Most people applying for UK visas of longer than 6 months must pay the Immigration Health Surcharge (IHS) as part of their application. This guide explains how much it costs in 2026, who is exempt, and how refunds work.
What Is the Immigration Health Surcharge?
The IHS is a mandatory fee paid upfront by most visa applicants staying in the UK for more than 6 months. Once paid, it gives the applicant access to the NHS on broadly the same basis as a permanent UK resident for the length of their visa. It does not cover standard NHS patient charges that also apply to UK residents, such as prescription charges in England or dental treatment.
How Much Is the IHS in 2026?
- £1,035 per year for most adult applicants
- £776 per year for students, their dependants, Youth Mobility Scheme applicants, and children under 18 at the date of application
These rates were unchanged in the Home Office’s April 2026 fee schedule.
How Is the IHS Calculated?
The surcharge is calculated for the full length of leave you are applying for and must be paid in full before your application is submitted — it cannot be paid in instalments or after your visa is granted.
Applications covering part of a year are rounded up. For example, a visa for 2 years and 3 months is charged at the rate for 2.5 years.
Example: An applicant granted a 5-year Skilled Worker visa pays 5 × £1,035 = £5,175 upfront, in addition to the visa application fee.
For applicants applying for a visa in stages — for example, a 3-year grant followed by a further 2-year extension — the same total IHS is paid overall, but split across two payments rather than one, which can ease cash flow.
Which Visas Require the IHS?
The IHS applies to most routes lasting longer than 6 months, including:
- Spouse and partner visas
- Skilled Worker visas
- Graduate visas
- Student visas
- Article 8 family and private life applications
Who Is Exempt From the IHS?
Some applicants do not need to pay the IHS, including:
- applicants for Indefinite Leave to Remain (ILR) or British citizenship, since the IHS applies only to time-limited visas
- applicants on the Health and Care Worker visa, and their dependants
- applicants for settlement under the Victim of Domestic Abuse route
- Standard Visitor visa applicants, since visitor visas are not subject to the IHS
- some applicants who can demonstrate they cannot afford the fee, where an IHS exemption may be requested alongside a fee waiver
Getting an IHS Refund
A full refund is available where a visa application is refused, withdrawn, or where the applicant is granted a shorter period of leave than applied for — in the latter case, the difference is refunded.
Refunds are also available in specific circumstances after a visa is granted, for example for EU/EEA students who hold a valid European Health Insurance Card and do not work in the UK, or for certain non-visa health and care workers who can apply for annual reimbursement.
Why the Length of Your Visa Application Matters
Because the IHS is charged per year of leave requested, the length of visa you apply for has a direct effect on the upfront cost. This is a factor worth considering when choosing between visa options of different lengths, particularly for family visa applications or when deciding whether to apply for a shorter Graduate visa extension versus committing to a longer sponsored route.
Speak to Our Immigration Lawyers
If you are unsure how much IHS you will need to pay, whether you qualify for an exemption, or how visa length affects your total cost, JPS Immigration Lawyers can advise on the most cost-effective and compliant way to structure your application.
Contact our immigration lawyers for advice on your visa application and associated costs.
Jay Sudra, IAA-Regulated Immigration Adviser & Founder, JPS Immigration
Former UK Home Office Immigration Officer & British Diplomatic Service Entry Clearance Officer
22+ years’ experience | BBC News contributor | LinkedIn profile
Reference: GOV.UK — Pay for UK healthcare as part of your immigration application
Frequently Asked Questions
Do I pay the IHS monthly or as a lump sum?
As a lump sum, upfront, before your visa application is processed. It cannot be paid in instalments.
Is the IHS refunded if my visa is refused?
Yes, a full refund is provided if your application is refused, withdrawn, or granted for a shorter period than you paid for.
Do I need to pay the IHS for an ILR application?
No, the IHS does not apply to Indefinite Leave to Remain or British citizenship applications.
Does the IHS cover everything the NHS provides?
It gives access to NHS treatment on the same basis as a resident, but does not cover standard patient charges such as prescriptions or dental treatment that apply to everyone.
Can I get a discount if I have private health insurance?
No, holding private health insurance does not exempt most applicants from paying the IHS, other than in specific categories set out in the exemptions above.
