £819 plus £1,035 a year on the standard Skilled Worker route. Which one applies depends on the job and employer, not on cost.

People often search for these two visas side by side as if they were a menu, and the price gap is large enough that the question is understandable. The difference is real. The Health and Care Worker visa has a lower application fee, no immigration health surcharge for the worker or their family, and a lower salary floor for most of its jobs. But it is not an option a worker picks. It is open only to people in a listed health or social care job, sponsored by a particular kind of employer, and GOV.UK describes it as a version of the same application: you apply online for a Skilled Worker visa and are asked whether you are applying for a Health and Care Worker visa.

This guide sets out what is the same, what differs and what each difference costs, using GOV.UK's route pages, Appendix Skilled Worker, and GOV.UK's pages on the health surcharge, all read on 10 October 2026. It does not say which route applies to you. That is determined by the occupation code on your certificate of sponsorship and the type of employer, and the sponsor and a regulated adviser are the people who can check it.

What each visa is for

GOV.UK's Skilled Worker page says the visa "allows you to come to or stay in the UK to do an eligible job with an approved employer." You need a certificate of sponsorship, an eligible occupation code, English at the required level and a minimum salary.

The Health and Care Worker page says the visa "allows medical professionals to come to or stay in the UK to do an eligible job with the NHS, an NHS supplier or in adult social care." To qualify you must be a qualified doctor, nurse, health professional or adult social care professional, work in an eligible health or social care job, work for an approved UK employer and be paid the minimum salary.

The employer side is narrower than it sounds. GOV.UK says the job offer must come from the NHS, an organisation providing medical services to the NHS, or an organisation providing adult social care. The Rules define the employer categories in detail, and the sponsor can say which category it falls into.

The jobs are listed by occupation code. GOV.UK's Health and Care Worker list includes generalist and specialist medical practitioners, the nursing codes (midwifery, community, specialist, practitioner, mental health, children's and other registered nurses), physiotherapists, occupational therapists, speech and language therapists, psychologists, pharmacists, optometrists, dental practitioners, radiographers, paramedics, podiatrists, social workers, laboratory and pharmaceutical technicians, nursing auxiliaries and assistants, and managers in health services and residential care. Care workers (6135) and senior care workers (6136) appear only for people extending, updating or switching.

The cost difference, line by line

These are the figures on GOV.UK's route pages on 10 October 2026.

  • Application fee, Health and Care Worker: £324 per person for up to 3 years, £628 per person for more than 3 years. GOV.UK says "The fee is the same whether you apply from inside or outside the UK."
  • Application fee, Skilled Worker, applying from outside the UK: £819 per person for up to 3 years, £1,618 for more than 3 years.
  • Application fee, Skilled Worker, extending, switching or updating inside the UK: £943 for up to 3 years, £1,865 for more than 3 years.
  • Application fee, Skilled Worker, job on the immigration salary list: £628 for up to 3 years, £1,235 for more than 3 years, whether inside or outside the UK.
  • Immigration health surcharge, Health and Care Worker: none. GOV.UK says "You - and your partner or children - will not have to pay the healthcare surcharge."
  • Immigration health surcharge, Skilled Worker: usually £1,035 per year of the stay, and £776 per year for applicants under 18.
  • Money to hold: £1,270 for the worker on both routes, with the same 28-day rule, unless an exemption applies. Dependants need £285 for a partner, £315 for the first child and £200 for each further child on both routes.

GOV.UK's Skilled Worker page points to the difference directly: "If you’re a doctor or nurse, or you work in health or adult social care, check if you’re eligible to apply for the Health and Care Worker visa instead. It’s cheaper to apply for and you do not need to pay the annual immigration health surcharge."

Dependants follow the worker's band. A Skilled Worker's partner or child pays the same fee as the worker "for the same length of time as you", and the surcharge. A Health and Care Worker's partner or child pays £324 or £628 and no surcharge.

The salary rules

The general Skilled Worker rule is a minimum of £41,700 or the going rate for the occupation, whichever is higher, with reduced options for new entrants, PhD holders and jobs on the immigration salary list. Our salary threshold guide goes through those options.

Health and Care Worker salary rules are lower for most jobs. GOV.UK says "You’ll usually need to be paid at least £25,000" or the going rate if that is higher. For jobs paid on national pay scales, such as NHS roles, the requirement is the pay-scale rate for the job and area. GOV.UK says "These going rates apply whether you’ll be working in the public or private sector."

