The Immigration Health Surcharge, commonly known as the IHS, is a fee most visa applicants from outside the UK must pay when applying for a visa lasting longer than six months. Once paid, it grants access to NHS services on broadly the same terms as a UK resident. This system has been in place since 2015 and was expanded in subsequent years to cover more visa categories. The IHS is paid upfront for the duration of the visa, meaning there is no ongoing monthly premium to manage while you are in the country.

Who is eligible for free NHS services under the IHS

Most people applying for a long-term UK visa — including skilled worker visas, student visas, family visas, and graduate visas — are required to pay the IHS. Once the surcharge is paid and the visa is granted, the holder and any dependants included in the application are entitled to use NHS services. Certain groups are exempt from paying the IHS, including those on Youth Mobility Scheme visas in some cases, diplomats, and certain categories of overseas visitors. Asylum seekers and refugees also have access to NHS care through a separate route. Visitors on short-term visas, such as a standard visitor visa, are generally not covered by the IHS and are expected to have travel or health insurance for their stay.

What services are covered

IHS payers can access the full range of NHS services available to UK residents. This includes GP consultations, hospital treatment, maternity care, mental health services, and emergency care. Dental treatment through the NHS, eye tests, and prescriptions are available but may carry standard NHS charges, just as they do for UK citizens. Elective and specialist treatments are also accessible when referred through the appropriate NHS pathway. It is worth noting that some services, such as cosmetic procedures not deemed medically necessary, are not covered regardless of your IHS status. The scope of coverage is broad and is one of the key reasons the IHS is considered good value compared to private health insurance for longer stays.

How to access NHS services as a visa holder

The first step for any visa holder arriving in the UK is to register with a local GP practice. You do not need proof of IHS payment to register — your visa and proof of address are typically sufficient. Once registered, your GP becomes your gateway to the wider NHS, referring you to specialists, hospitals, and other services as needed. In urgent situations, NHS 111 is available by phone or online and can direct you to the appropriate care. For genuine emergencies, Accident and Emergency departments are open to everyone regardless of immigration or IHS status. It is advisable to carry your Biometric Residence Permit or visa documentation when attending NHS appointments.

Common concerns and clarifications

A frequent question among visa holders is whether the IHS payment guarantees uninterrupted access throughout the visa period. In most cases, yes — as long as the visa remains valid and the IHS was paid in full at the time of application, access continues. However, if a visa is curtailed or cancelled, NHS entitlement may change. Another common concern relates to the cost of the IHS itself, which has increased in recent years and currently stands at a set annual rate per person. Students and those on the Youth Mobility Scheme may pay a reduced rate. The surcharge is paid per applicant and per dependant, so families should factor this into their overall visa budgeting. Pre-existing conditions are covered under NHS treatment without exclusion, which is a notable advantage over many private insurance plans.

Tips for managing healthcare in the UK

Register with a GP as soon as possible after arriving, even if you are not immediately unwell, as some practices have waiting lists. Keep a record of any medications you take and ask your GP about obtaining NHS prescriptions, which may be significantly cheaper than purchasing medication privately. If you are a student, your university may have a health centre that can support registration and minor health needs. Dental registration can be more challenging, as NHS dental practices are not always accepting new patients, so it is worth researching practices in your local area early. For mental health support, the NHS offers services through your GP as well as self-referral options in many areas of England, such as IAPT talking therapy services.

Understanding the IHS and how it integrates with NHS access gives visa holders in the UK a clearer picture of what to expect from the healthcare system. While the upfront cost of the surcharge can be significant, the breadth of services it unlocks — from routine GP care to hospital treatment — provides a strong foundation for healthcare during your time in the country.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.