What Is the Immigration Health Surcharge (IHS)?
The Immigration Health Surcharge (IHS) is a mandatory fee you pay with your UK visa application to access the National Health Service (NHS). It costs £776 per year for students, £1,035 per year for most other visa applicants. You pay the full amount upfront — before your visa is granted — and it covers your entire visa duration. No IHS payment, no visa. It is that simple.
The UK government introduced the IHS in April 2015 under the Immigration Act 2014. The idea: every non-EEA visa applicant contributes toward the cost of NHS care. Since 2015, the IHS has generated over £6.9 billion in revenue. The fee has increased significantly over time, with the most recent major hike in February 2024 — when student rates jumped from £470 to £776 per year (a 65% increase).
Once you pay the IHS, you are treated exactly like a UK resident for NHS purposes. GP visits, hospital stays, A&E, mental health therapy, maternity care — all free at the point of use. For the full picture of what the NHS covers and does not cover, see our complete UK student health insurance guide.
This article is the deep-dive on the IHS itself: how much you pay, who is exempt, how refunds work, and how to calculate your total cost.
Current IHS Rates (2026)
The IHS has two tiers: a discounted rate for students and certain other groups, and a standard rate for everyone else.
Fee structure
| Applicant type | Annual rate | 6-month rate |
|---|---|---|
| Students (Student visa) | £776 | £388 |
| Student dependants | £776 | £388 |
| Children under 18 (any visa) | £776 | £388 |
| Youth Mobility Scheme | £776 | £388 |
| Standard adult applicants | £1,035 | £517.50 |
| Skilled Worker visa | £1,035 | £517.50 |
| Family visa dependants | £1,035 | £517.50 |
How the IHS has changed over time
| Year | Student rate | Standard rate | Change |
|---|---|---|---|
| 2015 (launch) | £150/year | £200/year | — |
| 2020 | £470/year | £624/year | +213% (student) |
| Feb 2024 | £776/year | £1,035/year | +65% (student) |
| 2026 | £776/year | £1,035/year | No change |
The February 2024 increase was the largest single jump in IHS history. The UK government set the standard rate to match the estimated average annual cost of NHS care per person (£1,036), and the student rate at roughly 75% of that figure.
How to Calculate Your Total IHS Cost
The IHS is calculated in six-month blocks and rounds up. You always pay for complete six-month periods.
Calculation formula
Total IHS = (Number of full years × annual rate) + (remaining months rounded up to nearest 6 months × half-year rate)
Student visa examples
| Course duration | Visa granted | IHS calculation | Total cost |
|---|---|---|---|
| 1-year Master’s | 1 year 4 months | £776 + £388 | £1,164 |
| 2-year Master’s | 2 years 4 months | £776 × 2 + £388 | £1,940 |
| 3-year Bachelor’s | 3 years 4 months | £776 × 3 + £388 | £2,716 |
| 3-year PhD | 4 years 4 months | £776 × 4 + £388 | £3,492 |
| 4-year PhD | 4 years 4 months | £776 × 4 + £388 | £3,492 |
Why the extra 4 months? UK Student visas typically include a buffer period after your course ends — usually 4 months for courses over 12 months. You pay IHS for this buffer too.
Key rules to remember
- No partial months. If your visa is 13 months, you pay for 18 months (rounded up to the nearest 6-month block).
- Upfront, in full. You cannot pay in installments. The entire IHS is due at the visa application stage.
- Per person. Each applicant pays separately — main applicant and each dependant.
- No IHS for stays under 6 months. Short-term study visas (6 months or less) do not require IHS payment.
When and How You Pay the IHS
Step-by-step payment process
- Start your visa application on GOV.UK (Student visa, Skilled Worker, etc.)
- You are redirected to the IHS portal during the application — you cannot skip this step
- Enter your visa details — start date, end date, visa type
- The system calculates your fee automatically based on the duration
- Pay by debit or credit card — Visa, Mastercard, or American Express accepted
- Receive your IHS reference number — a unique code starting with “IHS”
- Return to your visa application to complete it
Important details
- Save your IHS reference number. You need it for your visa application, when registering with a GP, and if you apply for a refund later.
- Payment is linked to your passport. If you renew your passport, contact UKVI to update your records.
- Payment goes to the card you used. If someone else paid for you (parent, employer, agent), the refund goes to their card — not yours.
