The Immigration Health Surcharge (IHS): Everything UK Visa Applicants Need to Know.

The Immigration Health Surcharge (IHS) is a mandatory fee paid by most individuals applying for a UK visa. Introduced in 2015 under the Immigration Act 2014, the surcharge enables eligible migrants to access NHS services during their stay in the UK. Understanding when the IHS applies, how much it costs, and whether a refund may be available is an important part of preparing a successful visa application.

Understanding who must pay the IHS, how much it costs, and when refunds may be available is an important part of preparing a UK visa ap

plication.

What Is the Immigration Health Surcharge?

The Immigration Health Surcharge is a contribution towards the UK's healthcare system. Most migrants applying for permission to live in the UK for more than six months are required to pay the surcharge as part of their visa application.

Once paid, the visa holder can generally access NHS services in the same way as a UK resident for the duration of their visa. This includes access to GP services, hospital treatment, and emergency healthcare.

It is important to note that payment of the IHS does not exempt individuals from charges that UK residents themselves must pay, such as prescription charges, dental treatment, and eye care costs in England.

Who Must Pay the Immigration Health Surcharge?

Most applicants seeking a work, study, or family visa will be required to pay the IHS.

This includes applicants applying:

• From outside the UK for permission to stay longer than six months;

• From within the UK to extend their existing visa;

• To switch into another immigration category.

Each applicant must pay the surcharge individually, including spouses, partners, and dependent children.

For example, a Skilled Worker Visa applicant applying with a partner and one child would be required to pay three separate IHS charges.

Failure to pay the surcharge can result in a visa application being treated as invalid.

Who Is Exempt From Paying the IHS?

Certain categories of applicants are exempt from the Immigration Health Surcharge.

Common exemptions include:

• Applicants under the EU Settlement Scheme;

• Health and Care Worker Visa holders and their dependants;

• Asylum seekers and refugees;

• Victims of trafficking and modern slavery;

• Certain victims of domestic abuse applying under relevant immigration concessions;

• Individuals granted leave under the Ukraine schemes;

• Children under 18 in local authority care;

• Applicants who have received a full fee waiver.

  
  

Applicants who qualify for an exemption can continue to access NHS services without paying the surcharge.

How Much Does the IHS Cost?

The Immigration Health Surcharge is calculated based on the length of leave requested.

The current standard rate is £1,035 per year per applicant and a reduced rate of £776 per year applies to:

• Full-time students and their dependants;

• Youth Mobility Scheme applicants;

• Applicants under the age of 18.

The surcharge is calculated in six-month increments, with any partial period rounded up. For example:

• A 9-month visa attracts 12 months of IHS;

• A 16-month visa attracts 18 months of IHS.

The full amount must be paid at the point of application.

For example, a Skilled Worker applicant granted a 3-year visa would usually pay £3,105 in IHS fees (£1,035 × 3 years), in addition to the visa application fee.

How Is the IHS Paid?

The IHS is paid online during the visa application process. The application system automatically calculates the amount due based on the immigration route and duration of leave requested.

Once payment has been made, applicants receive a unique IHS reference number. This reference is linked to the visa application and should be retained for future reference, particularly if a refund becomes necessary.

A visa application cannot usually be submitted without first paying the IHS.

What Happens If You Do Not Pay?

Payment of the IHS is a mandatory requirement for most visa applications. If payment has not been completed, UK Visas and Immigration may contact the applicant and provide a short period to rectify the issue.

Failure to make payment within the specified timeframe can result in the application being rejected as invalid.

Many applicants assume that paying UK National Insurance contributions or holding private medical insurance removes the requirement to pay the Immigration Health Surcharge. This is not the case. Unless an exemption applies, the IHS must still be paid as part of the visa application process.

Can You Get an IHS Refund?

In certain circumstances, the Home Office will automatically refund all or part of the Immigration Health Surcharge.

Full Refunds

A full refund is usually available where:

• A visa application is refused and all appeal rights have been exhausted;

• An application is withdrawn before a decision is made;

• An application is rejected as invalid;

• The surcharge has been paid twice in error.

Partial Refunds

Partial refunds may be available where:

• A visa is granted for a shorter period than originally requested;

• One or more dependants are refused while the main applicant is granted leave;

• Certain eligible European students qualify under specific refund arrangements.

When Refunds Are Not Available

The IHS is generally non-refundable where:

• A visa is granted but the holder chooses not to travel to the UK;

• The visa holder leaves the UK before their visa expires;

• The visa holder switches into a category that no longer requires payment of the surcharge;

• Personal circumstances change after the visa has been granted.

How Long Does an IHS Refund Take?

In most cases, refunds are processed automatically by the Home Office and returned to the card originally used for payment. Refunds are typically received within six weeks of the relevant decision being finalised.

Where an appeal or administrative review is pending, the refund process may take longer and will generally not begin until all review or appeal rights have been exhausted.

If a refund has not been received after six weeks, applicants may wish to contact the Home Office refund team for further assistance.

Final Thoughts

The Immigration Health Surcharge forms an important part of most UK visa applications. Understanding whether you are required to pay, how much you will be charged, and when a refund may be available can help avoid unnecessary delays and confusion during the application process.

As immigration rules continue to evolve, applicants should ensure they understand the requirements that apply to their specific circumstances before submitting an application.

At ORSAYA, we provide clear, honest, and tailored UK immigration advice to individuals, families, and businesses throughout the UK and across the world. Whether you are applying for a family visa, work visa, settlement, or British citizenship, we can help ensure your application is prepared correctly from the outset.

Frequently Asked Questions About the Immigration Health Surcharge

Do I pay the IHS for Indefinite Leave to Remain?No. Settlement applications, including Indefinite Leave to Remain applications, do not require payment of the Immigration Health Surcharge.

Do children pay the IHS?Yes. Children generally pay the surcharge, although a reduced annual rate applies to applicants under the age of 18.

Can I get my IHS back if I leave the UK early?Generally, no. The Home Office does not usually provide refunds simply because a visa holder leaves the UK before their visa expires.