Paying the Immigration Health Surcharge (IHS) places a significant financial burden on many migrants. The upfront cost is often high, especially for individuals applying for long-term visas or with dependents, making it difficult for low- and middle-income earners. Despite already contributing through taxes and National Insurance, migrants must still pay this additional fee to access the NHS. This can create feelings of unfairness and financial strain. For families, the total cost can be overwhelming, sometimes affecting decisions about staying in the UK. Overall, the IHS adds pressure during an already expensive immigration process.