Health Waivers and Australian Visa Applications
A health waiver is a legal mechanism that allows the Department of Home Affairs to grant a visa even if the applicant fails the health requirement, provided specific conditions are met. The health requirement is part of the Public Interest Criteria (PIC), found in Schedule 4 of the Migration Regulations 1994.
Employer-sponsored visas (e.g., 482 SID, 186 ENS (TRT), 494 SESR)
Partner visas (e.g., 820/801, 309/100 and 300 Fiancee visa)
Humanitarian and protection visas
Certain student visas (e.g., Subclass 500 for Foreign Affairs or Defence Sector)
The waiver is not available under PIC 4005, nor in cases where the health condition presents a public health risk, such as active tuberculosis.
How Does Failing the Health Requirement Work?
After undergoing a Migration Health Examination, the Department receives a report from a Medical Officer of the Commonwealth (MOC). A visa applicant may be assessed as “Does Not Meet” if:
The condition is likely to result in significant health care or community service costs, or
The condition may prejudice access to health care or community services needed by Australian citizens or permanent residents (e.g., dialysis or organ transplants).
At this point, you will be issued with FORM 884: Does not meet the health test and s57 Natural Justice letter relevant to provide further evidence relevant to PIC4007 (2) health waiver and offered an opportunity to provide evidence of any compelling and compassionate circumstances.
When Can the Department Exercise a Health Waiver?
To grant a waiver under PIC 4007(2), the delegate must be satisfied that:
- All other visa criteria are met
- Granting the visa is unlikely to result in undue cost or prejudice to access for the Australian community
- Any impact is mitigated, through private insurance, personal finances, support networks, or limited usage of services
- Compassionate and compelling circumstances support the waiver (e.g., Australian citizen family members, established life in Australia)
Compassionate and Compelling Circumstances
There are a range of factors considered when assessing compassionate and compelling circumstances under migration law.
These circumstances are evaluated on a case-by-case basis, taking into account the individual’s situation and supporting evidence.
Examples of compassionate and compelling circumstances
that may be taken into account include (but are not limited to):
- The Australian citizen or permanent resident sponsor has been diagnosed with a serious health condition and would be unable to access suitable treatment if required to relocate overseas.
- There is no viable permanent migration pathway for the couple in the applicant’s home country (or any other country where they have the legal right to reside) — for example, same-sex migration is not legally recognised in that country.
- The sponsor would face severe financial hardship if required to live in the applicant’s home country, being unable to maintain a basic standard of living due to barriers such as lack of language proficiency, family support, or employment opportunities.
- The sponsor currently holds or previously held a Protection, Refugee or Humanitarian visa, and refusing a waiver would result in family separation, as the sponsor cannot safely return to their home country and no third-country option is available.
- Adverse impact on Australian citizen minor children, such as where the sponsor has provided evidence that they are legally prevented by the other parent from removing the children from Australia if a waiver is not granted.
- The sponsor has strong family ties in Australia and has demonstrated ongoing caring or financial responsibilities toward family members who rely on their support.
- Australia would lose a significant benefit that the applicant or sponsor contributes to the business, economic, cultural, or community development of the country — for example, through highly specialised skills, business expertise, or valuable community service (including employment or volunteering).
- The sponsor and their family are well-established in a remote, rural, or regional area, contributing to local community and workforce stability.
- The sponsor, applicant, or other working family members possess skills listed on the Medium and Long-term Strategic Skills List (MLTSSL) and are employed in occupations that are in high demand in Australia.
- The applicant or sponsor possesses a unique or specialised skillset that is essential to their employer’s business operations, and/or there is evidence that the employer would experience significant detriment if a health waiver were not exercised.
- There are other compelling or compassionate circumstances, such as the location, dependency, or wellbeing of the applicant’s or sponsor’s family members.
- For Skilled visa applications, the applicant and/or other working family members demonstrate valuable occupational skills that make a meaningful contribution to the Australian workforce or community.
How the Significant Cost Threshold (SCT) Is Applied in Health Assessments
Having a medical condition does not automatically mean that you will exceed the Significant Cost Threshold (SCT). The assessment depends on factors such as the type and severity of your condition, the anticipated need for health or community services, and your intended period of stay in Australia.
