The Immigration Health Surcharge (IHS) is a compulsory NHS charge paid upfront with almost every UK visa application. For sponsoring employers it is frequently the single largest line in a relocation budget — often more than the visa fee itself — and it is charged per person, for every year of the visa granted.
Rates verified against GOV.UK in August 2026. Use the calculator below to work out the exact cost for an applicant and their dependants.
Reviewed by the Morgan Smith Immigration team — IAA-regulated UK immigration specialists. Last reviewed 2026-08-07.
TL;DR
The Immigration Health Surcharge (IHS) is paid to the Home Office as part of a UK visa application and gives access to the NHS. The 2026 rate is £1,035 per person per year, or a discounted £776 per year for students, their dependants, Youth Mobility Scheme applicants and anyone under 18. It is charged on the full length of the visa granted, paid in full before the application is submitted, and refunded automatically if the visa is refused.
£1,035
Standard rate, per person per year
£776
Discounted rate, per person per year
Upfront
Paid in full before you submit
What is the Immigration Health Surcharge?
The Immigration Health Surcharge (IHS) is a payment most people must make as part of an online UK immigration application. Paying it gives you access to the National Health Service on broadly the same basis as a UK resident, from the date your visa starts, for as long as your permission to stay lasts.
It is not an insurance premium and it is not optional. Holding private medical insurance does not exempt you from paying it, and the amount does not change based on your age, health or how much NHS care you actually use.
For employers and global mobility teams, the surcharge matters because it is charged per person, per year, upfront. A Skilled Worker relocating with a partner and two children on a three-year assignment generates four separate surcharge payments covering the full three years, all payable before the applications can be submitted. Many sponsors choose to cover the surcharge for the main applicant as part of the relocation package, and whether dependants are covered too is a policy decision worth making explicitly before an offer is issued.
The surcharge is separate from the visa application fee, the Certificate of Sponsorship fee and the Immigration Skills Charge. Each is paid separately, and only the surcharge is calculated on the length of the visa.
The Surcharge in Four Questions
Why the Immigration Health Surcharge exists, when it falls due, who collects it and how the amount is worked out.
Why is it required?
The surcharge was introduced so that temporary migrants contribute to the cost of the NHS care they can access, in the same way that UK residents contribute through taxation. It is charged regardless of whether you ever use the NHS, and regardless of whether you also hold private medical cover.
When is it paid?
Upfront, inside the online visa application, before the application can be submitted and before the visa fee is paid. It covers the entire length of the visa in a single payment — there is no instalment option and no way to pay later.
Who is it paid to?
The Home Office, through the official Immigration Health Surcharge service on gov.uk, as part of your immigration application. It is not paid to the NHS directly, not paid to your sponsor, and not paid to any third party. Beware of any site charging a fee to “process” your surcharge.
How is it calculated?
Rate multiplied by the length of leave granted, rounded up. A leftover period of six months or less is charged as a half year; more than six months is charged as a full year. The rate depends on your route and age, not on your health or how much NHS care you expect to use.
Who Does the Immigration Health Surcharge Apply To?
Most applicants pay. A smaller group pays a discounted rate, and some routes are exempt entirely.
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Who Must Pay
You must pay if you are applying from outside the UK for a visa lasting more than six months, or if you are applying from inside the UK for a visa of any length. Dependants aged 18 or over normally pay the same amount as the main applicant. Private medical insurance makes no difference — you still pay.
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Who Pays the Discounted Rate
The discounted rate of £776 per year applies to Student and Child Student visa applicants, the dependants of students, Youth Mobility Scheme applicants, and anyone who is under 18 at the date of application. A child dependant on any route is charged at the discounted rate.
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Who Is Exempt
No surcharge is payable on visitor visas, on visas of six months or less applied for from outside the UK, or on Health and Care Worker visas — including that applicant’s dependants. Also exempt: EU Settlement Scheme applicants, indefinite leave to remain applicants, children under 18 in local authority care, and identified victims of trafficking or modern slavery.
Immigration Health Surcharge Rates
The rate depends on your route and your age — not on your health, or how much NHS care you expect to use.
