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The Immigration Health Surcharge (IHS) is a critical component of the UK immigration process for applicants intending to live in the UK for more than six months.
This mandatory fee helps fund the National Health Service (NHS) and provides visa holders access to healthcare services during their stay.
However, your pay can vary significantly based on your visa type, length of stay, and whether you’re applying with dependents.
In this guide, you’ll explore the purpose of the IHS, how it has evolved, how it is calculated, who is required to pay, and what to do in case of payment errors.
Purpose and Evolution of the IHS
The IHS was introduced under Section 38 of the Immigration Act 2014 and implemented through the Immigration (Health Charge) Order 2015.
Since its inception, the fee has been revised several times in response to changes in government policy and NHS funding requirements.
Common Eligible Visa Categories for IHS
| Visa Category | Eligible Visa Types |
| Work Visas | Skilled Worker Visa, Intra-company Transfer Visa, Temporary Worker Visa (Tier 5), Youth Mobility Scheme Visa, Innovator Visa, Start-up Visa |
| Student Visas | Student Visa (Tier 4), Student Visa (EU nationals post-Brexit), Short-term Study Visa (6 months or more) |
| Family Visas | Spouse Visa, Partner Visa, Parent Visa, Dependant Visas (of work or study visa holders) |
| Visitor Visas (long-term) | Visitor Visa (medical treatment over 6 months) |
| Other Temporary & Permanent Visas | Global Talent Visa, Tier 1 (Exceptional Talent) Visa, Representative of an Overseas Business Visa, Religious Worker Visa |
IHS Fee Changes Over Time
The IHS fee was initially set at £200 for most general applicants. The first significant increase came in 2018 when it doubled to £400.
In 2020, it was further raised to £624. The most recent change occurred in 2024 when the IHS for general applicants rose to £1,035.
| Year | General Applicants | Students, Children, Youth Mobility |
| 2015 | £200 | £150 |
| 2018 | £400 | £300 |
| 2020 | £624 | £470 |
| 2024 | £1,035 | £776 |
The most recent increase, implemented in 2024 via the IHS Amendment Order, significantly raised the cost for applicants across most categories.
Pro Tip: Failure to pay the IHS renders your visa application invalid, resulting in automatic refusal. Full payment is essential for a valid visa or immigration application.
IHS vs. NHS Health Surcharge
Immigration Health Surcharge and NHS Health Surcharge are often used interchangeably. However, the IHS refers explicitly to the fee paid during the immigration application process.
In contrast, the NHS Health Surcharge refers to fees paid by overseas nationals for accessing NHS services.
| Aspect | Immigration Health Surcharge (IHS) | National Health Surcharge (NHS) |
| Definition | A fee is paid as part of a UK visa application. | A general term for the cost overseas nationals pay to use NHS services. |
| Purpose | To fund the NHS and grant access to healthcare during a visa holder’s stay. | To enable foreign nationals to access NHS services. |
| Who Pays It | Visa applicants staying in the UK for more than six months. | Overseas nationals needing access to NHS services. |
| When Paid | During the online visa application process. | Usually referred to in the context of healthcare access, not payment timing. |
| Official Use | Legally recognized and used in UK immigration rules. | Informal or interchangeable use in public and media discussions. |
| Common Usage | Used by UK Visas and Immigration (UKVI) and legal documents. | Sometimes used in place of IHS in casual or general discussions. |
| Overlap | A specific type of NHS-related charge for immigration. | A broader concept may include or refer to the IHS. |
NHS Access vs NHS Coverage
Paying the Immigration Health Surcharge (IHS) grants you access to the National Health Service (NHS) in the UK for the duration of your visa.
However, it’s essential to understand that access to the NHS is not the same as full healthcare coverage; not everything is free.
The IHS Cover
The IHS allows you to use the NHS on the same basis as a UK resident. It includes:
- General Practitioner (GP) appointments
- Hospital treatment and emergency care
- Maternity care
- Mental health services
- Accident and emergency services
- Inpatient and outpatient hospital treatment
If you’re treated within the NHS system, you won’t be asked to pay separately for these services when you access them.
The IHS Does Not Cover (You Still Have to Pay for These)
Despite paying the IHS, several services still come with additional out-of-pocket costs, even for UK citizens:
- Prescription Charges
- Dental Treatment
- Eye Tests and Glasses
- Assisted Conception Services
How You Calculate the IHS
The IHS is calculated based on the duration of your visa in 6-month blocks. Any partial period is rounded to the next whole 6-month period.
For example,
- A 16-month visa = Charged for 18 months
- A 33-month visa = Charged for 3 years
- A 2.5-year spouse visa = £2,587.50 (2.5 x £1,035)
Specific visa categories, such as student visas, also have additional time that is often included in the IHS calculation:
- 1 month before the course starts
- 4 months after it ends
The IHS calculation will include these extensions, which will affect the due surcharge.
