UK Immigration Health Surcharge (IHS) Fees 2026: Complete Guide to Costs, Rates & Payment

A five-year UK Skilled Worker visa for a family of four requires an £18,110 Immigration Health Surcharge (IHS) payment upfront. For HR teams managing UK relocations, this mandatory UK visa healthcare surcharge is often the largest and most miscalculated budget expense.

What is the UK Immigration Health Surcharge (IHS)?

The IHS is a mandatory upfront fee attached to most UK visa applications. Paying the UK visa healthcare surcharge secures full National Health Service (NHS) access for the entire duration of the visa.

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UK Healthcare Surcharge Coverage and NHS Access

Sponsored employees receive the exact same NHS healthcare access as UK residents starting from the first day of their visa.

• Covered NHS services: GP appointments, hospital care, A&E, and maternity services.
• Excluded services: Prescriptions, dental care, eye tests, and assisted conception (standard UK resident exclusions apply).

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Who Needs to Pay the IHS Fee?

• Outside the UK applicants: Mandatory for visas valid for more than six months.
• Inside the UK applicants: Mandatory for any length of stay or visa extension.
• Visa dependants: Every family member, including children, must pay a separate UK IHS fee.
• Private medical insurance: Holding private healthcare cover does not exempt applicants from paying the mandatory IHS fee.

Visitors and settlement applicants do not pay. GOV.UK lists every category.

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Current UK IHS Fee Rates for 2026

The UK Immigration Health Surcharge costs remain unchanged since February 2024, holding steady through the April 2026 fee update. When calculating your UK visa healthcare costs, you will fall into one of two main payment tiers.  

Standard IHS Rate for Adult Visa Applicants (£1,035 per year)

• Standard UK visa healthcare cost: £1,035 per person for each year of leave granted.
• Covered visa types: Applies to Skilled Worker, Global Business Mobility, Global Talent, Scale-up, and family routes.  
• Graduate visas: Holders must pay the full standard adult rate rather than the student discount.
• Adult dependants: Charged the exact same annual UK IHS fee as the primary applicant.  

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Discounted IHS Rate for Students, Children, and Youth Mobility (£776 per year)

• Discounted UK visa healthcare cost: £776 per person for each year of leave granted.  
• Eligible visa routes: Applies to Student visa holders, their dependants, and Youth Mobility Scheme applicants.  
• Under 18 applicants: Anyone under 18 years old automatically qualifies for this lower rate.  
• Age lock protection: Age is fixed at the time of application, meaning a child who turns 18 mid-visa retains the cheaper UK Immigration Health Surcharge rate.

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IHS Cost Breakdown by Visa Type & Duration

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Skilled Worker Visa IHS Costs

Budget £1,035 per adult per sponsored year, then the same again for each adult dependant. Read it beside your sponsor licence and CoS costs for a true cost per hire.
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Related read: 
See the full three-year cost of a Skilled Worker hire, with application fees, sponsor licence, CoS and Immigration Skills Charge broken down per route: UK Visa Sponsorship Budget Planning Guide for Employers

Student Visa & Graduate Visa Healthcare Surcharge

Student visas cover the course plus about four months, so a 12-month master's attracts 16 to 17 months of leave and £1,164. Switch to the Graduate route and the rate jumps to £1,035 a year.

Family & Spouse Visa IHS Fee Calculations

• Spouse visa from outside the UK: 33 months of leave, charged as three years, £3,105
• In-country extension: 30 months, charged as two and a half years, £2,587.50

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How to Calculate Your Total IHS Payment

The online visa portal automatically calculates your total Immigration Health Surcharge based on your application dates. However, understanding the maths prevents budget surprises.

Understanding the 6-Month Rounding Rule

The UK government rounds visa durations up into six-month blocks, which is where relocation budgets often break.  

