The UK Immigration Health Surcharge in 2026: What It Costs, Who Pays, and How to Plan for It

If you've ever looked up the total cost of a UK visa application and nearly fallen off your chair, the Immigration Health Surcharge (IHS) is almost certainly the reason why. It's one of the most misunderstood costs in the UK immigration process — and for HR teams and developers building immigration compliance tools, it's a critical data point that often gets overlooked until the bill arrives.

Here's everything you need to know about it.

What Is the Immigration Health Surcharge?

The Immigration Health Surcharge is a fee paid by most non-UK, non-EEA nationals who apply for a visa to live, work, or study in the UK for more than six months. It grants access to NHS services during your stay — broadly on the same terms as a UK resident.

It is paid at the point of visa application, not on entry to the UK. And crucially, it is paid per person, for every year of the visa. A three-year Skilled Worker visa for a family of four means you're paying the IHS twelve times over.

The 2026 Rates

The current IHS rate (as of 2026) is:

• £1,035 per year for most visa applicants
• £776 per year for students and their dependants (a 25% discount)
• £776 per year for Youth Mobility Scheme applicants

For a standard 5-year Skilled Worker visa, that's £5,175 in health surcharge alone — before visa fees, legal costs, or the Certificate of Sponsorship fee.

Rates are rounded up to the nearest whole year, so a 30-month visa costs the same as a 36-month one in IHS terms.

Who Must Pay?

The IHS applies to:

• Skilled Worker visa applicants and their dependants
• Student visa applicants (discounted rate)
• Family visa applicants (spouse, partner, child)
• Graduate visa applicants
• Global Talent visa applicants
• Innovator Founder and Start-up visa applicants
• Most other long-term visa categories

Who Is Exempt?

A number of groups are exempt from paying the IHS:

• NHS workers and care workers: Since 2020, NHS workers have been exempt. Since October 2023, overseas care workers on Health and Care Worker visas are also fully exempt.
• Asylum seekers and refugees
• Those applying for leave outside the Immigration Rules in certain circumstances
• Short-stay visa applicants (under 6 months)
• Applicants from certain countries with reciprocal healthcare agreements (though these are rare and limited)

If you're an employer sponsoring overseas workers, verifying whether your candidates qualify for the Health and Care Worker visa exemption can save them thousands of pounds.

How Is It Paid?

The IHS is paid online via the UK Visas and Immigration (UKVI) payment service as part of the visa application process. There is no option to pay it in instalments — it must be paid in full, upfront, for the entire visa duration.

Once paid, applicants receive an IHS reference number which is submitted alongside their visa application. Without this reference, the application will be rejected.

Common Mistakes HR Teams Make

1. Forgetting to include it in relocation cost estimates
The IHS is often omitted from employer relocation packages because it feels like a personal expense. But for high-demand roles, more employers are covering it (or at least partially reimbursing it) as part of competitive offers.

2. Not accounting for dependants
Each dependant pays the full IHS separately. A sponsored worker bringing a partner and two children will owe IHS for all four family members.

3. Confusing it with the visa fee
The visa fee and IHS are two separate charges paid in the same application flow. Both must be paid, but they're calculated differently and paid to different systems.

4. Missing the Health and Care Worker exemption
If you're sponsoring a nurse, doctor, or care worker on the Health and Care Worker visa, they are exempt from the IHS. Failing to apply in the correct visa category means paying a surcharge they legally didn't owe.

Will the IHS Rate Change?

The short answer is: probably. The IHS has increased significantly over the years — it started at £200 per year in 2015 and has risen to £1,035 in 2026. Future rate changes are announced by the Home Office and are subject to Parliamentary approval.

HR teams and immigration compliance professionals should monitor announcements from the Home Office and UKVI, especially around Autumn Statement and Budget periods when fee changes are typically signalled.

A Practical Cost Planning Note

For anyone building HR tools or immigration calculators: the IHS should always be computed as rate × ceil(visa_months / 12) × number_of_applicants. Don't forget the ceiling — it catches a lot of developers off guard.

For HR teams: when assessing the total cost of sponsoring an overseas worker, the full loaded cost includes the Certificate of Sponsorship fee, the visa application fee, and the IHS for the worker and any dependants. For a single Skilled Worker on a 3-year visa, that's typically £3,000–£4,500 in government fees alone before legal costs.

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Tools like ImmigrationGPT can help workers and employers understand the UK immigration system, check the sponsor register, and get plain-English answers to complex immigration questions — including the IHS.

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This article is for informational purposes only and does not constitute legal or immigration advice. For guidance specific to your circumstances, consult a regulated UK immigration adviser.