The Immigration Health Surcharge (IHS) is a mandatory fee that most UK visa applicants must pay to access NHS services during their stay. This comprehensive guide explains current IHS rates for 2026, who needs to pay, exemptions available, and how the surcharge is calculated for different visa categories including student, work, and family visas.
Understanding the Immigration Health Surcharge UK Visa Requirements
The Immigration Health Surcharge (IHS) is a fee paid by most non-UK nationals applying for a visa to live in the United Kingdom for more than six months. Introduced in April 2015 under the Immigration Act 2014, this surcharge grants visa holders access to the National Health Service (NHS) on the same basis as permanent UK residents.
The IHS fee is separate from the UK visa application fee and must be paid as part of your application. According to the House of Commons Library, the surcharge has generated over £6.9 billion since its introduction, with £1.7 billion raised in the 2023/24 fiscal year alone.
Immigration Health Surcharge Rates and Fees 2026
The Immigration Health Surcharge costs £1,035 per year for most visa applicants. Students, their dependants, Youth Mobility Scheme applicants, and those under 18 pay a reduced rate of £776 per year. The total amount depends on the length of your visa.
The current IHS rates came into effect on 6 February 2024 following a 66% increase from the previous rates. The Department of Health and Social Care sets the surcharge based on the estimated average cost of providing healthcare to migrants, calculated at approximately £1,036 per person per year.
How is the IHS Fee Calculated?
The IHS is calculated based on the total length of visa permission granted, not the duration of your employment contract or course. The calculation follows specific rules:
- Full year charge: For each complete year of visa validity
- Part year over 6 months: Full annual rate applies
- Part year 6 months or less: Half the annual rate applies (£517.50 or £388)
- Applications from inside UK: Half the yearly cost for stays under 6 months
You can calculate your exact IHS liability using the official GOV.UK IHS calculator.
Who Needs to Pay the Immigration Health Surcharge?
You must pay the IHS if applying for a UK visa for more than 6 months from outside the UK, or for any length of stay if applying from inside the UK. This includes work visas, student visas, family visas, and most other immigration categories.
The Immigration Health Surcharge applies to most temporary migrants seeking permission to live in the UK. According to the official Home Office guidance, payment is required regardless of whether you have private health insurance.
Visa Categories Requiring IHS Payment
- Skilled Worker visa: Standard rate of £1,035 per year
- Student visa: Reduced rate of £776 per year
- Graduate visa: Standard rate of £1,035 per year
- Spouse and Partner visas: Standard rate of £1,035 per year
- Fiancé(e) visa: Standard rate of £1,035 per year
- Ancestry visa: Standard rate of £1,035 per year
- Youth Mobility Scheme: Reduced rate of £776 per year
- Dependent visas: Same rate as main applicant (children under 18 pay £776)
Immigration Health Surcharge Exemptions
Key exemptions include Health and Care Worker visa holders and their dependants, visitor visa applicants, those applying for Indefinite Leave to Remain (ILR), asylum seekers, and applicants who demonstrate financial hardship on certain family or human rights routes.
Certain applicants are exempt from paying the Immigration Health Surcharge. Exemptions are set out in legislation and are not discretionary—if you qualify, you are automatically exempt.
Full IHS Exemptions (No Payment Required)
- Health and Care Worker visa holders: Exempt in recognition of their NHS contribution
- Dependants of Health and Care Workers: Also fully exempt
- Visitor visa applicants: Stays of 6 months or less from outside the UK
- Indefinite Leave to Remain applicants: Settlement applicants are exempt
- Asylum seekers: Those applying for asylum or humanitarian protection
- Victims of human trafficking: Those granted leave on these grounds
- EU Settlement Scheme: Pre-Settled and Settled Status applicants
- Diplomatic exemptions: Diplomats and their family members
- NATO personnel: And relevant civilian employees
- Children in state care: Under 18 in local authority care
IHS Fee Waivers for Financial Hardship
Applicants on certain Family and Human Rights visa routes, as well as the Hong Kong BNO route, may apply for a fee waiver if they can demonstrate they cannot afford the surcharge. A fee waiver application must be submitted before the main visa application.
