The health surcharge is £1,035 a year, or £776 for students, their dependants, Youth Mobility holders and under-18s. It is paid upfront for the whole period of permission and is usually larger than the visa fee. Applications made from outside the UK for six months or less do not pay it.
Health Surcharge
The Immigration Health Surcharge in 2026
What the Surcharge Is
A charge levied under section 38 of the Immigration Act 2014 on people coming to the UK for more than six months. Paying it gives access to the NHS on broadly the same basis as a resident, for the duration of your permission. It is not insurance and it is not optional — an unpaid surcharge makes the application invalid.
£1,035 a year at the standard rate; £776 for students, their dependants, Youth Mobility holders and anyone under 18 at the date of application. A period of more than six months but under a year is charged as a full year. From inside the UK, six months or less is charged at half the annual rate. No surcharge is payable applying from outside the UK for six months or less.
Why It Is So Large
Because it is charged for every year of permission, in advance, per person. A family of four granted three years pays for twelve person-years upfront. Against application fees of a few hundred pounds each, the surcharge is usually the dominant number in the total cost of an application.
The Rates
Annual Surcharge Rates
| Applicant | Per year | Half year, applying in the UK |
|---|---|---|
| Standard rate | £1,035 | £517.50 |
| Students and their dependants | £776 | £388 |
| Youth Mobility Scheme | £776 | £388 |
| Under 18 at the date of application | £776 | £388 |
Source: GOV.UK immigration health surcharge rates. Checked 22 August 2026.
Working Out Your Total
Take the rate for each applicant, multiply by the number of years of permission you are applying for, and apply the rounding rule to any part year. The rule is straightforward: more than six months but less than a year is charged as a full year, wherever you apply from.
- A student granted three years: £776 × 3 = £2,328.
- A Skilled Worker granted three years: £1,035 × 3 = £3,105.
- A partner granted 33 months: two full years plus a part year over six months, charged as three: £3,105.
- A partner granted 30 months: two years and six months — £2,587.50 at the standard rate.
- A child on the same 30-month grant: £1,940 at the under-18 rate.
- A five-year grant for a family of four adults: £20,700.
The arithmetic is worth doing before choosing how long to apply for. Our pages on entry clearance fees and work visa fees set the surcharge alongside the application fees.
Who Pays
Anyone applying from outside the UK for more than six months, and anyone applying from inside the UK for any period. Dependants pay in their own right at their own rate. Holding private medical insurance makes no difference — it does not exempt you.
- Work routes: including Skilled Worker, Global Talent, Innovator Founder, Scale-up and High Potential Individual.
- Study routes: the student route and the Graduate route, at the lower rate.
- Family routes: the spouse route, the fiancé route and dependants.
- Other routes: including UK Ancestry, Youth Mobility and the BN(O) route.
Exemptions
- Health and Care Worker visa holders and their dependants: fully exempt — see our Health and Care Worker page.
- Anyone applying for indefinite leave to enter or remain: no surcharge at settlement — see our page on settlement.
- Visitors and stays of six months or less applied for from abroad: including the standard visitor route.
- Asylum seekers, humanitarian protection, trafficking and slavery victims, stateless persons.
- Children under 18 taken into care by a local authority.
- Those covered by the domestic violence concession.
- EU Settlement Scheme applicants, Ukraine Extension Scheme applicants and S2 healthcare visitors.
- Diplomats, NATO civilian employees, visiting armed forces and armed forces dependants.
- Frontier workers holding an S1 certificate, and Falkland Islands British Overseas Territory citizens.
Waivers Are Not the Same as Exemptions
A waiver is discretionary and means-tested, available principally on human rights based family and private life applications made from inside the UK where the applicant cannot afford to pay. Income, outgoings, savings and accommodation all have to be evidenced. See our page on human rights applications.
What It Comes To by Route
On the Skilled Worker route a three-year grant costs £3,105 in surcharge against an £819 application fee from abroad. On the student route a three-year degree costs £2,328 against £558. On the partner route a 33-month grant costs £3,105 against £2,064 for the application itself.
Those ratios are the point. Reading only the headline fee understates the real cost of most applications by a factor of three or four, and for families the multiplier is the number of people. Our page on the financial requirement covers the other money question on family routes.
Why the Grant Length Matters More Than the Fee Band
On most routes you choose how long to apply for, and the surcharge scales with that choice while the application fee often does not. A three-year Skilled Worker grant and a five-year one differ by one fee band; they differ by £2,070 in surcharge. The longer grant is still usually better value because it avoids a second application, but the cash needed upfront is very different.
For families the effect compounds. Two adults and two children on a five-year grant pay £10,350 each at the standard rate, or £3,880 each at the under-18 rate for the children — a bill that has to be found in a single payment at the point of applying, months before anyone travels.