- Payment confirmation email arrives within minutes. Check your spam folder if you do not see it.
What happens after you pay?
Your IHS payment is recorded against your visa application. When your visa is granted, your NHS eligibility is activated automatically. There is no separate step to “register” for NHS access — your IHS payment is the registration. You just need to register with a GP surgery near your university.
What Does the IHS Cover?
The IHS gives you the same NHS access as a UK resident. That means:
Fully covered (free at point of use)
- GP (General Practitioner) visits — your primary doctor for all health issues
- Hospital treatment — inpatient stays, surgery, intensive care
- A&E (Accident & Emergency) — always free, no appointment needed
- Mental health services — NHS Talking Therapies, psychiatric care, crisis support
- Maternity care — full antenatal, birth, and postnatal care
- Sexual health services — STI testing, contraception, family planning
- Specialist referrals — after GP referral (cardiology, dermatology, etc.)
- Diagnostic tests — blood tests, X-rays, MRI, CT scans
- Vaccinations — flu, COVID-19, and others on the NHS schedule
Not covered by the IHS (even after payment)
- Dental treatment — NHS dental care has separate charges (£27.90–£332.10 in England)
- Optical care — eye tests, glasses, and contact lenses are not free (except in Scotland)
- Prescriptions in England — £9.90 per item (free in Scotland, Wales, Northern Ireland)
- Private healthcare — the IHS covers NHS only, not private doctors or hospitals
For the full breakdown of NHS gaps and how to cover them, read our comprehensive UK NHS guide.
Who Is EXEMPT from the IHS?
Not everyone needs to pay. Several categories of visa applicants are fully exempt from the Immigration Health Surcharge.
Full exemption categories
| Category | Details |
|---|---|
| Indefinite Leave to Remain (ILR) | Applicants for settlement do not pay IHS |
| Health and Care Worker visa | Doctors, nurses, care workers — and their dependants |
| EU Settlement Scheme | EU/EEA nationals with pre-settled or settled status |
| Asylum seekers | Those claiming asylum or humanitarian protection |
| Human trafficking victims | Applying for discretionary leave as trafficking victims |
| Domestic violence victims | Applying for domestic violence concession |
| Diplomatic staff | Accredited diplomats and their families |
| NATO/armed forces | Members of visiting forces under international agreements |
| British Overseas Territory citizens | Residents of the Falkland Islands |
Conditional exemptions and reimbursements
EU/EEA students with a valid EHIC: If you hold a European Health Insurance Card issued by an EU/EEA country and you do not work in the UK, you can apply for a full IHS reimbursement after arrival. Important: this downgrades your coverage from full NHS access to EHIC-level (“medically necessary treatment” only). Apply within 12 months of arrival through GOV.UK.
Health and social care workers (non-visa): If you work in an eligible health or care role but are NOT on a Health and Care Worker visa (e.g., you are on a Student visa working part-time in healthcare), you can apply for annual IHS reimbursements of up to £776.
Fee waiver applicants: People applying for certain family or human rights visas can request an IHS exemption if they demonstrate they cannot afford to pay. This requires a separate fee waiver application.
Who is NOT exempt?
- Students on a Student visa — you must pay, even if your home country has an NHS reciprocal agreement
- Skilled Worker visa holders (except Health and Care Workers)
- Graduate Route visa holders — you pay the standard rate of £1,035/year
- Family visa applicants — standard rate applies
- Visitors — short-term visitors (under 6 months) do not pay IHS, but also do not get free NHS care (except A&E)
How to Get an IHS Refund
You paid the IHS but your circumstances changed. Can you get your money back? In many cases, yes.
Automatic refund scenarios
These refunds happen without you needing to apply:
| Scenario | Refund type | Timeline |
|---|---|---|
| Visa application refused | Full refund | Within 28 days |
| Visa application withdrawn | Full refund | Within 28 days |
| Visa curtailed by UKVI | Partial refund (unused months) | Within 28 days |
Refunds you must apply for
| Scenario | Refund type | How to apply |
|---|---|---|
| Leaving the UK early | Partial refund (unused months) | Online through GOV.UK |
| Switching to an exempt visa | Partial refund (overlap period) | Online through GOV.UK |
| Overpayment | Difference refunded | Contact UKVI directly |
| Health/care worker reimbursement | Up to £776/year | Annual application on GOV.UK |
| EU EHIC reimbursement | Full IHS amount | Online within 12 months of arrival |
Step-by-step: How to claim an IHS refund
Step 1: Check your eligibility. Visit GOV.UK IHS refund page to confirm your scenario qualifies for a refund.
