Immigration Health Surcharge (IHS)
The Immigration Health Surcharge (IHS) is an upfront fee paid by most UK visa applicants that gives them access to NHS services during their stay. It is currently £1,035 per year of leave granted — paid in full at the time of the visa application.
In This Article
- What is the Immigration Health Surcharge?
- Current IHS rates (2025/2026)
- How is the IHS calculated?
- Who is exempt from the IHS?
- IHS for dependants
- What does the IHS give you access to?
- Refunds
- 2025/2026 updates
- Common mistakes to avoid
- Frequently asked questions
- Related terms
What is the Immigration Health Surcharge?
The Immigration Health Surcharge was introduced in April 2015 under the Immigration Act 2014. It requires most non-EEA visa applicants (and, since 2021, EEA nationals requiring visas) to pay an upfront contribution toward National Health Service (NHS) costs before they arrive in the UK.
Unlike private insurance, the IHS is a flat contribution to NHS funding. Once you've paid it, you're entitled to the same NHS services as a UK resident — free GP and A&E, charges for dental and optical care.
Current IHS rates (2025/2026)
| Applicant type | Rate per year |
|---|---|
| Standard (adults, students, workers) | £1,035/year |
| Discounted (students under 18, youth mobility applicants) | £776/year |
| Health and Care Worker visa holders | Exempt |
| Dependants of Health and Care Worker visa holders | Exempt |
The standard rate of £1,035/year applies to most Skilled Worker visa applicants.
How is the IHS calculated?
The IHS is paid upfront for the full visa duration, rounded up to whole years:
Examples (standard rate, Skilled Worker):
| Visa duration | IHS payable |
|---|---|
| 1 year | £1,035 |
| 3 years | £3,105 |
| 5 years | £5,175 |
| 5 years + 14 days (entry clearance allowance) | £6,210 (rounded up to 6 years) |
Part-year periods are rounded up to the nearest year, not down. So a 3-year 1-day visa costs the same IHS as a 4-year visa.
The IHS is calculated and paid through the visa application portal — applicants cannot make a separate payment or pay in instalments.
IHS Cost Calculator
Estimate your Immigration Health Surcharge at the current £1,035/year rate.
Paid upfront at visa application. Does not include visa application fees or the Immigration Skills Charge (employer-side).
Who is exempt from the IHS?
The following categories do not pay the IHS:
- Health and Care Worker visa holders and their dependants
- Asylum seekers (while awaiting a decision)
- Refugees and those with humanitarian protection
- EU Settlement Scheme holders (pre-settled and settled status)
- Victims of modern slavery in certain circumstances
- Children in local authority care
- Ukrainian Homes for Ukraine scheme holders
- Workers from certain countries with bilateral health agreements (e.g., Australia for reciprocal treatment, not full IHS exemption)
Irish nationals do not need a visa and therefore do not pay IHS.
IHS for Dependants
Each dependant applying for a UK visa must pay the IHS separately. A family of four applying for 3-year visas would each pay £3,105 — a total of £12,420 in IHS alone, before visa application fees.
For families, this adds up fast. The applicant pays, not the employer, though some employers offer financial support as part of their relocation package.
What does the IHS give you access to?
IHS holders are entitled to the same NHS services as UK residents on the same terms. That means GP visits, hospital treatment (A&E, outpatient, inpatient), mental health services, and maternity care are all free at point of use.
Services that carry charges for all patients (including UK residents) remain chargeable:
- NHS dental treatment (charges apply)
- Optical services / eye tests (charges apply, though NHS-funded eye tests exist for certain groups)
- Prescriptions (flat fee per item in England; free in Scotland, Wales, Northern Ireland)
You can't use the IHS to claim against private hospitals or get faster treatment — it's a contribution to general NHS funding, not a premium for a specific plan.
Refunds
You can get a refund in these situations:
- Visa refused — full IHS refund
- Application withdrawn before a decision — full refund
- Visa curtailed and leave ends earlier than anticipated — partial refund for unused whole years
- Visa holder departs UK permanently before visa expiry — partial refund may apply
Refunds are processed by UKVI and can take several weeks. The visa application fee (separate from IHS) is generally not refunded on refusal.
2025/2026 updates
The IHS has increased several times since its introduction at £200/year in 2015:
| Year | Standard rate |
|---|---|
| 2015 | £200/year |
| 2017 | £400/year |
| 2020 | £624/year |
| 2023 | £1,035/year |
| 2025 | £1,035/year (unchanged) |
The Migration Advisory Committee and the government have both signalled the rate could rise again before 2027.
Common mistakes to avoid
Budget for the full IHS upfront. Unlike annual premiums, it's paid in one lump sum at application. A 5-year family visa can mean over £20,000 in IHS alone.
Don't assume the Health and Care Worker visa exemption covers private sector healthcare roles. It applies to that specific visa route, not to anyone working in healthcare on a standard Skilled Worker visa.
Watch the rounding. UKVI rounds up to the nearest year. A 3-year 1-day visa costs 4 x £1,035, not 3. And if your visa is refused, claim your refund. It won't happen automatically. Keep the IHS payment reference.
Frequently asked questions
Does paying the IHS mean I get free NHS treatment for everything?
Not quite. You get the same deal as UK residents: free GP, hospital, and maternity care, but dental and optical services still carry charges. The IHS is not a private healthcare plan.
Can my employer pay the IHS on my behalf?
They can, and some do. There's no legal obligation, but larger employers sometimes cover or reimburse the IHS as part of a relocation offer. Worth asking about during negotiations.
Do children need to pay the IHS?
Yes. Every child on a dependent visa pays separately. Under-18s on Youth Mobility visas get a discounted rate, but children on Skilled Worker dependent visas pay the full adult rate.
Is the IHS the same as visa health insurance?
No. It's a contribution to NHS funding, not an insurance policy. You can't claim against private hospitals or jump queues with it. Some sponsored workers buy separate private health insurance (often employer-provided) for faster consultant access.
Related terms
- Skilled Worker Visa
- Health and Care Worker Visa
- Certificate of Sponsorship
- Immigration Skills Charge