Extensions Restart the Clock
The surcharge is not a one-off. Each new grant of permission carries its own charge for its own period, so someone on a five-year route to settlement pays twice before they get there — once at entry clearance and again at extension. Only the settlement application itself is exempt.
That pattern is worth mapping before the first application. Our pages on the spouse extension and on settlement set out where each payment falls in a five-year timeline.
What Paying It Gets You
Access to the NHS on broadly the same basis as an ordinarily resident person, for the period of your permission. That includes GP services, hospital treatment and emergency care. It does not cover prescription charges, dental treatment, optical services or assisted conception in England, which are charged as they are for residents.
Because visitors pay no surcharge, they are not covered. NHS hospital treatment is chargeable to them, and bills are pursued. Travel insurance with medical cover is the practical answer for anyone visiting, and it is worth having whatever the length of the trip.
Paying
The surcharge is paid as part of the online application, before you pay the application fee. The system calculates the amount from the permission you are applying for, and you receive an IHS reference number. Keep it — it appears on the application and is used for any refund.
There is no instalment option. If the amount is calculated incorrectly, or you pay for a shorter period than you apply for, the application can be treated as invalid, which is a worse outcome than paying too much. Where you overpay, the excess is refundable.
Getting the Calculation Wrong
The system works out the amount from the permission you say you are applying for. Where those two things diverge — you pay for two years and apply for three — the application can be treated as invalid rather than simply underpaid, and an invalid application is not a decision you can challenge. It is a submission that never happened, with the timing consequences that follow.
The safeguard is to check the period the payment page states against the period on your application before confirming, and to keep the IHS reference number from the confirmation. Paying too much is recoverable; paying for the wrong period is not always.
Refunds
- The application is refused: the surcharge is refunded even though the fee is not.
- The application is withdrawn: before a decision.
- Permission is granted for less than you paid for: the difference is refunded.
- You paid at the wrong rate: for example the standard rate where the student rate applied.
- An exemption applied and was missed: including the Health and Care Worker exemption.
Refunds are usually processed automatically, but they are worth checking for rather than assuming. This asymmetry — surcharge refundable, fee not — is the strongest reason to get the application right before submitting rather than relying on a second attempt.
If You Believe You Were Exempt
Where an exemption applied and the surcharge was paid anyway, it is refundable — the Health and Care Worker exemption is the one most often missed, particularly by dependants applying separately from the main applicant. Keep the IHS reference and raise it as soon as the grant is made rather than years later.
Rumoured Rate Changes
Figures above the published rates circulate periodically, usually attached to a claim that an increase has already taken effect. The current rates are £1,035 and £776, and they did not change in the 8 April 2026 fee round even though most application fees did.
Rates are set by regulations and change by statutory instrument, which means an increase is published before it takes effect. Check the GOV.UK rate page at the point of applying rather than acting on a figure from a forum, and be sceptical of any number presented without a commencement date attached.
Sources: the GOV UK health surcharge pages, the published rates, the exemption guidance and section 38 of the Immigration Act 2014. Figures verified 22 August 2026.
Frequently Asked
Health Surcharge Questions
How much is the health surcharge?
£1,035 a year at the standard rate and £776 a year for students, their dependants, Youth Mobility holders and anyone under 18 at the date of application.
How is a part year charged?
More than six months but less than a year is charged as a full year, wherever you apply from. Six months or less, applying inside the UK, is charged at half the annual rate.
Do visitors pay it?
No. Applications from outside the UK for six months or less do not pay the surcharge. Visitors are billed for NHS hospital treatment instead, so travel insurance matters.
Is it payable on a settlement application?
No. Applications for indefinite leave to enter or remain are exempt.
Are Health and Care Worker applicants exempt?
Yes, along with their dependants. It is a full exemption, not a reduced rate.
Does private medical insurance exempt me?
No. Holding private cover makes no difference to whether the surcharge is payable.
Do I get it back if I am refused?
Yes. The surcharge is refunded on refusal or withdrawal, and the difference is refunded where permission is granted for less than you paid for. The application fee is not refunded.
Does it cover dental and prescriptions?
No. Prescription charges, dental treatment, optical services and assisted conception in England are charged as they are for residents.
Can I pay in instalments?
No. It is paid in full as part of the online application, before the application fee.
Do children pay the same as adults?
Anyone under 18 at the date of application pays £776 a year rather than £1,035, whatever the route the family is on.
Do I pay again when I extend?
Yes. Each grant of permission carries its own surcharge for its own period. Only the settlement application is exempt.
Has the rate gone up to a higher figure?
The published rates remain £1,035 and £776, and they did not change in the April 2026 round. Check the GOV.UK rate page rather than acting on a figure without a commencement date.