Current IHS rates
Standard applicants: **£1,035 per year** for adults (18+), **£776 per year** for children under 18. Student visa applicants: £776/year. Youth Mobility: £776/year. Graduate visa: £1,035/year.
You pay the full surcharge upfront at visa application. For a 5-year Skilled Worker visa, that's £5,175 per adult — plus equivalent amounts per dependant.
Who's exempt
The major IHS exemption is the **Health and Care Worker visa** — applicants and all their dependants pay zero IHS. For a 5-year family-of-four application this saves around £20,000 versus the general Skilled Worker route, which is why NHS and care-sector recruiters emphasise this advantage.
Other exempt categories: UK-funded international aid workers, UK-domiciled researchers on specific fellowships, diplomatic staff.
How the amount is calculated
IHS is charged for the entire visa duration rounded up. A visa granted for 3 years 6 months = 4 years of IHS. If your visa is refused or you withdraw the application, IHS is fully refunded within 30 days.
If you leave the UK partway through the visa (e.g. you resign a sponsored job and leave), you don't get a refund — the surcharge is committed upfront for the full visa term.
Cost-of-living impact
For a 5-year Skilled Worker visa, a family of four pays: £5,175 × 2 adults + £3,880 × 2 children = £18,110 in IHS alone, on top of visa fees. Many applicants budget for IHS separately — it's paid to the NHS, not lost to third parties.
The Health and Care Worker route dramatically changes this math. Same family of four pays £0 IHS. Combined with the lower salary threshold (£25,000 vs £41,700), the Health and Care Worker visa is often the most cost-efficient way for international clinicians to relocate with family.