Step 2: Gather your documents. You need:
- Your IHS reference number (from your visa application)
- Your passport number
- Your visa or BRP details
- Proof of departure (flight booking, exit stamp) if leaving early
- Bank details of the card used to pay
Step 3: Submit your application. Use the online portal on GOV.UK. The form asks for your immigration details, the reason for your refund, and your payment information.
Step 4: Wait for processing. Refunds typically take 6 to 8 weeks to process. The money goes back to the original payment card. If that card is expired or closed, the issuing bank usually redirects the payment to your new card or account.
Step 5: Follow up if needed. If you have not received your refund after 8 weeks, contact UKVI via the online enquiry form. Keep your IHS reference number handy.
Important refund rules
- Refunds are calculated in full months. If you leave 2.5 months before your visa expires, you are refunded for 2 months.
- The refund goes to the original payer. If a parent or agent paid your IHS, the refund goes to their card.
- Apply within 5 years. You must claim your refund within 5 years of the IHS payment date.
- EU EHIC reimbursements have a 12-month deadline. Apply within 12 months of arriving in the UK.
- No refund for voluntary non-use. If you stay in the UK but simply do not use the NHS, you cannot get a refund.
IHS vs Private Insurance: Do You Need Both?
This is one of the most common questions international students ask. The short answer: the IHS is mandatory, private insurance is optional but sometimes useful.
What the IHS gives you
The IHS gives you full NHS access — the same as a UK citizen. For most healthcare needs, this is sufficient. You do not need private insurance to see a GP, go to hospital, or access mental health services.
What the IHS does NOT give you
- Fast access to specialists (NHS waiting times can be weeks or months)
- Dental coverage without additional charges
- Optical coverage (eye tests, glasses)
- Private room in hospital
- Repatriation coverage (medical evacuation to your home country)
- Coverage outside the UK during holidays
When private insurance makes sense
| Situation | Why private insurance helps |
|---|---|
| You have a pre-existing condition | Faster specialist access, no NHS waiting list |
| You need dental work | NHS dental is hard to access; private plans cover check-ups and treatment |
| You wear glasses/contacts | Private optical plans cover eye tests and lenses |
| You travel during holidays | Travel insurance covers you outside the UK |
| You want repatriation cover | NHS does not cover medical evacuation home |
| You cannot tolerate long waits | Private insurance means days, not weeks, for a specialist |
Typical costs
- IHS alone: £776/year (mandatory)
- IHS + dental plan: £776 + £120–£300/year
- IHS + comprehensive private: £776 + £480–£960/year
Our recommendation: For most students, the IHS alone is enough. If your budget allows one upgrade, choose a dental plan (£10–£25/month). It covers the biggest gap in NHS coverage.
Want to compare supplementary insurance options? Use our insurance comparison tool to find plans that work alongside your NHS access.
IHS for Specific Visa Types
Different visas have different IHS implications. Here is a quick reference.
Student visa (Tier 4)
- Rate: £776/year (discounted)
- Payment: Upfront for the full visa duration including the 4-month buffer
- Dependants: £776/year each (spouse, children)
- Example: 3-year degree + 4-month buffer = £776 × 3 + £388 = £2,716
Graduate Route visa
- Rate: £1,035/year (standard rate — NOT the student discount)
- Duration: 2 years (3 for PhD graduates)
- Example: 2-year Graduate Route = £1,035 × 2 = £2,070
- Note: You reapply for IHS when switching from Student to Graduate visa
Skilled Worker visa
- Rate: £1,035/year (standard)
- Exception: Health and Care Worker visa holders are fully exempt
- Dependants: £1,035/year each (children under 18: £776)
Youth Mobility Scheme
- Rate: £776/year (discounted)
- Duration: 2 years
- Total: £776 × 2 = £1,552
Short-term Study visa (up to 6 months)
- No IHS required. But you also do not get free NHS access (except A&E).
- If you need healthcare, you must pay out-of-pocket or use travel insurance.
