The () is a fee paid upfront by most non-UK visa applicants, giving them access to the National Health Service for the duration of their leave. In 2026 it costs £1,035 per year for most visa types and £776 per year for students and children under 18. It is paid as a lump sum before the visa is granted — not monthly, not after arrival.
This guide covers who must pay, who is exempt, exactly how it is calculated, when you get a refund and the common mistakes that cause people to overpay or underpay.
The 2026 rates
| Applicant type | Annual rate | 2-year total | 3-year total |
|---|---|---|---|
| Adult (most visas) | £1,035 | £2,070 | £3,105 |
| Student visa holder | £776 | £1,552 | £2,328 |
| Child under 18 | £776 | £1,552 | £2,328 |
| Adult on Youth Mobility Scheme | £1,035 | £2,070 | n/a |
| ILR / Settlement applicant | £0 | n/a | n/a |
The student rate applies to anyone holding a Student visa (Tier 4 or post-2021 Student visa). If you switch from Student to Skilled Worker, the higher adult rate applies from the date of the Skilled Worker visa.
Who must pay IHS
You must pay if you are applying for:
- Skilled Worker visa (any duration over 6 months)
- Student visa (any duration)
- Family visa (spouse, partner, children, parents)
- Graduate visa
- Health & Care Worker visa
- Innovator Founder / Global Talent
- Youth Mobility Scheme
- Any visa valid for more than 6 months
Visas of 6 months or less (standard visitor, short-term student, transit) do not require IHS payment.
Who is exempt from paying IHS
Exemptions in 2026 are narrow. You do not pay IHS if you are:
- A national of a country with a reciprocal healthcare arrangement with the UK — as of 2026 this list is limited to Australia and New Zealand (partial exemptions only; check gov.uk for current list)
- Applying for or already hold or Indefinite Leave to Enter
- A British citizen or settled person (no visa required)
- An asylum seeker whose claim is being processed
- Applying for a visa of 6 months or less
- A victim of domestic violence on the Destitution Domestic Violence Concession
Former exemptions for healthcare workers, diplomats, and some others have been significantly narrowed since 2023. Do not assume a previous exemption still applies without checking.
How IHS is calculated — the key rules
Partial years count as full years. This is the most expensive rule. If your visa is for 3 years and 4 months, you pay IHS for 4 years, not 3.33 years.
Round up, always. The formula is: total months ÷ 12, round up to the nearest whole year, multiply by the annual rate.
Worked example:
- Skilled Worker visa: 3 years and 1 day
- Years charged: 4 (3 full years + any remainder = +1 year)
- IHS: £1,035 × 4 = £4,140
This catches many people off-guard. A Skilled Worker visa is typically granted for the duration plus a buffer. If your employer issues a CoS for "3 years" and the Home Office grants leave for "3 years and 14 days," you pay for 4 years.
Tip: Check the exact months on your visa and calculate before paying to avoid surprises.
How to pay IHS
IHS is paid during the online visa application process, before the application is submitted. You cannot bypass this step.
- Complete the online visa application form on gov.uk.
- The system automatically calculates the IHS amount based on visa duration and applicant type.
- Pay by Visa, Mastercard, or Maestro (debit or credit). American Express not accepted.
- Once paid, you receive an IHS reference number which must be included in the application.
- If you have dependants applying simultaneously, they each need their own IHS payment.
You can pay IHS online and then submit the application days or weeks later — the IHS reference is valid for the application session. However, if you start a new application session, you may need to pay again (check the gov.uk system guidance).
Dependants and IHS
Each dependant applying simultaneously pays IHS separately:
- A spouse applying on a Skilled Worker dependant visa: £1,035/year × visa duration
- A child under 18 accompanying a parent: £776/year × visa duration
- A child turning 18 during the visa: the rate is set at application — if under 18 when applying, the child rate applies for the whole visa
Family example: Adult + spouse + 2 children, 3-year visa:
- Adult: £1,035 × 3 = £3,105
- Spouse: £1,035 × 3 = £3,105
- Child 1: £776 × 3 = £2,328
- Child 2: £776 × 3 = £2,328
- Total IHS: £10,866
IHS refunds
Full refund: If your visa application is refused, the IHS is refunded in full within 6–10 weeks. No application is needed — the refund is processed automatically to the card used.
Partial refund: If your leave is curtailed (shortened) after being granted — for example you leave the UK voluntarily, your visa is revoked, or you switch to a lower-surcharge visa — you can claim a refund for complete unused months. Apply via the IHS refund form on gov.uk within 3 months of your leave ending.
No refund if: you use your leave fully, or you are removed from the UK following an immigration breach.
What IHS actually covers
IHS gives you access to NHS treatment on the same basis as a UK resident:
- ✅ GP appointments
- ✅ A&E and urgent care
- ✅ Hospital treatment (inpatient and outpatient)
- ✅ NHS mental health services
- ✅ Maternity care (most)
Not covered (you pay regardless of IHS):
- ❌ NHS prescription charges (currently £9.90 per item unless exempt)
- ❌ NHS dentistry (you pay NHS treatment charges)
- ❌ Optical (NHS sight tests reduced-cost; glasses full-price)
- ❌ Assisted conception and some fertility treatments
- ❌ Cosmetic procedures
Frequently asked questions
Frequently asked
No. IHS is mandatory for all qualifying visa applicants. There is no opt-out, even if you have comprehensive private health insurance. You will pay IHS and your insurance will overlap.
No, but it is increasingly common, especially for sponsored Skilled Workers. Around 40% of large UK employers in tech and finance now offer partial or full IHS reimbursement as part of the relocation package. Negotiate it before accepting an offer.
No. You get an NHS number when you register with a GP. IHS payment is a separate process from NHS registration. Register with a GP within a few weeks of arrival — don't wait until you're ill.
You can claim a partial refund for unused complete months if your leave ends early. If you voluntarily depart, you must notify UKVI of your departure and then apply for the refund within 3 months.