UK Visa IHS Surcharge 2026: £1,035 Per Year, Exemptions, Refunds

TL;DR

The Immigration Health Surcharge is the largest single line item on most UK visa applications. The 2026 rates are £1,035 per year of leave for adults and £776 per year for under-18s and full-time students, paid upfront with the visa application. A Skilled Worker family of four on a five-year grant pays £18,110 in IHS alone. Refunds, exemptions, and the statutory basis follow below.

Last reviewed: 31 May 2026

How the IHS works (statutory basis, who collects it, where it goes)

The Immigration Health Surcharge is a per-year charge paid by most non-UK nationals applying for a visa of more than six months, set under the Immigration (Health Charge) Order 2015 as amended in February 2024. It is collected by UK Visas and Immigration at the point of visa application and transferred to the Department of Health and Social Care, which allocates it to NHS funding across England, Scotland, Wales and Northern Ireland on the basis of the Barnett formula. The IHS gives the visa holder full access to NHS services on the same basis as a UK resident for the duration of their leave, with the exception of prescription charges, dental charges and a handful of fee-payable services that apply equally to UK nationals. The UK visa fee calculator at the top of this hub calculates the IHS automatically alongside the Home Office application fee and shows the running total for a household.

The IHS is charged on the length of leave being granted, not on actual NHS use, and is paid upfront with no instalment option. The 2024 increase from £624 to £1,035 for adults (a 66% uplift) was made under statutory instrument 2023 No. 1283 and laid before Parliament with cross-bench scrutiny. The increase took effect from 6 February 2024 for all applications submitted on or after that date. A judicial review of the 2024 rate change brought by a coalition of medical professional bodies was not granted permission to proceed.

2026 rates by category (adult, under-18, student)

The current IHS rates apply across all visa routes that attract the surcharge. The category is determined by the age of the applicant on the date of application and, in the case of student rates, by the type of leave being granted:

Adult applicant on a work, family or other non-student visa: £1,035 per year of leave
Dependant child under 18 on the date of application: £776 per year of leave
Student visa holder of any age: £776 per year of leave
Dependant of a student visa holder: £776 per year of leave
Youth Mobility Scheme applicant: £776 per year of leave
Health and Care Worker on a clinical NHS role: £0 (exempt, see section below)

The IHS is rounded up to whole years where a grant is for a fractional period. A 30-month Spouse visa grant rounds to three years for IHS calculation purposes, so the IHS for an adult on a 30-month Spouse grant is £3,105 not £2,587.50. This rounding can add up to £776 to a Spouse visa bill for an under-18 dependant on the same 30-month grant.

For combined family applications the IHS is calculated separately for each person and summed. A Skilled Worker family of four (two adults, two under-18 dependants) on a five-year grant pays IHS of (£1,035 x 5 x 2) + (£776 x 5 x 2) = £10,350 + £7,760 = £18,110. That figure is larger than all of the Home Office application fees, biometric enrolment, English language testing and tuberculosis testing combined for the same family.

Who is exempt from the IHS (S2 healthcare, EU Settlement Scheme dependants, others)

The IHS exemptions are set in Schedule 2 of the Immigration (Health Charge) Order 2015. The most commonly used exemptions in 2026 are:

Health and Care Worker visa holders working in clinical NHS roles or on social care roles directly funded by an NHS commissioner
Dependants of UK nationals applying under the Spouse or Parent route where the UK national is a returning resident
EU Settlement Scheme applicants and their family members applying after the original window under the citizens' rights provisions of the Withdrawal Agreement
Persons with an S2 healthcare certificate from an EEA state, which provides reciprocal arrangements for ongoing pre-arranged NHS treatment
Diplomats and members of armed forces visiting under official arrangements
Victims of modern slavery and human trafficking where confirmed through the National Referral Mechanism
Asylum applicants and persons granted humanitarian protection
British National (Overseas) applicants from Hong Kong applying under the BN(O) visa route are NOT exempt from IHS, contrary to common belief - they pay the full £1,035 per year

Exemptions are claimed at the point of application. A claim made after the IHS has been paid requires a separate refund request through gov.uk and adds 6 to 12 weeks to the refund timeline.

