For any professional relocating to the United Kingdom, the Immigration Health Surcharge (IHS) represents a significant component of the initial visa cost. Introduced to ensure that international residents contribute to the National Health Service (NHS), the IHS is a mandatory fee paid at the point of the visa application. At Recruitroo, we ensure that both employers and candidates have full transparency regarding these costs to avoid any last-minute financial hurdles during the relocation process.
What is the IHS and Why is it Mandatory?
The IHS is not an insurance policy; rather, it is a contribution that grants you the same access to the NHS as a permanent UK resident. In 2026, the surcharge remains a prerequisite for almost all visa categories lasting longer than six months. Once paid, you are entitled to use the NHS for primary care (GPs), emergency services, and hospital treatments without additional charges, though some costs—such as prescriptions and dental care—still apply in most of the UK.
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Upfront Payment: The IHS must be paid for the entire duration of your visa upfront. For a five-year Skilled Worker Visa, this represents a considerable initial investment.
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Family Coverage: Every dependent joining you must also pay the surcharge at the same rate, ensuring the whole family has access to healthcare from day one.
Calculating Your Costs and Exemptions
As of 2026, the standard IHS rate is approximately £1,035 per year for adults. However, there are specific categories where these costs are waived or reduced:
- Health and Care Worker Visa: Professionals working in eligible health or social care roles are exempt from the IHS, as are their families. This is a significant incentive for the sector.
- Student Rates: Those on Student or Graduate visas typically pay a reduced rate compared to Skilled Workers.
- Refunds: If your visa is refused or if you pay twice in error, the Home Office has a structured (though often slow) refund process.
Accessing Care: Your NHS Number
Paying the surcharge is the first step, but accessing care requires local registration. Once you arrive in the UK and have your BRP or digital status, your next priority should be registering with a local General Practitioner (GP). Your GP surgery will issue you an NHS Number, which acts as your unique identifier within the healthcare system. This number is essential for booking appointments, receiving vaccinations, and managing referrals to specialist hospital services.
Expert Advice: "Always keep a digital copy of your IHS payment confirmation. While your status is linked to your passport, having the payment reference handy can solve administrative delays when registering with a GP for the first time." — Sarah O'Brien, Talent Acquisition Lead.
How Recruitroo Simplifies the Financial Burden
For many employers, covering the IHS cost for their international hires is a key part of their relocation package. Recruitroo’s platform allows for seamless expense tracking and payment management, ensuring that these fees are handled efficiently. We also provide candidates with detailed "Healthcare Onboarding" guides, explaining how to find the best GP in their new postcode and how the UK pharmacy system works.
Scaling your UK team? Book a demo with our team to see how we manage visa costs. Candidates can explore roles with IHS support at Recruitroo.com/candidates.