The Immigration Health Surcharge: Who Pays and How Much in 2026

The Immigration Health Surcharge (IHS) is a charge levied on most non-EEA visa applicants to contribute to the cost of NHS services. Our Bolton immigration solicitors explain who must pay it, how much it costs, and who is exempt.

What is the IHS?

The IHS is paid as part of a visa application. It grants the visa holder (and their dependants) access to NHS services on broadly the same basis as a UK resident — including GP appointments, hospital treatment and emergency care — without further charge at the point of use.

Current IHS Rates (2026)

• Standard rate: £1,035 per year per person
• Student and under-18 rate: £776 per year per person

The IHS is calculated based on the length of visa being applied for. For a 33-month spouse visa, the IHS for one adult would be approximately £2,888 (33/12 × £1,035).

Who is Exempt from the IHS?

• Health and Care Workers and their dependants
• Applicants for Indefinite Leave to Remain (no IHS due)
• British Overseas Territory citizens in certain circumstances
• Dependants of certain diplomatic staff
• Applicants under the EU Settlement Scheme

IHS and Asylum Seekers

Asylum seekers who are granted Section 95 support do not pay the IHS and can access NHS treatment. Those with refugee status or humanitarian protection are not required to pay the IHS during their period of limited leave to remain.

Total Cost of a UK Visa Application

For most visa applicants, the total cost includes: the visa application fee, the IHS, biometric appointment fees (if applicable), translation and notarisation costs, and legal fees. For a family of three applying for spouse/family visas, the visa and IHS fees alone can easily exceed £10,000.