Recent Changes and What to Expect
February 2024: The big increase
The standard IHS rate rose from £624 to £1,035 (a 66% jump). The student rate rose from £470 to £776 (a 65% jump). This was the largest single increase since the IHS was introduced in 2015.
April 2026: Visa fee increases (IHS unchanged)
From 8 April 2026, UK visa application fees increased by 6.5%. However, the IHS rates remained unchanged at £776 (student) and £1,035 (standard). The government reviews IHS rates annually but has not announced any further increases for 2026.
What might change in the future?
The UK government has signalled that IHS rates will continue to track the estimated average cost of NHS care. If NHS costs rise (due to inflation, staffing costs, or expanded services), the IHS will likely increase too. Budget accordingly — if you are applying for a 3 or 4-year course, the rate could change when you apply for visa extensions.
Frequently Asked Questions
How much is the IHS for a 3-year Master’s degree?
For a 3-year Master’s programme, your Student visa is typically granted for 3 years and 4 months (including the post-study buffer). You pay £776 × 3 + £388 = £2,716 upfront. This covers your full NHS access for the entire visa period.
Can I pay the IHS in installments?
No. The IHS must be paid in full at the time of your visa application. There is no installment plan or payment schedule. The entire amount is charged to your debit or credit card in one transaction. Budget for it as part of your visa costs.
What happens if my IHS payment fails?
Your visa application cannot proceed without IHS payment. If your card is declined, try a different card or contact your bank to authorize the international payment. Some banks block large international transactions by default — call ahead and let them know to expect it.
How long does an IHS refund take?
Automatic refunds (visa refused or withdrawn) typically arrive within 28 days. Manual refund applications (leaving early, switching visa categories) take 6 to 8 weeks. The money goes to the original payment card. If you have not received your refund after 8 weeks, contact UKVI.
Do I need to pay IHS again if I extend my visa?
Yes. Each new visa application requires a new IHS payment for the duration of that visa. If you switch from a Student visa to a Graduate Route visa, you pay the IHS again at the applicable rate (£1,035/year for Graduate Route). There is no credit or carry-over from your previous IHS payment.
Is my family covered by my IHS payment?
No. Each family member needs their own IHS payment. Your spouse or partner pays the standard rate (£1,035/year), while children under 18 pay the discounted rate (£776/year). Each dependant applies separately and pays separately.
Can I get an IHS refund if I never used the NHS?
No. The IHS is not a pay-per-use fee. It is a surcharge for the right to access the NHS. Whether you visit a GP once or never, the fee is the same and non-refundable (unless you qualify for a specific refund scenario like leaving the UK early or having your visa refused).
Do EU students still need to pay the IHS?
Yes. Since January 2021, EU students applying for a Student visa must pay the IHS like all other international students. However, EU/EEA students with a valid EHIC who do not work in the UK can apply for a full IHS reimbursement after arrival. This reverts coverage to EHIC-level only.
Is the IHS tax-deductible?
No. The IHS is a government surcharge, not a tax or insurance premium. It cannot be deducted from your income for tax purposes. It is also not considered a qualifying expense for student loan or scholarship purposes in most cases.
What is the IHS reference number and why do I need it?
Your IHS reference number is a unique code (starting with “IHS”) that you receive after payment. You need it to: complete your visa application, register with a GP in the UK, and apply for any refund. Store it somewhere safe — losing it creates delays.
Related Articles
- Student Health Insurance in the UK: NHS, IHS & What You Actually Need — The complete guide to NHS coverage, dental gaps, and post-Brexit rules
- Health Insurance for Student Visa Documentation — How health insurance fits into visa applications worldwide
- How to Choose Health Insurance as an International Student — Step-by-step framework for evaluating insurance in any country
The Bottom Line
The Immigration Health Surcharge is a significant upfront cost — £776/year for students, potentially £2,000–£3,500 for a full degree programme. But it buys you something valuable: full NHS access for your entire stay, on par with UK residents. Pay it during your visa application, save your reference number, register with a GP when you arrive, and you are covered.
If your circumstances change — you leave early, your visa is refused, or you qualify for an exemption — refund options exist. Just act promptly and keep your documentation.
Ready to compare insurance options for your UK studies? Whether you need supplementary dental coverage or comprehensive private insurance alongside your NHS access, our insurance comparison tool helps you find the right plan for your budget.
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