Rates set by the Home Office and subject to change. Last reviewed: August 2026.
| Item | Cost (2026) |
|---|---|
| Standard rate | £1,035 per person, per year |
| Discounted rate | £776 per person, per year |
| Standard half-year | £517.50 |
| Discounted half-year | £388 |
| Visas 6 months or less (from outside UK) | Not payable |
| Visitor visas and Health and Care Worker visas | Exempt — check current fees |
Immigration Health Surcharge Calculator
Choose the route, the length of the visa and the number of dependants. The breakdown updates as you change each field.
Estimated Immigration Health Surcharge
£3,105
Charged as 3 years at the standard rate.
| Who | Rate | Period charged | Amount |
|---|---|---|---|
| Main applicant | £1,035 / year | 3 years | £3,105 |
| Total payable | £3,105 |
Estimate only, based on the published GOV.UK rates and rounding rules. The exact amount is confirmed by the Home Office’s own Immigration Health Surcharge service when you apply. If the leave you are granted runs a few days beyond a whole year, that part-period rounds up to the next half year — so the amount charged can be higher than a round-number visa length suggests.
Worked Examples
Four common scenarios, calculated using the 2026 rates. Select any example to load it into the calculator above.
Spouse Visa (applying from outside the UK)
£3,105
2 years 9 months · charged as 3 years
Granted for 2 years 9 months. The extra 9 months is more than six months, so it rounds up to a third full year.
Load in calculatorStudent Visa (2 years)
£1,552
2 years · charged as 2 years
Charged at the discounted student rate of £776 per year, for exactly 2 years.
Load in calculatorSkilled Worker Visa (3 years)
£3,105
3 years · charged as 3 years
Charged at the standard rate for 3 years. Add dependants and this figure multiplies.
Load in calculatorSpouse Visa Extension (in the UK)
£2,587.50
2 years 6 months · charged as 2 years 6 months
Granted for 2 years 6 months. The extra 6 months is charged as a half year, not a full one.
Load in calculatorQuick Reference: Cost by Length of Visa
Per person. Multiply by the number of people on the application — every dependant pays their own surcharge for the same period.
| Length of visa granted | Standard rate | Discounted rate |
|---|---|---|
| 6 months or less — applying from outside the UK | Not payable | Not payable |
| 6 months or less — applying inside the UK | £517.50 | £388 |
| Over 6 months, up to 1 year | £1,035 | £776 |
| Over 1 year, up to 1 year 6 months | £1,552.50 | £1,164 |
| Over 1 year 6 months, up to 2 years | £2,070 | £1,552 |
| Over 2 years, up to 2 years 6 months | £2,587.50 | £1,940 |
| Over 2 years 6 months, up to 3 years | £3,105 | £2,328 |
| 5 years (maximum on most work routes) | £5,175 | £3,880 |
What the Surcharge Covers
Paying the surcharge gives you NHS access on the same basis as a UK resident — but not everything is free at the point of use.
✓ What It Covers
- Use the NHS free of charge from the date your visa starts, on the same basis as a UK resident
- Register with a GP and access hospital treatment, maternity care and emergency care
- Rely on cover for the full length of your permission to stay, not just the period you have paid up to
- Receive an automatic refund if your application is refused or withdrawn before a decision
- Get a partial refund if the Home Office grants you less time than you paid for
✗ What It Does Not Cover
- Get free prescriptions, dental treatment, eye tests or assisted conception — these are still charged
- Pay in instalments — the full amount is due before you submit the application
- Use private medical insurance as a reason not to pay the surcharge
- Treat payment as any guarantee your visa will be granted — it is a separate decision
- Reuse an IHS reference number — each one works only once, so reapplying means paying again first
How to Pay the Immigration Health Surcharge
Five steps, completed inside your online visa application.
Start Your Online Visa Application
Begin the application on gov.uk. The surcharge is built into the application journey, so you do not pay it separately or in advance.
Work Out the Amount Due
The service calculates the surcharge from the length of leave you are applying for, your route and the number of dependants included.
Pay in Full by Card
Payment is taken by debit or credit card. The whole amount is due at this point — the Home Office does not offer instalments.