• Over six months: Any partial year extending beyond six months is charged as a full year.  
• Six months or less: Any partial year up to six months incurs half the annual rate (£517.50 for standard adults, £388 for the discounted rate).  
• Short stays from abroad: Visas under six months applied for outside the UK are entirely exempt from the IHS fee.  
• The Skilled Worker trap: A three-year Certificate of Sponsorship (CoS) includes a 14-day grace period. This extra fortnight pushes the visa into a new six-month block, adding a £517.50 UK IHS fee per person to your total costs.

The CoS dates decide your surcharge, so the assignment is where to get it right. Our guide covers Defined versus Undefined CoS, SMS allocation and the 10 to 12 week hiring timeline: UK Certificate of Sponsorship: HR's Complete 2026 Guide

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Calculating IHS for Main Applicants and Dependants

Your total UK visa healthcare costs are assessed individually for each applicant.

• Individual assessment: Every family member is charged based on their specific visa route and age.
• Worker dependants: Adult partners of Skilled Workers pay the standard £1,035 per year.  
• Student dependants: Adult partners of international students pay the discounted £776 per year.  
• Child dependants: All children under 18 pay the £776 discounted rate, regardless of the main applicant's visa route.

Each dependant adds £4,500 to £11,000 once surcharge, fees and relocation are counted. The full picture: Hidden Costs of UK Visa Sponsorship: Beyond Application Fees

Example IHS Fee Calculations for Common Visas

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UK IHS Fee Exemptions and Discounts 2026

Certain UK visa categories provide a full Immigration Health Surcharge waiver.

• Fully exempt applicants: Health and Care Worker visa holders, indefinite leave to remain (ILR) applicants, EU Settlement Scheme participants, diplomats, asylum seekers, Ukraine scheme applicants, and those entering the Isle of Man or Channel Islands.

Health and Care Worker Visa Exemption

This is the most valuable UK visa healthcare waiver available for medical and social care professionals.

• Total family savings: Main applicants and all dependants pay nothing, saving a family of four £18,110 over a five-year visa.
• Employer strategy: Always check if a role qualifies for this exemption before defaulting to a standard Skilled Worker visa application.

Check whether a role qualifies before defaulting to Skilled Worker. Our guide covers eligible clinical roles, the £324 application fee, the £25,000 and £31,300 salary floors and the July 2025 care worker closure: UK Health and Care Worker Visa 2026: The Complete Guide for Employers

Permanent Settlement and ILR

Permanent settlement applications do not require an IHS payment, but there is a common pitfall.

• The ILR trap: If an employee applies for ILR but is granted limited leave instead, they must pay the full UK IHS fee before that limited visa is issued.
• ILR carries no surcharge but a £3,226 fee per person, dependants included. What that means for your budget and timing: UK ILR for Employers: Your Step-by-Step Action Guide

Short-Term Visas Under Six Months

Surcharge rules depend entirely on where the application originates.

• Outside the UK: Visas for six months or less are fully exempt, but provide no free NHS access beyond emergency treatment.
• Inside the UK: Any visa application or extension under six months made from within the UK still incurs half the annual rate.

EU and Swiss Student IHS Refunds

European students can claim an Immigration Health Surcharge reimbursement through the EHIC or S1 scheme.

• S1 scheme holders: Those registered with the NHS Business Services Authority can reclaim part or all of the fee.
• EHIC holders: Full-time, non-working students from the EU, Switzerland, Norway, Iceland, or Liechtenstein qualify if their visa started on or after January 1, 2021.
• Manual claims process: These UK IHS refunds are never automatic and must be actively claimed by the applicant.

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How and When to Pay the UK Immigration Health Surcharge

Step-by-Step IHS Payment Process

• Start GOV.UK application: Begin your UK visa application on the official Home Office portal.
• Automatic calculation: The system calculates your total UK IHS fee based on the entered travel dates.
• Full upfront payment: You must pay the full surcharge before submitting the visa application.
• Save IHS reference: Save the unique IHS reference number displayed on screen and emailed to you.
• Finalize submission: Pay the visa application fee and schedule your biometric appointment.

