Understanding the Health Criteria for Australian Visas: PIC 4005 & PIC 4007

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In a significant effort, Home Affairs Minister Clare O’Neil and Immigration Minister Andrew Giles have agreed on a review of the ‘significant cost threshold’. This threshold serves as the backbone of Australia’s migration health requirement, which most applicants for Australian visas are required to meet.

The threshold is currently used to refuse visa applications in cases where an applicant or their child possesses a health condition or disability that is anticipated to result in “a substantial cost to the Australian community” for treatment or support.

The review highlights the necessity to strike a balance between immigration policies and humanitarian considerations. This assessment aims to ensure the migration health requirement aligns with principles of fairness, inclusivity, and compassion. By reevaluating this regulation, the ministers are seeking ways to mitigate potential adverse effects on individuals and families facing health-related challenges. The outcomes of this review hold the potential to reshape immigration policies, ensuring they reflect the values of a society that prioritises the well-being and dignity of all individuals, irrespective of their health status.

The Visa Health Requirement

Most applicants for Australian visas must meet the health requirement. The criteria for health assessments are determined by a range of factors, including the intended duration and purpose of the stay, the country you apply from, any special circumstances that apply, as well as the specific visa subclass.

To satisfy the health requirement, visa applicants must satisfy the criteria outlined in Public Interest Criteria (PIC) 4005 or 4007.

The health requirement requires that the visa applicant must:

• undertake the specified medical assessment(s) upon request;
• be free from tuberculosis;
• be free from disease or condition that can lead to public health threat or danger to Australians; and
• be free from disease or condition that may require health care or community services during visa stay, which may result in a significant cost to the Australian community or prejudice the access of Australians to health care or community services.

Unlike PIC 4005, PIC 4007 allows visa applicants who may not meet the health requirement to seek a waiver at the discretion of the Minister. This flexibility allows for a nuanced consideration of individual circumstances. It is essential to note, however, that PIC 4007 is not available to certain visa subclasses.

When assessing compliance with the health requirements, a critical aspect involves the assessment by a Medical Officer of the Commonwealth (MOC). The MOC considers whether an applicant has a health condition that could pose a substantial cost to the Australian community, encompassing both health care and community services necessary to manage the condition.

For applicants with a permanent or ongoing with a reasonably predictable course, the MOC will estimate what the condition will cost the community over the applicant’s remaining life expectancy up to a maximum of 10 years. You cannot be granted a visa if you do not meet the health requirement because your condition is likely to be a significant cost unless a health waiver is available and exercised.

The ‘Significant Cost Threshold’

The presence of a disease or health condition does not always mean that the applicant will not meet the health requirement due to significant costs. The likely costs will depend on what kind of disease or condition the applicant has and how severe it is.

Since 1 September 2021, the policy threshold for the level of costs regarded as ‘significant’ is AUD$51,000.

Health Waiver PIC 4007

A health waiver is only available for visas to which PIC 4007 applies. Waivers are accessible for a specific set of visa types, extending to approximately half of all visa applicants.

It is important to note that no health waiver is available if the applicant fails to meet health on (active) tuberculosis, danger to the community, or other public health risk grounds.

For a successful outcome of a health waiver, the visa applicant must demonstrate that granting a visa is unlikely to result in:

• undue cost to the Australian community; or
• undue prejudice to the access to health care or community services of Australians.?

The Department considers an applicant as not meeting the Health Requirement if the potential health care and community service costs over the proposed period of stay are more than the Significant Cost Threshold, which is currently at AUD 51,000.

The following mitigating factors (where documentary evidence has been provided) may serve as the foundation for a successful health waiver:

• an Australian citizen sponsor has been diagnosed with a health condition and would be unable to access appropriate treatment if forced to relocate;
• there is no permanent migration pathway to the applicant’s home country available to the sponsor (for example, because same-sex migration to that country is not available);
• the sponsor would be seriously adversely affected financially, such that they would be unable to subsist (maintain or support themselves at a minimal level) in the applicant’s home country due to a lack of language skills, family support, and/or employment opportunities;
• the sponsor holds/held a Protection or Refugee/Humanitarian visa and a decision not to waive would separate them from their spouse/children as they are unable to return to the country from which they fled and there is no third country option;
• there is evidence of an adverse impact on Australian citizen or permanent resident minor children if a decision not to waive is made or not exercising the waiver would cause or lead to the continued long-term or permanent separation of Australian citizen or permanent resident minor children from their parents, where either the child or the child’s parent or parents are in Australia;
• the sponsor has significant family links to Australia, and has demonstrated caring or financial obligations towards them;
• Australia would miss out on a significant benefit that the applicant/sponsor could contribute to Australia’s business, economic, cultural, or other development or are providing a valuable community service;
• the sponsor/family is already settled in a remote, rural, or regional area, and it is assessed that a decision to waive would bring economic or social benefit to that area;
• the sponsor/applicant and/or other working family members in a non-skilled visa application have occupational skills in high demand;
• the applicant and/or other working family members have occupational skills that are found on the National Skills Commission’s latest Skills Priority List;
• if not on the MLTSSL or the National Skills Commission’s Skills Priority List, the applicant/sponsor has a unique skillset that is vital to their employer’s business, and/or there is evidence that the employer would suffer detriment if a health waiver was not exercised; or
• there are any other compelling or compassionate factors including the location and circumstances of the applicant and/or sponsor’s family members.

Final Thoughts

Understanding the intricacies of the health requirement is essential for a successful visa application. As outlined in this newsletter, the criteria for health assessments are multifaceted, considering various factors.

It is essential to be aware of the distinction between PIC 4005 and PIC 4007. While the former sets a strict health criterion, the latter allows for a discretionary health waiver in specific circumstances.

For a more in-depth discussion tailored to your circumstances, reach out to us for a peresonalised assessment of your available options.

Remember, Migration Affairs is here to support you. Contact our immigration experts for personalised advice on your circumstances and eligibility.

Your success in this journey is our success.

Changes to the migration program can occur without notice. The above information is not intended to be legal advice and is correct as of the date of writing this article.

Contact Migrations Affairs to speak with our immigration experts for tailored advice on the circumstances and eligibility.

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