A group of occupation codes has different salary rules: health services and public health managers (1171), health care practice managers (1231), residential and day care managers (1232), biochemists (2113), physical scientists (2114), laboratory technicians (3111), dispensing opticians (3211), pharmaceutical technicians (3212), and the care worker codes 6135 and 6136. For these, GOV.UK says "You’ll usually need to be paid at least £31,300 per year, or the lower ‘going rate’ for your job, whichever is higher."

Skilled Worker has its own lower floor for healthcare and education jobs paid on national scales: GOV.UK says "Your salary must be at least £25,000 - or more if your job’s ‘going rate’ is higher." So a nurse sponsored on the standard Skilled Worker route is not held to £41,700. The salary floor is therefore not the reason most people in these jobs end up on one route or the other.

Time, family and settlement

Decision times differ in one case. GOV.UK says Health and Care Worker applicants usually get a decision within 3 weeks. For Skilled Worker, the usual decision time is 3 weeks outside the UK and 8 weeks inside the UK. Both pages say you may be able to pay for a faster decision.

Family: both routes allow a partner and children as dependants where the eligibility rules are met, with the same evidence of relationship and the same maintenance funds. The care worker restrictions (dependants only in listed cases since 11 March 2024) apply to codes 6135 and 6136 on either version. Our care worker dependants guide covers them.

Length of stay and settlement: both visas can last up to 5 years at a time, can be extended repeatedly while the person still qualifies, and both pages say that after 5 years you may be able to apply for indefinite leave to remain. Both use Appendix Skilled Worker. From 26 March 2027, rule SW 22A.1 requires English at level B2 in speaking and listening for settlement as a Skilled Worker; the settlement rules are covered in our English requirement guide.

English at entry is the same. Both pages say that new applicants must show English at level B2 (CEFR), and both give the same ways to show it. The older B1 level applies to people who held the visa before 8 January 2026 when they extend or update.

Moving between the two: GOV.UK says a Skilled Worker switching from a Health and Care Worker visa does not need to prove English again, and the same is true the other way. The updating section for Health and Care Worker says "You must apply online for a Skilled Worker visa. You’ll be asked if you’re applying for a Health and Care Worker visa as part of your application - make sure you choose ‘yes’."

If you pay the surcharge and later move into health or care

The surcharge is paid once, at application, for the whole stay. GOV.UK's surcharge page has a refund route for people who end up in health or care work: "You and your dependants may be able to get a refund of the IHS." The refund covers only periods worked in health or care for 6 months or more, and a refund for dependants is possible only if their visa covers the same period as yours. GOV.UK's refund page has the eligibility check.

The Graduate visa page gives a related example: "If you get a job in public sector healthcare after you have paid the healthcare surcharge, you may be able to get a refund." The details, including which employers and what proof, are on the refund application pages.

The refund page also lists cases where there is no refund. One is "you’re switching to another visa which is exempt from the IHS", so anyone who moves between a surcharge-paying route and the Health and Care Worker route partway through a paid period should read that page before assuming a refund.

Worked examples (illustrative)

These examples are invented to show how the published fees combine. They are not advice. Which route applies depends on the job and the sponsor, not on which is cheaper.

Example 1. A worker is applying from abroad for a 3-year stay. On the standard Skilled Worker route the fee is £819 and the surcharge is 3 × £1,035 = £3,105, a total of £3,924. On the Health and Care Worker route the fee is £324 and there is no surcharge. The difference is £3,600 for the worker alone.

Example 2. The same worker brings a partner and one child under 18, all for 3 years. On the Skilled Worker route each person pays £819. The surcharge is £3,105 for the worker, £3,105 for the partner and 3 × £776 = £2,328 for the child. That makes £3,924 + £3,924 + £3,147 = £10,995 in fees and surcharge. On the Health and Care Worker route each person pays £324, so the total is £972. The maintenance funds are the same on both: £1,270 + £285 + £315 = £1,870, unless an exemption applies.

Example 3. A worker already in the UK on a Skilled Worker visa as a health professional moves to an NHS employer. GOV.UK's description of updating a Health and Care Worker visa says the application is made online as a Skilled Worker application and answered 'yes' to the Health and Care Worker question. The fee in the UK on this route is £324 for up to 3 years. Whether the worker can claim back part of an earlier surcharge is a question for the refund pages.