IHS Fees by Visa Type: Detailed Breakdown
A 3-year Skilled Worker visa requires £3,105 IHS per person. A 5-year spouse visa costs £5,175 in IHS. Student visas for 3-year undergraduate degrees typically require approximately £2,716 (including pre and post-study periods).
IHS for Skilled Worker Visa
Skilled Worker visa applicants and their adult dependants pay the standard IHS rate. The surcharge is calculated based on the visa length, not the employment contract duration:
- Up to 3 years: £2,070 (main applicant), £3,105 maximum charged initially with refund if granted shorter
- 3-year visa: £3,105 per person
- 5-year visa: £5,175 per person
- Child dependants (under 18): £776 per year
IHS for Student Visa
Students benefit from the reduced IHS rate. However, visa permission typically extends beyond the course duration to include pre-arrival and post-study periods:
- 1-year course: Approximately £1,552 (including 1 month before and 4 months after)
- 3-year undergraduate: Approximately £2,716 (with pre and post-study allowance)
- Student dependants: £776 per year (same reduced rate)
IHS for Spouse and Family Visas
Spouse, partner, and other family visa applicants pay the standard rate. The 10-year route to settlement means significant total IHS costs:
- Initial 2.5-year visa: £2,587.50 per applicant
- Extension (2.5 years): Additional £2,587.50
- Total (5-year route): £5,175 in IHS alone before ILR
- Child dependants: £776 per year (reduced rate for under 18s)
How to Pay the Immigration Health Surcharge
The IHS is paid online during your visa application. After completing your visa form, you will be directed to the IHS payment portal where you pay by credit or debit card and receive a unique IHS reference number (format: IHS123456789) for your application.
The Immigration Health Surcharge payment process is integrated into the online visa application system. Payment must be completed before your visa application can proceed.
Step-by-Step Payment Process
- Step 1: Complete your online visa application form on GOV.UK
- Step 2: You will be automatically redirected to the IHS payment portal
- Step 3: The system calculates your IHS liability based on visa length
- Step 4: Pay the full amount by credit or debit card
- Step 5: Receive your unique IHS reference number (IHS followed by 9 digits)
- Step 6: The IHS reference is automatically linked to your visa application
What Happens If You Do Not Pay?
If you do not pay the IHS or pay an insufficient amount, UK Visas and Immigration will send you an email notification. You must complete payment within the specified timeframe (usually 10 working days for applications outside the UK, or 7 working days for UK applications) or your visa application will be automatically refused.
Immigration Health Surcharge Refunds
You are entitled to a full IHS refund if your visa application is refused. Partial refunds may be available if you leave the UK early, switch visa categories with overlapping IHS payments, or are granted a shorter visa than applied for. Refunds are not automatic—you may need to apply.
Understanding when you may be entitled to an IHS refund is important, particularly given the substantial amounts involved. The refund process varies depending on the circumstances.
When You Can Get a Full Refund
- Visa application refused: Automatic refund within 6 weeks to the original payment card
- Application withdrawn: Before a decision is made
- Successful administrative review: If the refusal is overturned
- EU students with valid EHIC: Full-time higher education students may claim back
Partial IHS Refunds
Partial refunds may be available in specific circumstances:
- Switching visa categories: Overlapping IHS periods may be refunded
- Granted shorter visa: If granted less time than paid for
- Leaving the UK early: Some circumstances allow partial recovery
When Refunds Are NOT Available
- Visa granted and used: No refund if you simply did not use NHS services
- Visa cancelled due to breach: No refund for overstaying or rule violations
- Voluntary departure: Generally no refund for choosing to leave early
What Does the Immigration Health Surcharge Cover?
