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 healthcare in many countries, NHS treatment in the UK is not covered by private insurance arrangements for visa holders — it is the IHS that funds their entitlement. Holders who pay the IHS are generally entitled to the same NHS services as a UK resident, with the same exemptions (e.g., 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 duration of the visa being applied for, calculated in whole or partial 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.
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.
This is one of the most significant costs of UK visa sponsorship for families. It is paid by the applicant(s), 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, including:
- GP and primary care — free at point of use
- Hospital treatment — free at point of use (including A&E, outpatient, inpatient)
- Mental health services — free at point of use
- Maternity care — 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)
The IHS does not entitle holders to bring health insurance claims against the NHS — it functions as a contribution to general NHS funding, not a premium for a specific plan.
Refunds
The IHS can be refunded in specific circumstances:
- 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) |
Further increases are widely anticipated given NHS funding pressures. The Migration Advisory Committee and the government have signalled the IHS may rise again before 2027.
Common Mistakes to Avoid
- Not budgeting for IHS upfront. Unlike annual premiums, IHS is paid in one lump sum at application — for a 5-year family visa, this can run to over £20,000.
- Assuming Health and Care Worker visa exemption applies to private sector healthcare. The exemption is for the Health and Care Worker visa specifically — not for anyone working in healthcare on a standard Skilled Worker visa.
- Calculating IHS at the number of days, not years. UKVI rounds up to the nearest year for the charge. A 3-year 1-day visa doesn't cost 3.003 × £1,035 — it costs 4 × £1,035.
- Not claiming a refund after a refusal. Refunds don't happen automatically — the applicant must request them. Keep the IHS payment reference.
Frequently Asked Questions
Does paying the IHS mean I get free NHS treatment for everything?
You get the same entitlement as UK residents — which means free GP, hospital care, and maternity services, but charges for dental and optical care. The IHS does not provide unlimited or private healthcare.
Can my employer pay the IHS on my behalf?
Yes. Many larger employers reimburse or pay the IHS as part of their relocation package. There is no legal requirement for them to do so, but it is a competitive offer in the market for internationally-sponsored talent.
Do children need to pay the IHS?
Yes, each child applying for a dependent visa must pay the IHS. The rate for children under 18 on Youth Mobility visas is discounted, but children on Skilled Worker dependent visas pay the same rate as adults.
Is the IHS the same as visa health insurance?
No. The IHS is a surcharge paid to fund the NHS — it does not work like private health insurance. You cannot use it to claim against private hospitals or get faster treatment. Some sponsored workers additionally purchase private health insurance (often provided by employers) for faster consultant access.
Related Terms
- Skilled Worker Visa
- Health and Care Worker Visa
- Certificate of Sponsorship
- Immigration Skills Charge
Find UK employers offering sponsorship packages that may include IHS support. Search visa-sponsored jobs →