Immigration Health Surcharge Explained

The Immigration Health Surcharge must be paid when submitting most visa applications for a stay of more than six months. It is paid through the IHS online service at immigration-health-surcharge.service.gov.uk, which generates a reference number that is entered into the visa application form.

The IHS is calculated based on the length of the visa applied for. For example, a Skilled Worker Visa for five years currently costs £1,035 × 5 = £5,175 for an adult applicant. Dependants must also each pay the IHS in full. For a family of two adults and two children applying for five-year visas, the total IHS cost would be substantial — over £14,000 at current rates.

The IHS is separate from the visa application fee and is in addition to it. Both must be paid before the application is processed. The IHS fee is set by the government and has increased significantly in recent years — always check the current rate before calculating your total costs.

Several categories of migrants are exempt from the IHS:

• Health and Care Worker Visa holders and their dependants;
• Global Talent Visa holders and their dependants;
• Victims of domestic violence or modern slavery applying under dedicated routes;
• Those on certain visitor visas (short stays under 6 months do not require the IHS);
• Diplomats and their households;
• EU Settlement Scheme holders (who have digital status rather than a visa);
• Those on the Afghan Relocations and Assistance Policy (ARAP) and similar humanitarian routes.

If you are in an exempt category, you should not pay the IHS — paying it incorrectly is difficult to reverse during the application process. Check carefully whether an exemption applies before proceeding.

Paying the IHS entitles you to use the NHS in broadly the same way as a UK resident — including GP registration, hospital treatment, mental health services, and prescriptions (prescription charges apply in England). However, it does not entitle you to treatment that is specifically excluded or charged to overseas visitors, such as certain fertility treatments.

A partial refund of the IHS may be available if your visa application is refused, if you leave the UK significantly earlier than the visa expiry, or if you are granted ILR or citizenship before the visa expires. Refund requests are made through the IHS service. The amount refunded is calculated on a pro-rata basis for complete remaining months.

Employers cannot legally deduct the IHS from an employee's salary without agreement, and some employers voluntarily cover the IHS as part of a relocation package — it is worth negotiating this when accepting a sponsored job offer.