The Immigration Health Surcharge (IHS), sometimes called the NHS surcharge, is an additional cost for many UK visa applications. It is separate from the visa application fee and is normally paid upfront for the period covered by the application.
If you are preparing a spouse visa application or an extension from within the UK, include the surcharge in your budget before submitting. The total depends on the applicant’s category and the length of permission.
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Chat with us on WhatsAppWhat is the Immigration Health Surcharge?
The IHS forms part of the immigration application process for many people coming to the UK or extending their stay. Whether you must pay depends on the permission you are applying for.
Where payment is required, it allows access to NHS services on broadly the same basis as UK residents once the visa starts. It does not make every treatment or service free.
Read the official Immigration Health Surcharge guidance.
How much is the surcharge?
The current annual rates are:
| Applicant category | Annual rate per person |
|---|---|
| Most applicants, including adult spouse visa applicants | £1,035 |
| Applicants under 18 at the date of application | £776 |
| Students, their dependants and Youth Mobility Scheme applicants | £776 |
These are annual calculation rates, rather than yearly instalments. Part-years are charged under the applicable rules, so check the official calculation guidance for the total.
Example: a spouse visa extension
For an adult spouse extension covering 30 months, the standard-rate calculation is £1,035 × 2.5 = £2,587.50. This is the surcharge alone; the visa fee and any other costs are separate.
An initial spouse visa issued for 33 months normally attracts three years’ surcharge, giving a standard-rate total of £3,105. Confirm the amount generated by the application system before payment.
Do you pay the IHS every year?
No. You normally pay the full amount during the application process. If you later make another application requiring the surcharge, a further payment will normally be due for that permission.
Keep the payment confirmation and IHS reference with your application records. Follow the instructions in the official application account.
Who normally needs to pay?
The surcharge usually applies to applications made outside the UK for permission lasting more than six months, and to applications for temporary permission made inside the UK, unless an exemption applies.
Having private medical insurance does not remove the payment requirement.
Who is exempt?
Examples include applicants for Indefinite Leave to Remain, eligible Health and Care Worker visa applicants and their dependants, and applicants under the EU Settlement Scheme. Other exemptions also exist.
Visitor visa applicants do not pay the IHS, but that does not give them unrestricted free NHS treatment. Healthcare charging rules still apply.
Check the complete GOV.UK list of who needs to pay and who is exempt.
Does paying tax or National Insurance remove the charge?
Do not assume that working in the UK or paying National Insurance creates an exemption. Check the rules for your immigration category before omitting payment.
For families, the practical issue is budgeting for the full application. Separate the visa fee, surcharge, optional faster service, professional fees and other expenses so the total is clear.
What NHS costs can still apply?
You may still need to pay for services such as prescriptions where charges apply, dental treatment, eye tests and assisted conception.
Paying the surcharge does not itself grant a visa. GOV.UK also warns that NHS treatment may be chargeable while a visa decision is pending. Check your position if you need treatment before your permission starts.
Can you get an IHS refund?
A full refund is normally available if your visa application is refused, you withdraw before a decision, or you paid twice for the same application.
A partial refund may apply if less permission is granted than requested or you have qualifying overlapping payments when extending or switching inside the UK.
You do not normally receive a refund simply because you did not use the NHS, left the UK early or obtained ILR before your previous permission expired.
Refunds normally go back to the payment account or card. Separate reimbursement provisions may apply to eligible health and care workers and certain other applicants.
Read the official IHS refund guidance before expecting repayment.
Do you pay the surcharge when applying for ILR?
An application for Indefinite Leave to Remain does not normally require an IHS payment. Settlement is a separate application with its own fee and eligibility requirements.
If you are preparing for settlement, read our guide to settlement in the UK.
How Thai Visa Express can help
We can review the relevant immigration route, help organise supporting evidence and explain the application costs that need checking before submission.
UK immigration advice is provided through Thai Visa Express UK, regulated by the Immigration Advice Authority (IAA), registration F200700163. Our Thailand office is a separate overseas consultancy.
For UK in-country applications, visit our UK website. You can also use our contact form.
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