Use the Official IHS Fee Calculator
To avoid errors and ensure you pay the correct amount, it’s strongly recommended to use the official Immigration Health Surcharge (IHS) calculator provided by the UK government.
See how much to pay
What you’ll need:
- Visa type (e.g., Skilled Worker, Student, Spouse)
- Visa duration (in months or years)
- Whether you’re applying inside or outside the UK
The tool will automatically calculate the total surcharge based on your visa details and prevent miscalculations due to rounding or duration errors.
Using the official calculator reduces the risk of overpayment or application delays due to incorrect IHS fees.
Who Needs to Pay the IHS?
You must pay the IHS if:
- You are applying for a visa outside the UK for more than 6 months.
- You are applying from inside the UK for any visa (except settlement).
You do not need to pay if:
- You’re applying for a visitor visa.
- You’re applying for Indefinite Leave to Remain (ILR).
Important Clarification
Health and Care Worker Visas and Settlement Visas (such as Indefinite Leave to Remain (ILR)) are exempt from IHS payments.
The Health & Care Worker Reimbursement Scheme allows workers in health and social care (not on the Health & Care visa) to claim refunds if they work at least 16 hours per week for 6 months. It applies to roles such as:
- NHS receptionists
- Private care home managers
- Hospital cleaners/caterers
This scheme applies retroactively from 31 March 2020, and refunds are paid in 6-month arrears.
Who Pays More or Less for the IHS
The amount you pay for the Immigration Health Surcharge (IHS) depends on your visa type, age, and the length of your stay. Here’s a breakdown of who pays more and who pays less:
| Category | Amount per Year | Example (2-3 Year Visa) |
| Students, Dependants & Youth Mobility Scheme | £776 | £1,552 (for a 2-year visa) |
| Applicants Under 18 | £776 | £1,552 (for a 2-year visa) |
| All Other Visa Applicants | £1,035 | £3,105 (for a 3-year visa) |
The table illustrates how the IHS fee varies according to the applicant’s visa type, age, and the duration of their stay in the UK.
IHS Exemptions: Who Doesn’t Pay?
Specific individuals are exempt due to legal protections or diplomatic arrangements:
- British Overseas Territories Residents
- Applicants for the Isle of Man or the Channel Islands
- Victims of Slavery or Human Trafficking
- Victims of Domestic Abuse (Appendix VDA)
- Applicants protected by Article 3 of the ECHR
- Stateless Persons (Appendix Statelessness)
- Diplomats and Armed Forces Personnel
- S2 Healthcare Visitors (EEA Medical Arrangements)
For more details, the UK Government IHS Guide
Dependants and IHS: Calculating Fees Separately
If a dependant applies after the principal applicant, they will pay only for the remaining visa duration.
For example,
- Principal applicant: Visa from Oct 2024 to Oct 2026 = £2,070
- Dependant applies in May 2025: 18 months remaining = £1,552.50
Each dependant’s IHS is calculated individually, and eligibility for fee waivers may vary within a family.
In one case, John applied for a UK visa in October 2024 for a 2-year stay. As a general adult applicant, he pays the full Immigration Health Surcharge (IHS) of £2,070 (£1,035 per year × 2 years).
Now, John’s wife Sarah decides to join him later. She applied for her visa in May 2025, when only 18 months remained on John’s visa. Since the IHS is calculated based on the remaining duration of the visa, Sarah only needs to pay for the 18 months remaining.
Because IHS is calculated in 6-month blocks, her fee is worked out as follows:
- 18 months = three blocks of 6 months
- £776 per year (as a dependant) ÷ 2 = £388 per 6-month block
- 3 blocks × £388 = £1,164
Later, their child applies as a dependant. Depending on their circumstances, such as financial hardship or humanitarian grounds, they may qualify for a fee waiver or reduced IHS fee, making their cost different again.
What to Do If Your IHS Payment Fails (IHS Top-Up System)
Paying the IHS correctly is essential for a successful UK visa application. If the IHS is underpaid or unpaid due to a technical issue or mistake.
UK Visas and Immigration (UKVI) will usually issue a top-up payment link to allow applicants to correct the shortfall. However, this opportunity comes with strict deadlines.
Time Limits for IHS Top-Up Payments
Once UKVI issues a top-up link, the applicant must complete the payment within the following timeframe:
- 7 working days if the applicant is outside the UK
- 10 working days if the applicant is inside the UK
Failure to pay within the specified time will result in the visa application being refused or rejected. UKVI generally provides only one chance to top up the IHS.
Extensions beyond this are rarely granted, only in proven compassionate or exceptional circumstances.
Why the IHS Top-Up System Matters
The top-up system prevents minor IHS payment issues, often caused by system glitches or user confusion, from leading to automatic visa refusals.
It allows applicants to resolve payment problems without restarting the application process, saving time and stress.
