The Immigration Health Surcharge (IHS) is a fee most visa applicants pay to use the NHS during their stay. It costs £1,035 per adult per year on most routes, and £776 per year for students, children and Youth Mobility applicants. You pay the full amount upfront for the entire length of your visa when you apply. This guide explains the cost, how it is calculated, who is exempt, and when you can and cannot get a refund.
Immigration Health Surcharge calculator
Estimate what you will pay upfront for the NHS surcharge, based on your visa length and who is applying with you. Figures are the 2026 rates.
The surcharge is paid in one go when you apply. Each full year is charged in full; a leftover period of six months or less counts as half a year, and more than six months counts as a full year. If you are applying from outside the UK for a visa of six months or less you pay nothing, and this calculator does not cover that case. This is a guide, not immigration advice. Check the exact amount on the GOV.UK IHS payment page before you apply.
What the IHS is for
The surcharge gives visa holders broadly the same access to the NHS as a UK resident, including GP and hospital treatment. It is separate from the visa application fee, and you cannot use the NHS on most long-stay visas without paying it. Paying it does not make everything free: you still pay the same prescription and dental charges as everyone else in England.
How much it costs
| Applicant type | IHS per year |
|---|---|
| Most adults (for example Skilled Worker) | £1,035 |
| Students, child dependants, Youth Mobility, under-18s | £776 |
These rates apply to applications made on or after 6 February 2024 and are unchanged in 2026. Always confirm the current figure on GOV.UK before you apply.
How the total is calculated
You pay for the whole length of your visa at once, not year by year. Each full year is charged at the full rate, and the leftover part-year is rounded:
- A part-year of six months or less is charged at half the yearly rate.
- A part-year of more than six months is charged as a full year, wherever you apply from.
For example, an adult on a two-and-a-half year visa pays £1,035 for each of the two full years, plus £517.50 for the final six months, giving £2,587.50. An adult on an 18-month visa pays £1,035 plus £517.50. An adult on a 20-month visa pays two full years, £2,070, because the leftover eight months rounds up. Each family member pays their own surcharge at their own rate.
The short-visa exception
There is one case where you pay nothing. GOV.UK puts it plainly: you do not need to pay the surcharge if you are applying from outside the UK for 6 months or less. Where you apply from is what decides it. The same six-month grant applied for from inside the UK is charged at half the yearly rate, so £517.50 for an adult or £388 at the discounted rate. If you are extending or switching in country, expect to pay.
Who is exempt
Some applicants do not pay the IHS at all. The main exemption is for Health and Care Worker visa holders and their dependants. Short visit visas do not include the surcharge, because visitors are not entitled to free non-emergency NHS care in the first place. Rules on exemptions can change, so check your specific route before you budget.
Refunds
This is where expectations and reality part company. The IHS is not a deposit, and it is not refunded simply because you stop using the NHS.
You are refunded if:
- Your visa application is refused.
- You withdraw your application before a decision is made.
- You paid the IHS twice for the same application.
- You are granted less time on your visa than you asked for. You get the difference back.
- A dependant is refused. Their share comes back.
You are not refunded if:
- You leave the UK before your visa ends.
- You are told to leave the UK before your visa expires.
- Your visa is granted but you never come to the UK.
- You withdraw your application after the visa has been granted.
Health and Care Worker visa holders and their dependants can get a refund covering periods they worked in health or care, but only for stretches of six months or more. Shorter periods produce nothing.
Where a refund is due, it is automatic. You do not have to apply for it. It is paid back to the account or card you paid with, usually within six weeks of the decision on your application.
Frequently asked questions
How much is the Immigration Health Surcharge in 2026?
It is £1,035 per adult per year on most routes, and £776 per year for students, child dependants and Youth Mobility applicants, paid upfront for the full length of your visa.
Do I pay the IHS every year?
No. You pay the whole amount in advance when you apply, covering the entire visa period.
Does my family pay too?
Yes. Each dependant, including children, pays their own surcharge at the rate for their category.
Can I get a refund if I leave the UK early?
No. Leaving before your visa ends does not produce a refund, and neither does being told to leave early or never coming to the UK at all. Refunds are for refused or withdrawn applications, double payments, and being granted less time than you paid for.
Do I have to pay the IHS for a six-month visa?
Not if you apply from outside the UK for six months or less. If you apply from inside the UK for the same period, you pay half the yearly rate.
How long does a refund take?
Refunds are automatic and are usually paid back to the original card or account within six weeks of the decision on your application.
Does paying the IHS make all NHS care free?
No. It gives you access on the same terms as a resident, which still means paying prescription and dental charges in England unless you are exempt.
For how this fits with the wider cost of a visa, see the UK visa guide for newcomers and the Skilled Worker visa guide.