How refunds work (refused, withdrawn, early departure)

Three refund scenarios apply to the IHS, each with a different mechanism:

Application refused or withdrawn before decision: the IHS is refunded in full automatically to the original payment card within 6 to 12 weeks of the refusal or withdrawal notice. No separate refund request is required.
Leave granted but holder leaves the UK before the leave period ends: the IHS is refunded pro-rata in whole months. A request is made through the gov.uk IHS refund form, and the holder must surrender the biometric residence permit or eVisa profile.
IHS charged in error (for example, applicant was exempt but paid): a refund request is made through gov.uk with evidence of exemption status. Refund is to the original payment card.

The biometric residence permit must be surrendered (or the eVisa profile closed) before an early departure refund is processed. Submitting a refund request without surrendering the permit results in the request being held pending until the surrender is processed. Refunds are calculated in whole calendar months, so an applicant leaving on the 14th day of a month effectively forfeits the IHS for that month.

Refunds are not paid for unused portions of a year on a continuing visa. An applicant who leaves the UK for six months mid-grant and returns is not entitled to a refund for the six absent months because the leave itself continues to run.

Worked example: 5-year Skilled Worker family

The following worked example uses a Skilled Worker main applicant, partner and two children aged 10 and 14 on the date of application, all applying together on a five-year Skilled Worker grant from outside the UK. No exemptions apply and no priority service is selected.

Main applicant adult IHS (5 years x £1,035): £5,175
Spouse adult IHS (5 years x £1,035): £5,175
Child aged 10 IHS (5 years x £776): £3,880
Child aged 14 IHS (5 years x £776): £3,880

Total IHS bill: £18,110. Both children remain on the under-18 rate for the duration of the five-year grant despite ageing past 18 mid-leave, because the IHS rate is fixed at the date of application based on age then. The same family on a three-year grant would pay (£1,035 x 3 x 2) + (£776 x 3 x 2) = £6,210 + £4,656 = £10,866, but would face a second IHS bill of the same magnitude at the three-year renewal point.

If the same family departs the UK after 24 months of the five-year grant, the IHS refund is calculated as 36 unused months out of 60 for each person. The refund equates to 60% of the original IHS, totalling £10,866. The biometric residence permits are surrendered at the UK port of departure or returned by post.

Frequently asked questions

Why is the IHS charged upfront rather than annually?

The Home Office charges the IHS upfront as a single lump sum to reduce administrative cost and to ensure NHS access is funded for the full leave period at the point the visa is granted. An annual model would require continuous reassessment of immigration status and ongoing payment collection, which the Department of Health and Social Care has assessed as more expensive than the current upfront model. The trade-off is that the upfront bill is a meaningful cash constraint for many applicants.

Can the IHS be reduced or waived for low-income applicants?

No. The IHS is a flat per-year charge with no means-tested reduction or waiver. The exemptions listed in Schedule 2 of the Immigration (Health Charge) Order 2015 are based on category of applicant (asylum seeker, victim of trafficking, clinical NHS role) rather than on income. Fee waivers exist for some Home Office application fees on a destitution basis under Appendix FM of the Immigration Rules, but the fee waiver does not extend to the IHS itself.

What happens to the IHS if a visa is refused?

The IHS is refunded in full and automatically to the original payment card within 6 to 12 weeks of the refusal notice. No separate refund request is needed for refusal scenarios. The Home Office application fee, by contrast, is not refunded on refusal - only on withdrawal before processing begins.

Are dependants charged the same IHS rate as the main applicant?

Dependants are charged at the rate matching their category on the date of application. An adult dependant pays the adult rate of £1,035 per year; an under-18 dependant pays the under-18 rate of £776 per year. Student visa holders and their dependants pay £776 per year regardless of age. The age category is fixed at the date of application, so a 17-year-old dependant on the date of application remains on the £776 rate for the full grant even if they turn 18 during the leave period.

Has the IHS rate been challenged in court?

The February 2024 increase from £624 to £1,035 was challenged by a coalition of medical professional bodies on the grounds that the impact assessment did not adequately consider effects on overseas healthcare workers. Permission for judicial review was refused at the High Court in summer 2024, and the rate has remained in force since. Statutory instruments setting IHS rates are laid before Parliament under negative resolution procedure and have not historically been blocked.

Sources

Disclaimer: The figures and guidance on this page are informational. Kael Tripton Ltd is not authorised by the Solicitors Regulation Authority, the Office of the Immigration Services Commissioner, or the Financial Conduct Authority and does not provide immigration advice. For application-specific advice consult a regulated immigration adviser. Verify current fees and rules on gov.uk before applying.