The Immigration Health Surcharge (IHS) is a fee most people pay as part of a UK visa or immigration application. It is charged for each year of the visa and paid up front with the application. Once the visa starts, the holder can use the NHS without being charged for most services.
Key points
- The standard rate is £1,035 a year. Students, their dependants, Youth Mobility Scheme applicants and under-18s pay £776 a year.
- It is paid for the whole length of the visa when you apply, so a 3-year visa at the standard rate costs £3,105.
- You do not pay it for a visitor visa, for indefinite leave to remain or on the Health and Care Worker route.
- Having private medical insurance does not remove the charge.
- It is refunded in full if the application is refused or withdrawn before a decision.
How the Immigration Health Surcharge works
Most people pay the surcharge as part of their online immigration application.[1]Home Office, Pay for UK healthcare as part of your immigration application: Overview You usually have to pay it if you are applying:
- from outside the UK, for more than 6 months
- from inside the UK, for any length of time
You pay even if you have private medical insurance.[3]Home Office, Pay for UK healthcare as part of your immigration application: Who needs to pay
From the date your visa starts you can use the NHS free of charge. You still pay for some services, such as prescriptions, dental treatment, eye tests and assisted conception. If the Home Office has not yet decided your application, you may have to pay for NHS treatment.[1]Home Office, Pay for UK healthcare as part of your immigration application: Overview
How much it costs
| Applicant | Cost per year |
|---|---|
| Students, their dependants and Youth Mobility Scheme applicants | £776 |
| Anyone under 18 at the time they apply | £776 |
| All other visa and immigration applications | £1,035 |
The total depends on the length of the visa you are given and where you apply from.[2]Home Office, Pay for UK healthcare as part of your immigration application: How much you have to pay
| Length of visa | What you pay |
|---|---|
| 6 months or less, applying from outside the UK | Nothing |
| 6 months or less, applying from inside the UK | Half the yearly cost |
| More than 6 months but less than a year | A full year |
| More than a year, up to 18 months | A year plus half a year |
| More than 18 months but less than 2 years | 2 full years |
Who does not pay
You do not pay the surcharge for a visitor visa, or when you apply to remain in the UK permanently.[3]Home Office, Pay for UK healthcare as part of your immigration application: Who needs to pay The exemptions also include:
- people eligible for a Health and Care Worker visa, and their dependants
- applicants to the EU Settlement Scheme
- applicants for indefinite leave to remain or indefinite leave to enter
- a child under 18 who has been taken into care by a local authority
- people to whom the Home Office domestic violence concession applies, and their dependants
GOV.UK lists the full set of exemptions.
Example
A person applies from inside the UK to extend their stay for 18 months at the standard rate.
- One full year: £1,035
- Half a year: £517.50
They pay £1,552.50 with the application. A 3-year visa at the standard rate costs £3,105, and a 2-year student visa costs £1,552.[2]Home Office, Pay for UK healthcare as part of your immigration application: How much you have to pay
What people get wrong
People often treat the surcharge as part of the visa fee, and assume it is lost if the application fails. It is a separate payment, and it comes back in full if the application is refused or withdrawn before a decision.
The reverse also catches people out. You do not get a refund if you leave the UK before your visa ends, if you never travel after a successful application, or if you switch to a visa that is exempt.[4]Home Office, Pay for UK healthcare as part of your immigration application: Refunds
If you underpay, UK Visas and Immigration emails you. You then have 10 working days to pay if you are inside the UK and 7 working days if you are outside it. The application is turned down if the full amount is not paid in that time.[2]Home Office, Pay for UK healthcare as part of your immigration application: How much you have to pay
The bottom line
The Immigration Health Surcharge is the price of NHS access for the length of a visa. It is paid in advance, on top of the application fee, at £1,035 a year for most applicants. Check whether your route is exempt before you budget, and count every dependant, because each one is charged.
Common questions
£1,035 a year for most applications. It is £776 a year for students, their dependants, Youth Mobility Scheme applicants and anyone under 18 when they apply.
No. You do not pay it when you apply to remain in the UK permanently. If you apply for indefinite leave but are given limited leave instead, you must pay it before that leave is granted.
Yes. You get a full refund if your application is refused, or if you withdraw it before a decision is made. It is paid back to the card or account used.
Usually yes. Dependants aged 18 or over usually pay the same amount as the main applicant. Applicants under 18 pay the lower rate.
Sources
We cite the Immigration Rules, legislation and GOV.UK guidance directly. Rules change, so each source shows the date we last checked it.
- Home Office. Pay for UK healthcare as part of your immigration application: Overview. Checked 11 November 2026. ↩
- Home Office. Pay for UK healthcare as part of your immigration application: How much you have to pay. Checked 11 November 2026. ↩
- Home Office. Pay for UK healthcare as part of your immigration application: Who needs to pay. Checked 11 November 2026. ↩
- Home Office. Pay for UK healthcare as part of your immigration application: Refunds. Checked 11 November 2026. ↩