Immigration Health Surcharge (IHS) – Full 2025 Guide

Most people applying for a UK visa or extension must pay the Immigration Health Surcharge (IHS) — a mandatory contribution towards the National Health Service (NHS).

In 2025, the Home Office confirmed several key updates to the IHS system, including new fees and automatic digital linking to the UK’s immigration records.

At AHJ Immigration, we help clients plan visa budgets accurately, request exemptions where possible, and manage IHS payments during renewals or family applications.

What Is the Immigration Health Surcharge?

The IHS is a fee paid by most migrants to access the NHS while living in the UK. It ensures that temporary visa holders can use public healthcare services like residents, without paying per appointment.

Once paid, the IHS is automatically linked to your visa, allowing you to register with a GP, visit hospitals, and receive NHS treatment during your stay.

Who Needs to Pay the IHS?

You must pay the surcharge if you:

• Apply for a visa or extension for more than six months from outside or inside the UK;
• Are joining a family member or applying for work, study, or settlement routes;
• Apply under routes such as Skilled Worker, Spouse Visa, Student, or Private Life.

You do not need to pay if you’re:

• Applying for Visitor Visas (under six months);
• A Health and Care Worker Visa applicant;
• Applying for Indefinite Leave to Remain (ILR);
• An asylum seeker or a victim of trafficking;
• Eligible for a Fee Waiver under human rights or private life routes.

IHS Fees in 2025

The IHS rates increased in early 2025 under the Home Office’s annual review.

For example, a spouse-visa applicant applying for 2 years and 6 months must pay £2,587.50 upfront.

How to Pay the IHS

• The payment is made online when completing your visa or extension form.
• You’ll be automatically redirected to the IHS payment portal.
• You must pay in full before submitting your application.
• Once paid, you receive an IHS reference number confirming the payment.

If you apply for multiple dependants, you’ll pay for each applicant separately.

What the IHS Covers

Once approved, the IHS allows access to:

• GP appointments and hospital treatment;
• Emergency care and maternity services;
• Mental health services and prescriptions (with standard NHS charges).

However, it does not cover:

• Prescriptions, dental or optical services (some local charges apply);
• Private medical treatment;
• Cosmetic procedures or elective surgery outside NHS criteria.

When You Don’t Have to Pay

Certain categories are exempt from the IHS, including:

• Applicants under the Health and Care Worker Visa;
• Those applying for Indefinite Leave to Remain;
• Children under local authority care;
• Dependants of HM Forces members;
• Fee Waiver recipients on human rights or private-life applications.

Our team checks whether an exemption applies before you pay, saving time and cost.

Requesting a Fee Waiver

If you cannot afford the IHS, you can apply for a Fee Waiver before submission.
You’ll need to show that:

• You are destitute, or
• Payment would make you unable to meet essential living needs.

Fee Waivers are most common in human rights (Article 8) or private-life applications. Supporting evidence such as bank statements, rent arrears, or benefit letters is essential.

What Happens After Payment

Once paid, the IHS is automatically attached to your application.
If your visa is granted, your NHS access becomes active from the visa start date.
You’ll receive no separate card — your visa or BRP number is your NHS access key

Refunds and Overpayments

You may be eligible for an IHS refund if:

• Your visa application is refused or withdrawn;
• You pay twice in error;
• You leave the UK before your visa expires;
• You switch into a route exempt from IHS (e.g. Health and Care Visa).

Refunds are usually issued automatically to the original payment method within 6–8 weeks.

Common Mistakes to Avoid

1. Paying IHS for Visitor Visas – not required.
2. Entering incorrect passport number during payment.
3. Forgetting to include dependants’ IHS in the same transaction.
4. Applying for Fee Waiver after submission – it must be before applying.
5. Not keeping the IHS reference number for proof.

Digital IHS Linking in 2025

Since early 2025, the Home Office has linked IHS payments directly to digital immigration status (eVisa).
This means:

• No paper confirmation needed.
• NHS systems can verify coverage instantly.
• Refunds process automatically if your status changes.

This upgrade supports the UK’s move toward a fully digital immigration system by 2026.

IHS and Refunds After ILR or Citizenship

Once you gain Indefinite Leave to Remain (ILR) or British citizenship, you are no longer required to pay IHS.
If your new status is granted before your old visa expires, you may request a partial refund for the unused period.

How AHJ Immigration Can Help

Our OISC-regulated advisers provide:

• IHS fee calculation and budgeting advice;
• Fee Waiver and exemption applications;
• Refund submissions for refused or withdrawn visas;
• Guidance for family, skilled worker, and private-life routes.

We simplify the technical steps, saving applicants costly delays or double payments.

Why Choose AHJ Immigration

• Regulated, experienced advisers in Birmingham.
• Transparent fees and tailored immigration support.
• Free 30-Minute Consultation to assess your case.
• 1-Hour Paid Consultation for full document and financial review (deductible if you proceed).

📞 Call 0121 828 2224 or Book Your Consultation Online to get help with your visa and IHS payment today.

Disclaimer

Immigration fees and policies are subject to change. Information is correct as of October 2025. Always verify the latest IHS rate and exemption criteria on GOV.UK before applying.

FAQs

1. What is the current IHS rate in 2025?
£1,035 per year for most visa types and £776 per year for students or Youth Mobility applicants.

2. Who doesn’t have to pay the IHS?
Health and Care Visa holders, ILR applicants, asylum seekers, and individuals granted Fee Waivers are exempt.

3. Can I pay the IHS in instalments?
No. The surcharge must be paid in full at the time of submitting your application.

4. How do I get an IHS refund?
Refunds are processed automatically if your visa is refused or withdrawn. You can also request one manually for overpayments.

5. Does IHS give me full NHS coverage?
Yes, you can use NHS services like any UK resident, but prescription and dental charges may still apply.