Save Your IHS Reference Number
You receive the reference by email. It can only be used once, so keep it safe and do not reuse it on a later application.
Submit Your Application
Enter the reference, pay the visa fee and submit. If the application is refused or withdrawn, the surcharge is refunded automatically, usually within 6 weeks of the decision.
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Sources
Legal information on this page is based on guidance from GOV.UK, the UK Home Office / UK Visas and Immigration, legislation.gov.uk, and Free Movement. Rules change frequently — speak to our team to confirm current requirements.
Frequently Asked Questions
Common questions from employers, sponsors and applicants about the Immigration Health Surcharge.
What is the Immigration Health Surcharge (IHS)?
The Immigration Health Surcharge is a compulsory payment made as part of most UK visa and immigration applications. It gives you access to the NHS from the date your visa starts, on broadly the same basis as someone who lives in the UK permanently. It is paid to the Home Office as part of the online application, not to the NHS directly.
How much is the Immigration Health Surcharge in 2026?
The standard rate is £1,035 per person for each year of the visa. A discounted rate of £776 per year applies to students, their dependants, Youth Mobility Scheme applicants and anyone under 18 at the date of application. Part-years are charged at £517.50 or £388 respectively.
How is the Immigration Health Surcharge calculated?
It is calculated on the length of leave you are granted, rounded up. Any leftover period of six months or less is charged as a half year; anything over six months is charged as a full year. So a visa of 2 years 6 months is charged as 2.5 years, while a visa of 2 years 9 months is charged as 3 full years.
Who has to pay the Immigration Health Surcharge?
Anyone applying from outside the UK for a visa longer than six months, and anyone applying from inside the UK for a visa of any length. Dependants aged 18 or over usually pay the same amount as the main applicant, and child dependants pay the discounted rate.
Who is exempt from the Immigration Health Surcharge?
Visitors are exempt, as is anyone applying from outside the UK for six months or less. Health and Care Worker visa holders and their dependants are exempt, which is a significant saving for NHS and care-sector sponsors. EU Settlement Scheme applicants, indefinite leave to remain applicants and children under 18 in local authority care are also exempt.
When do I pay the Immigration Health Surcharge?
You pay it during the online application, before you submit and before you pay the visa fee. You cannot pay it afterwards or in instalments, and the application cannot be submitted until it has been paid in full.
Do I have to pay the Immigration Health Surcharge for my dependants?
Yes. Each dependant included in the application pays their own surcharge for the same period. Dependants aged 18 or over pay the same rate as the main applicant, and dependants under 18 pay the discounted rate of £776 per year. Dependants of students pay the discounted rate regardless of age.
Can I pay the Immigration Health Surcharge in instalments?
No. The full amount for the entire length of the visa must be paid in one payment before the application is submitted. This is why the surcharge is often the largest single upfront cost in a relocation budget, particularly for a family on a five-year route.
Will I get the Immigration Health Surcharge back if my visa is refused?
Yes. If your application is refused, or you withdraw it before a decision is made, the surcharge is refunded in full automatically — you do not need to apply for it. Refunds are usually paid within 6 weeks of the decision, to the card used to pay. Partial refunds are made if you are granted less time than you paid for.
Does paying the Immigration Health Surcharge make all NHS treatment free?
No. It gives you free access to most NHS services, but you still pay the same charges as UK residents for prescriptions, dental treatment, eye tests and assisted conception. You may also have to pay for NHS treatment received before your visa has been decided.
Further Information
Related routes and cost guides across the rest of the site.
Full 2026 fee tables for every UK visa route, updated from the Home Office schedule.
The main sponsored work route — fees, salary thresholds and sponsor duties.
Exempt from the surcharge entirely, for the applicant and their dependants.
Discounted surcharge rate of £776 per year for students and their dependants.
Partner route granted in 2 year 9 month and 2 year 6 month blocks.
Settlement applications carry no surcharge.
Need Help Budgeting for the Immigration Health Surcharge?
Our advisers cost the whole application — surcharge, visa fees, Certificate of Sponsorship and skills charge — so there are no surprises after an offer is made.