The health criterion is one of the many public interest criteria (PIC) that must be satisfied for an Australian visa to be granted. The rationale is because Australia’s public healthcare system should not be unduly affected by travellers and migrants.

The health criterion applies to almost all visas, both temporary and permanent with very few exceptions. For many permanent visas, even non-migrating members of the family unit of a visa applicant must undertake visa medicals unless it is considered unreasonable to do so.

What medical examination a visa applicant must undertake may depend on their period of stay, their country of passport, where they have lived in the last five years, their age, and what they intend to do in Australia, among other things. The easiest way of determining whether and what medical exams are required is using the current legislative instrument which sets out the particular circumstances and tests and determines that only approved medical practitioners in Australia and overseas are allowed to assess these tests.

The health requirement for an Australian visa requires any person that must be assessed against this criterion to be free from tuberculosis and free from a disease or condition that:

• is, or may result in the applicant being, a threat to public health in Australia or a danger to the Australian community; and

• a person who has it would be likely to require health care or community services and that community service would result in a significant cost to the Australian community or prejudice the access of an Australian citizen or permanent resident to health care or community services.

It is the significant cost which those with chronic and permanent conditions have difficulty meeting, especially for provisional and permanent visas, and which have featured in many media articles over the years. This is because the threshold for meeting the health requirement was $40,000 and the period for assessment if a permanent condition is for the expected lifetime of the person if the course of the condition is reasonably predicable beyond a five-year period. For those applying for temporary visas, the cost is determined for the proposed stay in Australia.

When a visa applicant does not meet the health requirement, they are sent information on how the costs have been broken down and what services are required. Costs for medication, surgery, and ongoing treatment can quickly add up.

From 1 July 2019, the policy to determine the significant cost threshold was increased to $49,000. However, possibly more important than this is that the costs are only calculated up to a maximum of 10 years. This is significant as young visa applicants with permanent conditions requiring ongoing health care would generally not meet the health requirement because obviously, they have longer to live. And for permanent visas, there is a further problem because many are combined visa applications (applications with secondary visa applicants who are members of the primary visa applicant’s family unit) and the health criterion is a “if one fails, all fail” requirement, meaning if one member of the family unit fails a visa medical all visa applicants must have their visa refused.

Lastly, while this new policy applies to all health PICs, there are in fact two health PICs: PIC 4005 and PIC 4007. This change may see some applicants meet the much stricter PIC 4005, which does not have a provision to waive the significant cost and prejudice to access requirements if the costs and prejudice is unlikely, which is only available with PIC 4007.