NHS surcharge?

Hello UKY friends!

Maybe I should be posting this in the visa category,
But when I get married, either  in the UK or in the US, when and how to I pay this?
I keep hearing about it, and I want to make sure I know EXACTLY what I need to do!
Also,how much is it usually?
I haven't applied for my fiance visa yet, so I have no clue, and I want to make sure I have enough money in savings cover any additional expenses!
Help please, and thank you,
So glad I found this website. You guys are really amazing. 

Best to keep your questions in the same thread, as it helps us keep everyone straight.   

The NHS levy isn't paid until after you switch from your fiancé visa to the spouse visa.  It is £200 a year, paid up front.  So for your two spouse visas it will be an extra £500 (assuming they keep the fee the same).

BUT, your fiancé visa will NOT give you access to the NHS without cost.  Be sure to carry insurance while you are here as you just never know when you will need it.  If you receive any treatment while you are on your fiancé visa, insist on a bill and keep the paperwork showing payment.  Without the paperwork, it will delay the processing of your spouse visa and if over £500 (unpaid) the spouse visa will be refused.

Thanks so much KFdancer!!
Just one follow up question, if we do end up just getting hitched in the US, do we then have to  pay the surcharge along with the cost of the Spouse visa here, and then it's sorted?
Or do we still have to do it once I'm there?
Thanks. And my apologies for posting in a different forum, i felt like I was asking way too many questions in the other, didn't want to overload anyone with my many inquiries! 

If you apply as a spouse, the fee for the first visa is £600 (as the visa is issued for 33 months and not 30 months as it would be in-country).  But no, you wouldn't need to have health insurance after you relocate if you married in the US.

So you could do fiancé visa:
£1,195 fiancé visa
£1,311 FLR(M) (term for spousal visa)

OR:
Spouse visa for £1,695

Both visas will then have another FLR(M) after 30 months of living in the UK, then there is another visa after that.  It's time consuming and expensive!

So if we get married in the U.S.  when I apply for my visa (spousal) does that automatically include the NHS surcharge? Is there a special section that you need to fill out to do that? Or do they just automatically tack it on?
Or is it a separate thing?
How do I do it?
Sorry, still confused about all of this. Thank you. xx

When you fill out the online application form you will be prompted to pay the IHS surcharge.


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Cheers.