IHS Health Surcharge: NHS Access and Student Visa Costs

The Immigration Health Surcharge (IHS) is a mandatory fee that gives you access to NHS (National Health Service) care during your stay in the UK. You must pay the IHS as part of your Student Route visa application; without payment, your application cannot proceed. The fee is non-refundable except in limited circumstances (visa refusal, early departure for specific reasons).

IHS Rates for Students

The IHS for international students is fixed annually by the UK government. For the 2025–2026 academic year:

Total cost calculation: Multiply the annual rate by your course duration (in years, rounded up for partial years).

Examples:

• 1-year MSc: £1,035
• 3-year PhD: £3,105
• 18-month postgraduate diploma: £1,035 + (£1,035 ÷ 2) = £1,553 (rounded up)
• Student with spouse and 2 children, 1-year course: £1,035 + (£719 × 3) = £3,192

What the IHS Covers

With the IHS paid, you have full access to NHS services:

• Primary care: GP consultations, prescriptions, vaccines
• Hospital care: A&E (emergency), inpatient and outpatient treatment
• Preventive care: Sexual health, antenatal care, contraception
• Mental health services: Counselling, therapy, psychiatric care
• Dental treatment: Emergency NHS dental care (routine care has limited availability)
• Vision care: Limited NHS eye testing

You do not pay additional charges for these services once you have paid the IHS. Your NHS care is free at the point of use—the IHS is a prepayment that covers your entire stay.

What the IHS Does Not Cover

• Private treatment: Private hospitals, private clinics
• Cosmetic surgery: Unless medically necessary (e.g., post-injury reconstruction)
• Some specialist treatments: Fertility treatment (some elements), certain medications for rare conditions
• Repatriation: If you need to be medically evacuated, travel home
• Travel insurance: Medical costs outside the UK

You may wish to purchase private health insurance for these gaps, particularly if you plan to use private healthcare or need repatriation insurance. Cost: £200–500/year.

Dependants and Family Members

If you bring your spouse and/or children to the UK, each dependent must also pay the IHS. Your spouse or partner pays £719/year; each child under 18 pays £719/year. Dependants cannot be added to your visa application without paying the surcharge.

Important: The IHS rate for dependants is not reduced for short-course students—all dependants pay £719 annually regardless of course length.

When to Pay the IHS

You must pay the IHS before or at the time of submitting your Student Route visa application. Payment is made online via the UK Immigration Online portal. You will receive a receipt with a unique IHS reference number (called a “check reference”) to include in your visa application form.

Payment deadline: If you pay the IHS and then do not submit your visa application within 90 days, the payment expires, and you must pay again.

Payment Methods

IHS can be paid via:

• Debit card (Visa, Mastercard)
• Credit card (Visa, Mastercard)
• PayPal
• Some countries accept local payment methods (check gov.uk for your country)

Payments are made to the UK government, not to any medical provider. Keep your payment receipt and IHS reference number.

Currency and International Payments

IHS is charged in GBP only. If you are paying from overseas, your bank will convert your local currency to GBP at their exchange rate (typically 1.5–3% higher than the mid-market rate). Budget for this conversion cost.

Example: A student from India paying £1,035 at a rate of 1 GBP = 107 INR will pay approximately 111,000 INR including bank charges.

IHS and Your BRP or eVisa

Once paid, your IHS check reference is added to your visa grant notification. When you receive your Biometric Residence Permit (BRP) or eVisa, it will include a reference to your IHS payment. This is your proof of payment for NHS access.

Keep your IHS receipt and visa documentation safe—you may need them to register with a GP or access NHS services.

Refunds: When You Can Get Your Money Back

The IHS is non-refundable in most cases, but you can claim a refund if:

1. Your visa is refused: You can claim back the IHS within 90 days of refusal. Submit a refund form via gov.uk with your visa refusal letter.

2. You extend your visa: If you extend your Student Route visa, you pay an additional IHS fee for the extension period; the original fee is not refunded.

3. You switch visa categories: If you switch from Student Route to Graduate Route, the IHS covers both and is not refunded.

4. You are sponsored by the UK government: Some government-sponsored students (e.g., Chevening scholars, GREAT scholarship holders) are exempt from the IHS. Check your sponsor’s eligibility criteria.

5. Early departure due to visa breach: If UKVI cancels your visa due to a breach, you cannot claim the IHS back.

You cannot claim a refund if you choose to leave the UK early, if your course is shortened, or if you pause your studies.

IHS and Change of Circumstances

If you extend your course after your initial visa grant, you will need to pay an additional IHS fee when applying for a visa extension. The original IHS does not extend automatically—it covers only your initial visa period.

If you defer (postpone) your course start date before arriving in the UK, you may need to apply for a new IHS payment and new visa if the deferment is more than a few months.

IHS Payment Issues

If your IHS payment fails:

1. Check your payment details and retry via the UK Immigration Online portal
2. Contact your bank if there is a payment block (some banks flag international government payments)
3. Try a different payment method
4. If the portal error persists, contact UKVI support

Do not submit your visa application without IHS payment confirmation. Your application will be rejected.

After You Arrive in the UK

When you arrive in the UK, you will need to:

1. Register with a GP: Contact a local GP surgery and register. You can find GPs at NHS.uk. Bring your passport, visa, and proof of address (accommodation letter).

2. Register with NHS dentistry (optional): Dental care has limited availability on the NHS; many surgeries are not accepting new patients.

3. Register for NHS prescriptions: Once registered with a GP, prescriptions cost £9.65 each (2025 rate), or you can purchase an annual prepayment certificate for unlimited prescriptions (approximately £136).

This article is for general information only and is not immigration advice. Consult a regulated OISC/IAA adviser for your case.

Sources

• gov.uk: Immigration Health Surcharge
• UKVI Immigration Rules, Appendix IHS
• NHS: Healthcare for Visa Holders
• UKCISA: Health Services for International Students

Last updated: 2025-04.