How much is the IHS for a spouse visa?

The IHS is £1,035 per year per person. For an initial 33-month spouse visa, the total IHS is approximately £2,849 (33 months). For the 30-month extension, it is approximately £2,588. Each dependant pays the same amount.

Do children on a spouse visa pay the IHS?

Yes. Each dependant, including children, pays the IHS at the same rate as the main applicant. There is no discount for children. This makes the total cost significant for families.

Can I pay the IHS in instalments?

No. The IHS must be paid in full upfront as part of the visa application. You cannot spread the payment over time. However, some immigration aid organisations may be able to help with the cost in exceptional circumstances.

Immigration Health Surcharge for Spouse Visas: Full Guide

The IHS is a mandatory payment for all spouse visa applicants and their dependants. At £1,035 per year per person, it adds significantly to the total cost of the spouse visa route. You pay for the full duration of your visa at each stage. After receiving ILR, you can claim a refund for any unused period.

What Is the IHS?

The Immigration Health Surcharge is a fee paid by visa applicants to access NHS healthcare during their stay in the UK. It was introduced in 2015 and has increased significantly since then. The current rate is £1,035 per year.

Once paid, the IHS entitles you to use the NHS on the same basis as a permanent resident. You do not need private health insurance, although the IHS does not cover everything (prescriptions, dental, and optical care have separate charges in England). For the full breakdown of all immigration costs, see our visa fees guide.

IHS Costs at Each Stage

The spouse visa route involves paying the IHS at multiple stages:

Initial spouse visa (33 months): Approximately £2,849 per person (33 months at the yearly rate, pro-rated).
Spouse visa extension (30 months): Approximately £2,588 per person.
ILR application: No IHS payment required. ILR gives permanent NHS access.

For a full breakdown of all spouse visa costs, see our cost breakdown guide.

How to Pay

You pay the IHS online as part of your visa application process on GOV.UK. You receive an IHS reference number which you enter in your visa application. The visa application cannot proceed without the IHS payment.

Payment is by debit or credit card. Keep your confirmation email and IHS reference number safe. You will need the reference number if you later claim a refund. If you have any issues, see our Home Office contact guide.

Dependants

Each dependant on your visa application pays the IHS separately at the same rate. For a family applying together:

2 adults + 1 child (33 months): Approximately £8,547 in IHS alone.
2 adults + 2 children (33 months): Approximately £11,396.

These figures demonstrate why the IHS is one of the most significant costs of the family visa route. See our hidden costs guide.

Getting a Refund

You can claim an IHS refund in several situations:

After receiving ILR: Claim a pro-rated refund for unused months. See our IHS refund after ILR guide.
Visa refused: Automatic refund within 6 weeks.
Leaving the UK early: Refund for unused complete months.

For full refund details, see our IHS refund guide.

Exemptions

Most spouse visa applicants are not exempt from the IHS. However, the following groups do not pay:

Health and care workers and their dependants.
Domestic violence victims applying under the DVILR route. See whether to use a solicitor for complex cases.
Applicants from certain countries with reciprocal healthcare agreements (limited).

If you believe you are exempt, check the GOV.UK exemptions list.