Finding a regulated adviser

Which route a job falls under turns on the occupation code the sponsor puts on the certificate, the type of employer and the worker's qualifications. If you want a regulated adviser to check them, GOV.UK explains how to find an immigration adviser, and only IAA-registered advisers, solicitors and other qualified persons can give immigration advice in England and Wales.

The Migratio directory lists IAA-registered advisers (with their level) and SRA-regulated solicitors, each with their regulator and registration number. Migratio is not regulated by the IAA or the SRA and does not give immigration advice. This page explains how the rules work; it does not tell you what to do in your case.

Questions people ask

Is the Health and Care Worker visa cheaper than the Skilled Worker visa?

On GOV.UK's figures, yes. The Health and Care Worker fee is £324 for up to 3 years or £628 for longer, with no health surcharge. The standard Skilled Worker fee is £819 or £1,618 from outside the UK, plus usually £1,035 a year in surcharge. Eligibility depends on the job and employer.

Can I choose the Health and Care Worker visa instead of Skilled Worker?

Not freely. GOV.UK says you must be a qualified health or social care professional in an eligible job, with an approved NHS, NHS supplier or adult social care employer. Doctors, nurses and similar workers on the Skilled Worker page are told to check eligibility for the Health and Care Worker visa first.

Do Health and Care Worker visa holders pay the NHS surcharge?

GOV.UK says the worker and their partner or children do not pay the immigration health surcharge, and the NHS can be used from the date the visa starts. Some services, such as prescriptions, dental treatment and eye tests, still have to be paid for.

What salary do I need for a Health and Care Worker visa?

GOV.UK says you will usually need at least £25,000, or the going rate if higher, and the national pay scale rate for NHS-type jobs. A group of codes, including care workers, has a different rule: at least £31,300 or the lower going rate, with reduced options in some cases.

Does the Health and Care Worker visa lead to settlement?

GOV.UK says that after 5 years you may be able to apply for indefinite leave to remain, if you meet the other requirements. Appendix Skilled Worker rule SW 22A.1 adds an English requirement of B2 in speaking and listening for applications on or after 26 March 2027.

Sources

Last checked 2026-10-10.

Related guides

  • Skilled Worker visa cost: worker and employer totals — A worker applying from outside the UK for up to 3 years pays £819 plus £1,035 a year in healthcare surcharge, and usually needs £1,270 held in savings. The employer separately pays a £525 certificate fee and the immigration skills charge, and its licence fee if it is new.
  • Skilled Worker salary: £41,700 and going rates — Under Appendix Skilled Worker the general salary test is at least £41,700 a year and the occupation's going rate, whichever is higher. Lower thresholds of £33,400, £37,500 or £25,000 apply to specific groups, and only guaranteed basic pay counts.
  • Bringing family on a Skilled Worker visa: costs and rules — Each partner and child pays the same application fee as the Skilled Worker for the same length of stay (£819 or £1,618 from outside the UK), plus the Immigration Health Surcharge, and must show £285 for a partner, £315 for the first child and £200 for each further child. Restrictions apply to dependants of care workers and some medium-skilled jobs.
  • Care worker visa in 2026: who can still apply — Under rule SW 6.1B, care workers (6135) and senior care workers (6136) can only apply for permission to stay, not for entry clearance from abroad. The rule allows either a switch after at least three months working legally for the sponsor, with an application before 22 July 2028, or an application by someone already holding permission in those codes.
  • Care worker visas and dependants: the 11 March 2024 rule — GOV.UK says a partner and children outside the UK can apply to join a care worker or senior care worker only if the worker has been continually employed in that role on a Skilled Worker visa since before 11 March 2024, or the child was born in the UK. Different conditions apply to dependants already in the UK.
  • Medium-skilled jobs after July 2025: the ISL and TSL — Since 22 July 2025 the Skilled Worker route is open to degree-level jobs, plus mid-level jobs only if they are on the Immigration Salary List or the Temporary Shortage List, or if the worker already held permission before that date. Both lists have a cut-off date for new certificates.
  • B2 English for Skilled Worker visas from 2026 — New Skilled Worker and Health and Care Worker applicants must show English at level B2 in reading, writing, speaking and listening. People who held the visa before 8 January 2026 and are extending or updating need B1. Settlement applications from 26 March 2027 need B2 in speaking and listening.