What is a Health Waiver?

When Is a Health Waiver Needed?

A health waiver may become relevant when a Medical Officer of the Commonwealth (MOC) determines that an applicant does not meet the health requirement because their medical condition may:

• Result in significant healthcare or community service costs to Australia; or
• Prejudice the access of Australian citizens or permanent residents to healthcare or community services that are in short supply.

The current Significant Cost Threshold (SCT) is AUD $86,000. The threshold was last updated on 1 July 2024.

Importantly, having a medical condition does not automatically mean that an applicant will exceed the health threshold. The assessment depends on the condition, its severity, expected treatment and the applicable assessment period.

How Is the Health Requirement Assessed?

Health assessments are generally undertaken as part of the visa application process.

Where a medical assessment is required, the results may be considered by a Medical Officer of the Commonwealth.

The MOC may provide an opinion about whether the applicant:

• Meets the health requirement;
• May meet the health requirement after signing a health undertaking; or
• Does not meet the health requirement.

The MOC's assessment focuses on the applicant's medical circumstances. The MOC does not generally take personal financial circumstances, such as private health insurance or an applicant's ability to personally pay for treatment, into account when providing the medical assessment.

What Is the Significant Cost Threshold?

The Significant Cost Threshold is used when determining whether a medical condition is likely to result in a significant cost to the Australian community.

The current threshold is AUD $86,000.

For temporary visa applicants, the estimated costs are generally assessed over the relevant intended period of stay.

For provisional or permanent visa applicants, the assessment is generally based on five years, or three years where the applicant is aged 75 or older. For certain permanent or ongoing conditions with a reasonably predictable course, costs may be assessed over the applicant's remaining life expectancy, up to a maximum of 10 years.

What Is Prejudicing Access?

The health requirement also considers whether an applicant's condition is likely to place significant demand on healthcare or community services that are considered to be in short supply.

Home Affairs currently identifies organ transplants and dialysis as services in short supply for this purpose.

A health waiver may be relevant where the applicable visa subclass permits one and the decision maker is satisfied that granting the visa would be unlikely to:

• Result in significant cost to the Australian community; or
• Prejudice access by Australian citizens or permanent residents to healthcare or community services in short supply.

Is a Health Waiver Available for Every Visa?

No.

This is one of the most important points to understand.

Health waivers are only available for particular visa subclasses where the applicable migration legislation provides for a waiver.

The relevant Public Interest Criterion and visa subclass must therefore be checked before determining whether a health waiver is possible.

For example, Public Interest Criterion 4007 contains a health-related waiver mechanism in specified circumstances. The Migration Regulations provide the legal framework for this assessment.

The current legislative framework also specifies which temporary visa subclasses are subject to particular health requirements under PIC 4005 and PIC 4007. These specifications can change through legislative instruments.

How Does a Health Waiver Work?

A health waiver is not simply an application asking the Department to ignore a medical condition.

Generally, the process involves:

1. Health examination

The applicant completes the required medical examinations through the approved process.

2. Medical assessment

Where necessary, the case is referred to a Medical Officer of the Commonwealth.

3. Health requirement outcome

The MOC may determine that the applicant meets or does not meet the health requirement, or may recommend a health undertaking where appropriate.

4. Health waiver consideration

If the visa subclass allows a health waiver and the applicant does not meet the relevant health requirement, the visa processing officer may consider whether the waiver can be exercised.

Home Affairs states that where a health waiver is available, the visa processing officer will consider it and may contact the applicant if further information is required.

5. Decision on the visa

Even where a health waiver is available, the applicant must satisfy the other requirements for the visa.

A health waiver does not automatically result in a visa grant.

What Evidence May Be Relevant?

The appropriate evidence depends on the visa subclass and the particular health issue.

Depending on the circumstances, evidence may include:

• Medical reports
• Specialist reports
• Treatment history
• Prognosis information
• Evidence about expected treatment requirements
• Evidence concerning healthcare arrangements
• Information about community services
• Evidence concerning family circumstances
• Evidence relevant to the applicant's proposed stay in Australia
• Other documents requested by the Department

The objective is to provide clear, reliable and relevant information addressing the specific health and migration requirements.

Health Waiver and Health Undertaking — Are They the Same?

No.

A health waiver and a health undertaking are different.

A health waiver concerns whether certain health requirements may be waived where the relevant visa subclass permits it.

A health undertaking is an agreement with the Australian Government to manage certain significant health conditions through an Australian health provider. Home Affairs may request a health undertaking in circumstances including certain tuberculosis risks and other significant health conditions.

If a person is required to sign a health undertaking, they must comply with the applicable requirements. Home Affairs states that a person who is asked to sign one must do so for the visa to be granted.

Does Private Health Insurance Guarantee a Health Waiver?

No.

Having private health insurance does not automatically mean that an applicant will satisfy the health requirement or qualify for a waiver.

The Medical Officer's assessment focuses on the relevant medical criteria and the applicable migration legislation. Personal financial circumstances and the ability to pay for treatment are not simply substituted for the formal health assessment.

What About Children Born in Australia?

There are special rules for certain children who were born and ordinarily resident in Australia.

Home Affairs states that a child may receive special consideration where the child:

• Is under 18 at the time of visa decision;
• Was born in Australia; and
• Is ordinarily resident in Australia.

The visa processing officer considers this automatically where applicable. If the child does not satisfy the special consideration requirements, a health waiver may still be considered if one is available for the visa subclass.

Can a Health Waiver Guarantee a Visa?

No.

A health waiver does not remove all other visa requirements.

The applicant may still need to satisfy requirements relating to:

• Identity
• Character
• English
• Sponsorship or nomination
• Relationship
• Skills
• Genuine temporary stay
• Financial requirements
• Visa-specific criteria
• Other public interest criteria

The availability and exercise of a health waiver depends on the applicable legislation and the individual circumstances of the case.

How We Can Help With a Health Waiver

At The Visa and Education Services Pty Ltd, we can assess your circumstances and help determine whether a health waiver may be relevant to your Australian visa application.

Our assistance can include:

• Reviewing the visa subclass you are applying for
• Reviewing your health assessment outcome
• Identifying the relevant health requirement
• Checking whether a health waiver is available
• Reviewing medical and supporting evidence
• Identifying additional evidence that may strengthen your case
• Preparing relevant submissions and supporting documentation
• Assisting with the visa application process

Get Professional Advice About Your Health Waiver

Health waiver matters can be complex because the outcome depends on both the applicant's medical circumstances and the specific legal requirements applying to the visa.

If you have been advised that you may not meet Australia's health requirement, do not assume that your visa application must automatically be refused. First determine whether a health waiver or another applicable provision may be available.

Registered Migration Agent: Navneet Kaur (MARN 2318181)

Contact The Visa and Education Services Pty Ltd for professional advice about your Australian visa options.

Disclaimer: This information is general in nature and is not a substitute for personalised migration or legal advice. Health waiver availability and Australian migration requirements can change. Your eligibility must be assessed against the legislation and policy applicable to your visa application at the relevant time.