Accepted Payment Methods and Employer Tax Rules

• Payment methods: Major debit and credit cards are accepted, charged in British pounds sterling (GBP).
• No installments: UKVI requires full payment upfront with no options for deferrals or payment plans.
• Bank spending limits: Overseas cards often fail due to daily transaction limits, so alert employees in advance.
• HMRC tax implications: If an employer pays or reimburses the UK IHS fee, HMRC treats it as a taxable benefit in kind usually settled via a PAYE Settlement Agreement.

The Immigration Skills Charge works the opposite way round: it is legally the employer's cost and cannot be recovered from the worker. Rates, exemptions and refunds: Immigration Skills Charge (ISC) 2026

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What Happens If Your IHS Calculation is Incorrect?

UKVI emails top-up payment requests directly to the applicant rather than the employer. Missing these notifications is a leading cause of UK visa refusals.

Handling IHS Top-Up Payment Requests

• Inside the UK deadline: Applicants applying within the UK have 10 working days to pay the top-up fee.
• Outside the UK deadline: Applicants applying from abroad have 7 working days to complete the payment.
• Refusal risk: Missing the deadline results in a visa refusal and forfeiture of the visa application fee.
• Email monitoring: Employees should check spam folders regularly and assign one person to track Home Office updates.

Resolving IHS Overpayment Issues

• Automatic refunds: Excess payments return automatically to the original payment card.
• Six-month rounding: Duplicate payments of six months or more are refunded, rounded down to the nearest six-month block.
• Non-refundable threshold: Duplicate payments covering periods under six months are not refunded.

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UK IHS Refunds: Eligibility, Timelines, and Claims Process

Automatic UK IHS Refunds

The Home Office automatically processes UK Immigration Health Surcharge refunds for specific application outcomes without requiring a separate claim form.

• Full IHS refund: Applies if your visa application is refused, withdrawn before a decision, or paid twice.
• Partial IHS refund: Issued if UKVI grants less leave than requested or if a dependant visa is refused.
• Refund timeline: Payments automatically arrive within six weeks of the official visa decision.
• Original payment method: Funds return directly to the original debit or credit card used during application.

GOV.UK sets out the full rules.

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What Happens to Your IHS Fee If You Switch Visas Early?

Switching visa routes before your current leave expires requires careful timing to avoid forfeiting paid fees.

• Exempt route switches: Switching to an exempt visa like the Health and Care Worker route or Indefinite Leave to Remain (ILR) does not unlock a refund for unused IHS months.
• Overlapping UK visas: In-country visa switches with overlapping dates qualify for a partial IHS refund, rounded down to six-month blocks.
• Timing strategy: Schedule visa switches close to your current expiration date to prevent losing £1,035 per unused year.

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Non-Refundable UK IHS Scenarios

Certain situations result in a complete loss of paid surcharge funds with zero Home Office recourse.

• Withdrawn visas: No refund is granted if a visa is cancelled after approval.
• Unused visas: Failing to travel to the UK after a visa is granted does not qualify for reimbursement.
• Early resignation: Employees who resign or leave employment early forfeit their paid IHS duration.
• Settlement applications: Indefinite Leave to Remain (ILR) applications offer no surcharge refunds for past visas.
• Employer repayment clauses: Employers reimbursing the UK IHS fee should include a repayment clawback clause in relocation agreements to cover early leavers.

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Plan Your IHS Costs Before the CoS Is Assigned

The Immigration Health Surcharge is driven by the dates on the Certificate of Sponsorship, so the ideal time to review it is before assigning assign the CoS. Model it with the CoS fee and Immigration Skills Charge, agree your reimbursement policy, then set the sponsorship length.
Run the numbers with our UK visa fees calculator, or book a demo to see how Jobbatical tracks IHS payments, top-up deadlines and refunds across every case.

Weighing the total against the cost of leaving the role unfilled: ROI of UK Visa Sponsorship: Cost vs Non-EU Talent Analysis
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Disclaimer: Immigration rules change quite frequently; please verify with official sources or contact us for the latest info before making any decisions.