NHS Surcharge Calculator

What is the Immigration Health Surcharge?

The Immigration Health Surcharge (IHS), commonly called the NHS surcharge, is a fee that most non-UK nationals must pay when applying for a UK visa lasting longer than six months. It is paid upfront at the time of your visa application and gives you access to National Health Service treatment during your stay in the UK on the same basis as a UK resident.

The surcharge applies to the main applicant and every dependant named on the application. A partner and children each pay separately at their applicable rate. For families applying for a five-year visa, the combined NHS surcharge bill can run into several thousand pounds before the visa fee and other immigration costs are even added. Use the ILR costs guide to see how the surcharge fits into your total immigration budget over time.

Current NHS surcharge rates

As of April 2025, the rates are:

• £1,035 per year for most visa applicants (Skilled Worker, Spouse, Dependent Adult, etc.)
• £776 per year for students on a Student visa or Youth Mobility Scheme, and for children under 18

The full amount is calculated for the entire visa duration and paid in one lump sum upfront. There are no monthly instalments. If your visa is for two years and six months, you pay for two and a half years worth of surcharge at the time of application.

How the NHS surcharge is calculated

The surcharge is prorated to the exact length of your visa. Partial years are not rounded down: even a single additional month beyond a full year adds a prorated charge for that month. The calculation is based on the number of complete months in your visa duration, rounded up to the nearest month.

Each person on the application pays individually. If you are applying with two adult dependants and one child, you pay four separate surcharge amounts at the applicable rate for each person. The calculator above handles this automatically and shows a per-person and combined total.

The surcharge rate you pay is locked in at the time of application. If rates increase while your visa is still running, you do not pay the difference until your next visa renewal.

NHS surcharge exemptions

Not everyone has to pay the Immigration Health Surcharge. The following categories are exempt:

• British nationals and settled residents who already hold indefinite leave to remain or British citizenship do not pay the surcharge.
• EU Settlement Scheme applicants applying for pre-settled or settled status are exempt from the IHS.
• Refugees and humanitarian protection holders granted asylum or humanitarian protection by the UK government do not pay the surcharge.
• Skilled Worker visa holders sponsored by NHS trusts or registered social care employers are fully exempt from the surcharge, as are their dependants. This is the Health and Care Worker visa exemption. Other healthcare workers not sponsored by an NHS or social care body may still owe the standard surcharge.
• Applicants from certain countries with reciprocal healthcare agreements may be exempt. Check the Home Office guidance for the current list.

NHS surcharge and indefinite leave to remain

One of the most significant financial benefits of reaching indefinite leave to remain is that the NHS surcharge ends permanently. Once you are granted indefinite leave to remain, you are settled in the UK and gain full access to NHS services without paying any annual surcharge.

For a family of four on standard rates, this represents an annual saving of over £4,000 per year. Over the years that follow settlement, that saving accumulates substantially. The financial case for pursuing indefinite leave to remain is often strengthened significantly when the NHS surcharge savings are factored in.

The surcharge is tied to your immigration status: as long as you are on a time-limited visa, you pay it at each renewal. Once you hold indefinite leave to remain, that obligation stops entirely. This is true for everyone in your household who also holds indefinite leave to remain.

NHS surcharge refunds

The Immigration Health Surcharge is refundable in specific circumstances:

• Visa refused: If your visa application is refused by the Home Office, you receive a full refund of the NHS surcharge.
• Visa withdrawn: If you withdraw your application before a decision is made, a full refund is usually issued.
• Left the UK early: If you leave the UK permanently before your visa expires, you can apply for a partial refund covering the complete months remaining on your visa from your departure date.
• Visa curtailed: If the Home Office curtails your visa and you leave the UK, a partial refund may be available for the unused period.

Refunds are processed by UK Visas and Immigration and can take several weeks. You must apply through the official government refund portal and provide evidence of your departure. Partial refunds are calculated on a per-month basis for complete months only.