Real Example: Dependant Child Visa Case
Client: Ahmed Tayag
Application Type: Family visa (Dependant child)
Location: Applying from outside the UK (Philippines)
The family first applied for the mother’s visa. The visa fee and IHS were paid successfully, and the process went smoothly.
They followed the same procedure when applying for the visa for their minor child, Baby Tayag. After paying the visa fee and proceeding to the IHS section, the system displayed a message:
“You don’t need to pay IHS.”
Despite this, the application generated an IHS reference number, so they submitted it.
Naturally, the mother became concerned, unsure why no IHS payment was required. She feared this might lead to rejection.
I identified this issue as a technical glitch in the visa system, not an error on the part of the applicant. As expected, UKVI reviewed the application a few days later and noticed that the IHS fee hadn’t been collected.
UKVI sent an official email with a top-up payment link. I used the link to pay the outstanding IHS fee, and the case continued without delays.
My Advice to Applicants
If you encounter a situation where the system tells you no IHS payment is required (even when it should be), don’t panic:
- Apply as prompted.
- Wait for UKVI to review your case.
- If a payment is due, you will receive a top-up link.
- Pay it immediately within the deadline.
This system is designed to help genuine applicants overcome minor system errors without penalty, provided they respond promptly and correctly.
Key Insights to Understand the Immigration Health Surcharge
Here are various key insights that help you better understand the UK Immigration Health Surcharge; these are:
The IHS Portal Uses Live Exchange Rates
The Immigration Health Surcharge is charged in pounds sterling, but if you’re paying from outside the UK, the amount is converted based on live exchange rates at the time of payment.
IHS Top-Up Payment Rule
UKVI will send you a one-time payment link if your IHS payment is incomplete or incorrect. To avoid visa refusal, you must pay the difference within seven working days (outside the UK) or 10 working days (inside the UK).
Appeal or Administrative Review Won? You Still Need to Pay IHS
Even if your visa is approved after a successful appeal or administrative review, you must still pay the IHS for the agreed-upon period before it can be granted.
Partial Refunds for Overpayment
If you accidentally overpay the IHS (e.g., you’re granted a shorter visa than expected), you may receive a partial refund automatically, depending on your case’s final decision and visa length.
How IHS is calculated for Dependants Joining Later
When a dependant applies after the principal applicant, their IHS is calculated based on the remaining time on the sponsor’s visa, not the full original term.
Calculating IHS for Visa Extensions on Courses or Employment
If you extend your visa due to longer studies or ongoing employment, you must pay additional IHS based on the extended duration.
Who Manages What? NHSBSA vs. UKVI Role
- UKVI (UK Visas and Immigration) handles IHS collection during the visa process.
- NHSBSA (NHS Business Services Authority) processes IHS refunds and reimbursements.
Your Right to Internal or External Review of IHS Issues
If your IHS payment or refund is disputed, you may have the right to request an internal review from UKVI or NHSBSA. In some cases, you can escalate to an external tribunal or ombudsperson.
Duration Buffers in Visa and IHS Calculations
Visa durations often include buffer periods. For example, a student visa may be issued one month before the course start date and remain valid for four months after the course completion date. These extra months are included when calculating IHS fees.
IHS for Dependants of ILR Holders or British Citizens
Dependents of individuals with Indefinite Leave to Remain (ILR) or British citizenship must still pay the Immigration Health Surcharge (IHS) if applying under a visa category that requires it, such as a family visa.
Here are some other key insights for IHS; you can find them using this link.
📄 IHS Key Facts PDF
Conclusion
The Immigration Health Surcharge is a vital part of your UK visa application. Understanding how it’s calculated, who pays what, and how exemptions or errors are handled can prevent costly mistakes.
If you’re unsure about your situation or encounter unexpected system issues, it’s always best to wait for UKVI’s official communication before panicking.
By planning and knowing your rights and obligations, you can confidently navigate the IHS process and ensure your application stays on track.
How KQ Solicitors Can Help With Your Immigration Health Surcharge
At KQ Solicitors, we provide expert guidance on all aspects of the Immigration Health Surcharge. Whether you’re applying for a visa, claiming an exemption, or seeking a reimbursement, we can help you:
- Understand your IHS liability based on visa type and duration
- Check your eligibility for IHS reimbursement, primarily if you work in health or social care
- Prepare and submit supporting evidence for IHS refunds (including for self-employed or third-party contracted workers)
- Challenge incorrect IHS charges or top-up notices
- Navigate fee waivers and refund claims effectively
- Avoid common IHS pitfalls during visa variations, appeals, or short-duration grants
Then why do you wait? Now is the perfect opportunity to schedule a 30-minute free consultation using our Contact Us button. Additionally, you may reach us by:
- 📞 Call Us: [+447429294455]
- 📧 Email Us: [info@kqsolicitors.com]
- 🌐 Visit Us Online: [KQ Solicitors]