Immigration Health Surcharge and IHS refunds
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The Immigration Health Surcharge (IHS) has become one of the most misunderstood, and increasingly burdensome, costs of moving to the UK.
Framed as a contribution to NHS access, the IHS is mandatory for most visa applicants, regardless of whether they actually use public healthcare.
This article breaks down how the IHS is calculated, who pays it, who’s exempt, and who can apply for a refund.
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What is the IHS?
Immigration Health Surcharge is a mandatory fee payable in addition to UK visa application fee for practically all types of visas permitting work or study in the UK.
The justification for the IHS was to make non-British residents with a temporary immigration status in the UK pay for the use of the NHS. However, the fee is mandatory for all, even those who fully rely on private medical care and do not need to use the NHS. It is therefore a tax payable by non-settled temporary residents.
Income raised by the IHS goes to general government funds and is then distributed to devolved health administrations.
If you have paid the IHS, you have the right to use the NHS in the same way as a British or settled person. You will still pay for some services, such as prescription medication, dental treatment or eye tests.
If you are applying for a visa to the Channel Islands or the Isle of Man, you will not be required to pay the IHS. Yet, you have to be aware that you won’t have access to the NHS in the UK and if you have to use it, you will be charged privately at 150% rate for the cost of treatment.
How much is the IHS?
- £1035 per year generally
- £776 per year for children under 18, students and their dependants and Youth Mobility visa holders
How the amount of IHS is calculated
The Immigration Health Surcharge is calculated on the basis of the length of the visa and is paid with the visa application fee. If you are applying for the skilled worker visa with 5 years’ sponsorship, the IHS will be £1035 x 5 = £5175. Your partner will be charged the same amount and the children will be charged £776 x 5 = £3880 per applicant.
If you are applying from outside the UK and the visa is for less than 6 months, you will not be charged the IHS.
If you are applying from the UK, any application for 6 months or less will be charged @50% of the standard fee, i.e. £517 for adults or £388 for children and students
In applications for longer than a year, the fee is calculated in 6 months’ increments. Anything up to 6 months is charged at the six months’ rate (£517 or £388) and everything that is more than six months is charged as a full year. For example, if you are sponsored for 2 years and 8 months, the IHS will be the same as for 3 years.
In most immigration categories, other than skilled workers, you don’t have a choice for the duration of the visa, and so the cost of the IHS comes as a set figure.
For example, ancestry visa is always granted for 5 years. If you have to extend your ancestry visa from the UK (say, not meeting the requirements for indefinite leave to remain after completing your 5-year residence), your only option in this route is to extend for another 5 years. It is not uncommon in these circumstances to opt for the Skilled Worker visa, or the Global Talent visa where you can choose the length of time you want to apply for.
If you are applying for the partner visa from outside the UK, the IHS is payable for 3 years as the visa is granted for 33 months. If you are applying from within the UK, the visa is granted for30 months and the IHS is payable for 2.5 years.
Who is exempt from paying the IHS
- Protection applicants (asylum seekers, victims of domestic abuse, applicants under the Ukraine Scheme, children under the local authority care, etc)
- Diplomats and their family members
- Members of HM Forces and their dependents
- Applicants under the EU settlement scheme
- Applicants for the Health Care Workers visa
- Applicants for Indefinite Leave to Remain or indefinite leave to enter
If you are unable to pay the visa fee and the IHS you may be eligible to apply for a fee waiver if your application is in one of the family routes or based on Human Rights. If you have been granted a fee waiver, you will be exempt from paying the IHS.
Who is eligible for IHS refunds
If your application was unsuccessful, you should receive a refund of the IHS automatically. You don’t have to apply for a refund. The refund will be credited to the card you used to make the payment. There will be some loss of money if the transaction was from outside the UK and in another currency than British pounds. Usually, it takes up to 6 weeks for the refund to be credited to your account.
If you've paid for the same period twice
You may be entitled to a partial refund of the IHS if you have paid for the same period twice.
For example, if you switch from one immigration category to another or change your sponsor and apply for a new visa when there is more than six months left on the previous visa. The refund is calculated in 6-month periods, rounding up to a completed period of six months. For example, if you have 13 months left on the skilled worker visa at the time when you switched to the partner visa, you should be eligible to a refund for a 12 month period.
If you have varied your application before it was decided, you would have paid the application fee and the IHS twice. You should receive a refund of your first application fee and the IHS paid with it.
You don’t have to apply for a refund which should be credited to your account automatically.
If your application was withdrawn
If your application was withdrawn before a decision was made on it, you will be entitled to a full refund of both the application fee and the Immigration Health Surcharge.
Varying an extension of stay application with ILR
It has long been the practice of the Home Office to refund the IHS if the application for permission to stay is varied to an application for indefinite leave to remain before the first application is decided.
The Home Office guidance on IHS refunds is silent on this point and it is our understanding that such refunds are discretionary.
Student reimbursement scheme
Students from the EU, Norway, Iceland, Switzerland and Liechtenstein can request a reimbursement of the IHS if:
- They have a valid EHIC card
- They are undertaking a full-time higher education course
- And they do not work or intend to work during their visa
Health and Care reimbursement scheme
If you are working in Health and care on a visa other than the Health and Care Worker visa you can claim reimbursement of the IHS in respect of any six months period from 31 March 2020 for which you paid the IHS. You can also claim reimbursement for your dependants. Source: gov.uk
You have to be employed by an eligible organisation or be self-employed, and work on average at least 16 hours per week.
The refunds are issued in 6-month increments.
You will have to provide evidence of eligibility, such as payslips showing that you are working in health and care sector, the name of the employer, your role, number of hours worked, and a supporting letter from the employer.
When applying for a refund, you will need your IHS number and that of any dependants eligible for a refund.
You should receive a refund within 6 weeks of applying.
Last updated on July 28, 2025
Last updated on July 28, 2025