The IHS provides access to NHS services on the same basis as UK residents, including GP consultations, hospital treatment, emergency care, and maternity services. However, it does not cover prescription charges, dental care, or optical services, which have separate fees.
After paying the Immigration Health Surcharge, you have access to most NHS services without further payment at the point of use:
Services Covered by IHS
- GP services: Registration and consultations with a local doctor
- Hospital treatment: Both outpatient and inpatient care
- Emergency care: A&E treatment and emergency admissions
- Maternity services: Antenatal, delivery, and postnatal care
- Mental health services: NHS mental health treatment
- Treatment for pre-existing conditions: Unlike private insurance
Services NOT Covered by IHS (Additional Charges Apply)
- Prescriptions: £9.90 per item in England (free in Scotland, Wales, Northern Ireland)
- Dental treatment: NHS dental charges apply
- Eye tests and glasses: Standard optical charges
- Some vaccinations: Non-essential travel vaccinations
- The Immigration Health Surcharge is £1,035 per year (£776 for students and under-18s)
- Payment is mandatory and must be made upfront in full—no instalments available
- Health and Care Worker visa holders and their dependants are fully exempt
- Full refunds are available if your visa application is refused
- IHS covers most NHS services but not prescriptions, dental, or optical care
Frequently Asked Questions About the Immigration Health Surcharge
What is the Immigration Health Surcharge (IHS)?
The Immigration Health Surcharge is a mandatory fee paid by most non-UK nationals applying for a visa to live in the UK for more than six months. It provides access to NHS healthcare services on the same basis as UK residents. The surcharge was introduced in 2015 under the Immigration Act 2014 and must be paid upfront as part of the visa application process.
How much is the IHS fee in 2026?
The Immigration Health Surcharge costs £1,035 per year for most visa applicants. Students, their dependants, Youth Mobility Scheme applicants, and those under 18 at the time of application pay a reduced rate of £776 per year. These rates have been in effect since February 2024. For example, a 3-year Skilled Worker visa requires £3,105 in IHS.
Who is exempt from paying the Immigration Health Surcharge?
Key exemptions include Health and Care Worker visa holders and their dependants, visitor visa applicants staying 6 months or less, those applying for Indefinite Leave to Remain, asylum seekers, EU Settlement Scheme applicants, victims of human trafficking, and children in local authority care. Applicants on certain family and human rights routes may also apply for fee waivers based on financial hardship.
Can I pay the IHS in instalments?
No, the Immigration Health Surcharge must be paid in full upfront when you submit your visa application. There is no option to pay in instalments. The full amount for the entire duration of your visa must be paid before your application can be processed. This requirement applies regardless of the total amount due.
What does the Immigration Health Surcharge cover?
The IHS provides access to most NHS services on the same basis as UK residents, including GP consultations, hospital treatment, emergency care, maternity services, and mental health treatment. However, it does not cover prescription charges (£9.90 per item in England), dental treatment, eye tests, or glasses. These services have separate NHS charges.
Will I get a refund if my visa is refused?
Yes, if your visa application is refused, you are entitled to a full refund of the Immigration Health Surcharge. Refunds are processed automatically to the original payment card, typically within 6 weeks. Refunds following a visa refusal can only be processed once 14 calendar days have elapsed since the refusal date. Contact the Home Office if you have not received your refund within 3 months.
Do I need to pay IHS if I have private health insurance?
Yes, you must still pay the Immigration Health Surcharge even if you have comprehensive private health insurance. There is no provision to opt out of the IHS based on private coverage. The surcharge is mandatory for all applicable visa categories regardless of any other healthcare arrangements you may have.
How is the IHS calculated for students?
Students pay the reduced IHS rate of £776 per year. The surcharge is calculated based on the total visa duration, which typically includes time before and after the course. For example, a 3-year undergraduate degree usually grants permission for approximately 3 years and 5 months (including pre-arrival and post-study periods), resulting in an IHS of approximately £2,716.