Quick answer
The Immigration Health Surcharge (IHS) is a fee paid upfront when you apply for a UK Student visa. It gives you access to the NHS for the full length of your visa, on the same terms as a UK resident. You pay it at the application stage, not at the point of treatment. Once paid, you don't need separate health insurance.
What is the Immigration Health Surcharge?
The IHS is a fee charged by the UK government to most people applying for a UK visa to live in the country for more than six months. You pay it as part of your visa application — before you arrive — and in return you get access to NHS services for the full duration of your visa, on the same terms as a UK resident.
Think of it as pre-paying for NHS access rather than buying private health insurance. Once you've paid, you won't be billed when you see your GP, go to A&E, or need an operation.
It does not cover prescriptions or most NHS dental treatment — more on both below.
Who has to pay it?
Anyone applying for a UK visa longer than six months that gives permission to live here. For students, that includes:
- Student visa (the main visa for international students)
- Graduate visa (post-study work, once you finish your degree)
- Skilled Worker visa (if you stay on after graduating)
Short-stay visas — a Standard Visitor visa or any visa of six months or less — do not attract the IHS.
A small number of nationalities are exempt due to bilateral healthcare agreements with the UK. You can check whether yours is on the list at GOV.UK.
How much does it cost?
The government sets the rate and updates it periodically. Your total depends on:
- Your visa type
- How many years the visa runs for
- How many dependants you are bringing
You pay the full amount upfront, not in monthly instalments.
Use the IHS calculator on GOV.UK before you start the main visa application. It shows current rates and gives you an exact total based on your circumstances.
Worked example: A three-year undergraduate Student visa for one person costs three times the annual IHS rate. A one-year taught Master's degree runs for 16 months on a Student visa (12 months of study plus a four-month grace period), so you would pay the annual rate plus a part-year amount for those extra months.
When and how do you pay?
You pay during the online visa application, at the point where the form prompts you. Payment is by debit or credit card. You receive an IHS reference number straight away, which you then enter on the main visa application form.
You cannot split the payment or pay in instalments.
What does it cover?
Once your visa is granted and you're in the UK, your IHS is active. You can:
- Register with a GP and get appointments free of charge
- Be referred to an NHS consultant or specialist
- Use A&E (accident and emergency) without charge
- Have hospital treatment or surgery on the NHS
What it does not cover
Prescriptions. In England, each item on a prescription costs around £9–10 (check the current charge on the NHS website, as it changes each April). Scotland, Wales, and Northern Ireland have free prescriptions. If you take regular medication, a Prescription Prepayment Certificate (PPC) caps your prescription spending at a flat annual fee and is worth looking at if you collect more than a couple of items per month.
NHS dental treatment. You will still pay NHS dental charges even with IHS. The NHS dental service page explains what each band of treatment costs. For help finding an NHS dentist that is taking new patients, see our NHS dental guide.
Overseas emergencies and travel. The IHS covers you in the UK only. It is not travel insurance. If you go home for the summer or travel during term breaks, arrange separate cover.
Cosmetic procedures. The NHS does not fund cosmetic treatment unless there is a clinical need, and the IHS does not change that.
Getting a refund
If your visa application is refused, you get a full IHS refund automatically — no separate application is needed.
If you leave the UK permanently before your visa expires, you can apply for a partial refund via the IHS refund page on GOV.UK. That page sets out the eligibility conditions and deadline for applying.
Going abroad for a holiday or heading home for the summer does not make you eligible for a partial refund. Your visa and IHS coverage remain active.
Your BRP or eVisa as proof
Your immigration status — shown on your BRP or your UKVI eVisa account — is what tells NHS providers you have paid the IHS. You do not normally need to produce an IHS receipt or reference number.
When registering with a GP, the surgery may ask to see your BRP or an eVisa share code to confirm your entitlement. They cannot charge you for NHS treatment if your visa covers it.
Frequently asked questions
Do I need private health insurance as well as the IHS?
No. The IHS replaces the need for private health insurance for most students. Some people take out small add-on policies for dental treatment or overseas travel, but you have full NHS access once your visa is granted.
Does my IHS carry over to a new visa?
No. Each new visa application requires its own IHS payment. There is no carry-over from a previous visa, even if months remain on it.
Can I claim back NHS treatment costs against my IHS?
No. The IHS funds the NHS collectively. You cannot draw from it individually or reclaim the cost of specific treatments. It gives you the right to use the NHS without being billed.
What if I am on a shorter course and finish early?
If you leave the UK permanently before your visa expires, a partial IHS refund may be available (see the refund section above). The GOV.UK page details what qualifies.
Does the IHS cover mental health services?
Yes. GP referrals to NHS mental health services, talking therapies, and crisis support are all covered. See our mental health guide for how to access these services as a student.
General information — not advice
This article provides general information about UK rules for international students. It is not financial, tax, legal, immigration or medical advice. Rules, fees and deadlines change — always confirm against the latest gov.uk guidance or speak to a qualified adviser before acting.
