Immigration Health Surcharge explained for Indians

When Indian families total up the cost of a UK move, one line often turns out bigger than the visa fee itself: the Immigration Health Surcharge, or IHS. It is the price of using the National Health Service while you are on a visa, and you pay it in full, up front, for every year of the visa and for every family member.

Here is how it works, what Indian students, workers and families actually pay, who is exempt, and when you can get money back.

Key points

• Most people applying for a UK visa of more than six months from outside the UK pay the IHS.
• The rate is £1,035 a year, or £776 a year for students, their dependants, Youth Mobility visa holders and under-18s.
• You pay for the whole visa length at once, when you apply, by card.
• Visitors don't pay it. Neither do Health and Care Worker visa applicants or people applying for ILR.
• It is refunded if the visa is refused, but not if you leave the UK early.
• Last checked 27 Oct 2026. Not legal advice.

What the surcharge is for

The NHS is funded through taxes. The surcharge, introduced in 2015, is the government's way of asking temporary migrants to contribute directly for the period they are entitled to treatment. Once your visa starts, you can use the NHS on broadly the same basis as a permanent resident.

It doesn't cover everything. You still pay the usual charges that residents pay, such as prescriptions in England, dental treatment and eye tests. And you pay it even if you have private health insurance.

The rates in 2026

According to GOV.UK, the yearly rates are:

*At about ₹127 to the pound (reference rate, 23 Oct 2026).

These rates have applied since 6 February 2024, when the main rate rose from £624 and the student rate from £470. No new rise had been announced as of this article's last check.

How the amount is worked out

You pay for the length of visa you are given, which can be longer than your job or course. GOV.UK's rules for part years are:

• More than 6 months but under a year: a full year.
• Over a year, up to 18 months: one year plus half a year.
• More than 18 months but under 2 years: two full years.

A one-year master's course with a visa of about 16 months, for example, usually means 1.5 years of the student rate: £1,164.

If you apply from inside the UK for six months or less, you pay half the yearly rate (£388 or £517.50). From outside the UK, visas of six months or less don't attract the surcharge.

What Indian families actually pay

A master's student going to Manchester: about 16 months of student-rate cover, £1,164 (about ₹1.48 lakh), on top of the £558 Student visa fee.

A Skilled Worker with a five-year visa, a wife and two children aged 4 and 7:

That is paid on the day of application, before anyone books a flight. Many families choose a shorter first visa and renew, spreading the cost, although each renewal brings another visa fee.

A young professional on the India Young Professionals Scheme: two years at £776, so £1,552.

Who doesn't pay

GOV.UK lists the main exemptions. Those most relevant to Indian applicants are:

• visitors, including parents on a Standard Visitor visa (they must pay for NHS hospital care instead, so they need travel insurance);
• anyone applying from outside the UK for a visa of six months or less;
• applicants for indefinite leave to remain, and people applying to the EU Settlement Scheme;
• Health and Care Worker visa applicants and their dependants.

Doctors, nurses and care workers from India on other routes who work in health or care can sometimes claim a refund for periods of at least six months worked in the sector. GOV.UK has a separate checker for that.

Refunds

You get a full refund if your visa is refused, if you withdraw before a decision, or if you paid twice for the same application. You get a partial refund if you are given a shorter visa than you paid for, if a dependant is refused, or if you paid twice for overlapping periods when extending or switching inside the UK (rounded down to whole six-month blocks).

You don't get money back if you leave the UK early, if your visa is granted but you never travel, or if you switch to a visa that is exempt. Refunds normally arrive within six weeks to the card used.

IHS against private cover in India

Indian professionals often compare the surcharge with what they paid for family health insurance at home. The comparison isn't quite fair in either direction. A family floater policy in India usually costs a fraction of the IHS, but it caps the sum insured, has waiting periods and often excludes existing conditions. The IHS has no cap, no waiting period and no exclusions for existing illness, and it covers GP visits, hospital care, maternity and emergency treatment. What it doesn't buy is speed: NHS waiting lists for planned treatment can be long, which is why some employers add private medical insurance on top.

Keep your Indian policy if you plan to return or spend long periods there; some insurers let you pause or port a policy. Cancelling it and buying again at 45 can mean new waiting periods.

Paying it

You pay online as part of the visa application, by debit or credit card, and get an IHS reference number that you enter on the visa form. That number can be used once. If you underpay, UK Visas and Immigration emails you and gives you seven working days to pay from outside the UK (ten from inside) before the application is refused.

Why it matters

The surcharge turns a UK move into a cash-flow question. For a family on a five-year Skilled Worker visa it can be more than half of all the official costs. Ask your employer whether it will reimburse the IHS; some do, though they aren't required to. Check our Skilled Worker visa guide for the other fees, and keep the long term in view: once you settle, the surcharge stops, which is one reason the debate over 10-year settlement matters so much to Indian families.

Budget for the surcharge first, not last. It is the cost most likely to surprise a family planning a UK move.

This article is general information, not legal advice. Rates change; check GOV.UK before you apply. Last checked 27 Oct 2026. Next review: April 2027 fee changes.