IHS Surcharge and NHS: Healthcare Guide for International Students in the UK

International students coming to the UK on a Student visa must pay the Immigration Health Surcharge (IHS) as part of their application. This mandatory fee grants access to the National Health Service (NHS) on a similar basis to UK residents. For the 2026–27 academic year, the student IHS rate is £470 per year of visa validity, and the NHS prescription charge in England is £9.90 per item (check official sources for current figures). With more than 679,000 international students enrolled in UK higher education in 2025, it is crucial to understand how the surcharge is calculated, what services are covered, and where additional costs might still apply. This guide explains everything you need to budget and prepare for your healthcare in the UK.

What is the Immigration Health Surcharge?

The IHS is a fee collected by UK Visas and Immigration from most visa applicants, including those on the Student route. Paying it gives you access to the NHS without being charged for hospital treatment, GP consultations, or emergency care while your visa is valid. The surcharge must be paid online before you submit your visa application, and you must continue to pay it each time you extend or switch your visa inside the UK. Students who fail to pay or underpay will have their application refused or delayed.

The fee is not health insurance – it is a government levy that helps fund the NHS. It does not guarantee that every treatment will be free, and it does not cover some services, such as dentistry or optical care. Nevertheless, it removes the risk of large hospital bills that uninsured visitors might face. For 2026 entry, the student rate remains significantly lower than the standard rate charged to other visa holders.

How is the IHS calculated for students?

Visa length determines the total payment

The IHS is charged for each year of leave granted, rounded up to the nearest half-year. Even if your course lasts exactly 12 months, you will likely receive a visa that includes an extra wrap-up period, often 2 to 4 months after the course end date. As a result, you must calculate the surcharge based on the total visa length, not just the course duration.

Example calculation for a one-year master’s degree starting in September 2026:

1. The course end date might be September 2027, plus a 4-month wrap-up period, so the visa end date becomes January 2028.
2. The total length is 1 year and 4 months. Rounded up, that is 1.5 years.
3. The IHS owed is £470 × 1.5 = £705.

How to pay and plan

• You pay the full IHS amount as part of your online visa application.
• If your visa is refused after you have paid the IHS, the fee is usually refunded automatically.
• If you apply for a shorter visa than your course requires, you may underpay and later be asked to top up the difference.
• Dependants (partners and children) pay the same £470 per person per year. Always check the official GOV.UK pages for the most recent rates.

Understanding your total study costs, including healthcare fees, can be complex. Want a personalised shortlist based on your grades? An advisor can help you assess your options.

What does the NHS cover for IHS payers?

Once you have paid the IHS and your visa is granted, you can use the NHS from the day you arrive. You do not need to wait until your Biometric Residence Permit (BRP) or eVisa status is confirmed – show your visa vignette or share code if needed.

Services that are free at the point of use include:

• GP (family doctor) consultations and nurse appointments
• Hospital treatment, both inpatient and outpatient
• Accident & Emergency (A&E) services, including emergency ambulance transport
• Maternity care and midwifery services
• Mental health services, including counselling and psychiatric care through the NHS
• Sexual health clinics and contraception services
• Diagnosis and treatment of most infectious diseases

Prescription medicines dispensed by a hospital pharmacy during an inpatient stay are free. However, prescriptions you collect from a community pharmacy usually attract a charge in England. In Scotland, Wales, and Northern Ireland, NHS prescriptions are free for everyone.

Additional healthcare costs to budget for

Although the IHS grants broad access, some health-related expenses are not covered. International students should set aside a small healthcare budget for these items:

• NHS prescription charges (England only): £9.90 per item as of 2026. If you need several prescriptions each month, a Prescription Prepayment Certificate (PPC) can reduce costs – a 3-month PPC costs around £32 and a 12-month one around £114 (check official sources for current figures).
• Dental treatment: NHS dental charges in England are not covered by the IHS. An emergency appointment costs around £26.80, with banded treatment charges ranging up to roughly £306.80 for more complex work (figures subject to annual review).
• Optical care: Eye tests and glasses or contact lenses are not free unless you qualify for certain exemptions. The average private eye test fee is about £25.
• Travel vaccinations: Vaccines required for travel outside the UK are not provided on the NHS.
• Some specialist services: IVF treatment and a few elective procedures may have restrictions or require you to meet specific NHS eligibility criteria.

If you have been issued a European Health Insurance Card (EHIC) or the new UK Global Health Insurance Card (GHIC) by an EU country, this may cover some necessary treatment during a temporary stay, but it does not exempt you from paying the IHS. In practice, Student visa holders must still pay the IHS, and you can then use the NHS fully.

How to register with a GP and access NHS services

Registering with a GP surgery

Register with a local GP practice as soon as you arrive, ideally in the first week. It is free and simple:

1. Search for GP practices near your accommodation on the NHS website.
2. Visit the surgery with your passport and proof of address (a tenancy agreement or university letter). Some practices now accept online registration.
3. You will be asked to fill in a GMS1 registration form. You may also be invited for a new patient health check.
4. Once registered, you can book appointments – many surgeries now offer telephone and video consultations.

You can choose to see a male or female GP, and you can request an interpreter if needed. If you feel unwell outside surgery hours, call NHS 111, a free 24-hour helpline that can direct you to the right service.

Accessing specialist care

For specialist treatment, a GP will usually need to refer you. This is standard NHS practice and does not incur any fee. Waiting times can vary, so register promptly and attend appointments to stay on referral lists.

Using the NHS in an emergency

In life-threatening situations, dial 999 for an ambulance or go directly to your nearest Accident & Emergency department. Emergency treatment is free regardless of your IHS payment status. For urgent but non-life-threatening problems, call 111 or use the NHS 111 online service. They can book you an appointment at an out-of-hours GP or an urgent treatment centre.

If you need to visit A&E, take your Biometric Residence Permit or a digital immigration status share code, along with your GP registration details if you have them.

FAQ

Q1: Do I have to pay the IHS if I am only studying a short course of 6 months?

If you are applying for a Student visa for a course of 6 months or less, you still need to pay the IHS. The immigration rules charge it based on visa length, and the minimum half-year fee applies. If you are coming on a Standard Visitor visa for a short study period of up to 6 months, the IHS is not required, but you will not have access to free NHS hospital treatment and must arrange private medical insurance.

Q2: Can I get a refund on my IHS if I leave the UK early?

Partial refunds are available only in specific circumstances. If you leave the UK before your visa expires and have more than 6 months of unused leave, you may be entitled to a pro-rata refund for each full 6-month period remaining. Refunds are not automatic; you must contact UKVI. IHS refunds are not given if you simply finish your course early but remain in the UK.

Q3: Are all medical treatments free once I’ve paid the IHS?

No. Most NHS hospital treatment and GP care is free, but charges apply in England for prescription medicines, dental care, and optical services. You may also need to pay for some travel vaccinations and elective cosmetic procedures. Check the NHS website for the latest cost exemptions before assuming a service is free.

Q4: What happens if I need dental treatment?

You can register with any NHS dental practice, but spaces are limited in some areas. NHS dental charges are not covered by the IHS; you will pay a subsidised rate per course of treatment. Emergency dental care is available at around £26.80 in England (check official sources for current figures). Some students choose private dental insurance or pay out of pocket.

References

• UK Visas and Immigration, 2026, Immigration Health Surcharge: guidance for applicants
• National Health Service, 2026, NHS entitlements: migrant health guide
• Higher Education Statistics Agency, 2025, Where do HE students come from?
• UK Government, 2026, Student visa: overview
• NHS Business Services Authority, 2026, Help with health costs