The Medical Officer of the Commonwealth (MOC) determines the estimated costs of your condition differently depending on the type of visa you are applying for:
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Temporary visa applicants:
The MOC will assess your estimated health and/or community service costs for the duration of your intended stay in Australia. -
Provisional or permanent visa applicants:
The MOC generally assesses your estimated health care costs over a five-year period, or three years if you are aged 75 years or older.
However, if you have a permanent or ongoing condition with a reasonably predictable course, the assessment may extend over your remaining life expectancy, up to a maximum of ten years.
What Is the Significant Cost Threshold (SCT)?
The Significant Cost Threshold is the benchmark used to determine whether a condition imposes a high cost burden. As of 1 July 2024, the SCT is AUD $86,000.
This means if the projected lifetime cost of treatment and community service support for a temporary or permanent visa applicant exceeds this amount, the MOC will assess them as not meeting the health requirement.
Examples of conditions often triggering SCT assessments:
- Cancer (with ongoing treatment)
- HIV/AIDS
- Intellectual disability
- Autism Spectrum Disorder
- Chronic renal disease (e.g., requiring dialysis)
- Complex mental health conditions
- Hemophilia or other high-cost chronic conditions
Significant Cost Threshold Value – Breakdown of Health and Welfare Cost Items
The SCT value captures a comprehensive range of health and welfare services used to estimate potential expenditure impacts under the Health waiver assessment.
Health Spending on Goods and Services Includes:
Hospitals
Medical and surgical care provided in public and private hospital settings, including emergency and inpatient services.
Primary Health Care
Health care delivered in the community, such as services provided by General Practitioners (GPs), nurses, and allied health professionals.
Unreferred / Referred Medical Services
Specialist consultations, diagnostic imaging, pathology, and laboratory testing.
Pharmaceuticals
Prescription medications and treatments subsidised under the Pharmaceutical Benefits Scheme (PBS).
Aged Care
Residential aged care, home care, and community-based aged care programs that support elderly Australians.
Research and Public Health
Public health campaigns, preventive medicine initiatives, and medical research aimed at improving health outcomes across Australia.
Welfare Spending on Payments and Services Includes:
Disability Services
Funded programs under the National Disability Insurance Scheme (NDIS), including employment, youth, and community participation support.
Specialised Education Support
Early intervention and inclusive education services for children with disabilities or developmental challenges.
Cash Welfare Payments
Direct support such as Carer Payment, Disability Support Pension, and Child Disability Assistance Payment.
Why These Costs Matter for Health Waiver Applications
When applying for a visa with a PIC 4007 health waiver, the Department evaluates whether an applicant’s condition is likely to result in health and welfare costs exceeding the SCT threshold.
What Is “Prejudice to Access”?
This refers to situations where the applicant’s condition would impact access to limited health resources in Australia. The most common examples include:
- Organ or bone marrow transplants
- Dialysis services
- High-dependency services (e.g., ICU beds, specific paediatric or geriatric care)
Key Considerations in Health Waiver Applications
Cost Assessment: The MOC estimates treatment and service costs over the visa duration (or lifetime for permanent visas).
Undue Burden: The delegate assesses whether these costs are “undue,” taking into account the applicant’s ability to offset or reduce those costs.
Mitigating Factors: Applicants may rely on private health insurance, family support, or personal funds to show the costs are manageable.
Timing: A health waiver is considered only after all other visa criteria are met.
Multiple Applicants: If more than one applicant fails the health requirement, all waiver assessments must be done jointly.
Our Health Waiver Legal Services
We recently assisted a client applying for a Subclass 482 (Skills in Demand Visa) visa whose child was diagnosed with autism. The Medical Officer of the Commonwealth (MOC) assessed the potential health-related costs at $125,000 over four years. Our team prepared a detailed submission addressing the MOC’s concerns, highlighting mitigating factors and providing strong supporting evidence. As a result, the health issue was successfully resolved and the visa was granted.
At Tolic Lawyers, we provide a comprehensive and strategic service to give your application the best possible chance of success, including:
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Reviewing MOC assessments and health reports
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Preparing persuasive health waiver submissions
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Gathering medical, financial, and expert evidence
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Drafting compelling compassionate and personal arguments
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Liaising with medical professionals and Department case officers
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Advising on appeal and review options if a waiver is refused
