A health waiver under PIC 4007 allows the Department to grant a visa despite a failed health assessment, provided the delegate is satisfied that granting it would not result in undue cost to the Australian community or undue prejudice to health and community service access. The applicant cannot request a waiver themselves – it is only considered after the Department invites a response to a ‘does not meet’ health assessment.
What a Health Waiver Can and Cannot Fix
Scenario | Waiver Available? |
Projected costs above the Significant Cost Threshold | Yes, if PIC 4007 applies |
Active tuberculosis | No – absolute bar |
Direct threat to public health or safety | No – absolute bar |
Visa subject to PIC 4005 (no waiver visas) | No – not available regardless of circumstances |
3 Steps to a Strong Health Waiver Submission
- Gather Detailed Medical Evidence: Specialist reports addressing the condition, prognosis, and likely future treatment needs.
- Document Financial Capacity: Bank statements, investment evidence, and private health insurance to demonstrate the ability to self-fund care.
- Address the Legal Test Directly: A written submission that responds to each element of “undue cost” or “undue prejudice”, supported by compassionate and personal circumstances.
Overview
Receiving a “does not meet” health assessment during a visa application is a confronting experience. For many applicants and their families, it feels like the end of the road. In a significant number of cases, however, it is not – provided the visa subclass allows a health waiver under Public Interest Criterion 4007, and provided the submission that follows is carefully prepared.
What Is a Health Waiver?
A health waiver is a formal discretionary mechanism that allows a delegate of the Department of Home Affairs to grant a visa even though the applicant has failed the standard health requirement. It is only available for visa subclasses governed by PIC 4007 – not PIC 4005.
Importantly, the applicant cannot simply request a waiver. The process is initiated by the Department, which will invite the applicant to provide submissions and evidence after a “does not meet” assessment is issued. Acting quickly and with well-prepared material at that stage is critical.
Which Visas Allow a Health Waiver?
PIC 4007 applies to a specific list of visa subclasses. Key examples include:
Partner Visas (Subclass 820/801 and 309/100)
Child Visas
Refugee and Humanitarian Visas
Subclass 482 Temporary Skill Shortage Visa
Subclass 186 Employer Nomination Scheme (Temporary Residence Transition stream only)
Skilled independent visas (Subclass 189, 190, 186 Direct Entry) are assessed under PIC 4005 and do not have access to a health waiver.
The Legal Test for a Health Waiver
The delegate must be satisfied that granting a waiver would not result in “undue” costs to Australia’s health care or community services, and would not “unduly” prejudice access by Australian citizens or permanent residents to those services.
The word “undue” is important – it introduces a proportionality assessment rather than an absolute test. The delegate must weigh the projected costs against the applicant’s specific circumstances and the factors supporting a grant.
What Cannot Be Waived
A health waiver cannot be exercised if the applicant’s condition:
Involves active tuberculosis.
Poses a direct threat to the health or safety of the Australian community.
These are absolute bars under PIC 4007(1)(a) and (b) and cannot be overcome by a waiver submission regardless of the circumstances.
What a Strong Waiver Submission Includes
A health waiver submission is a substantive legal and evidentiary document. The most successful submissions generally include:
Medical Evidence
Detailed reports from relevant medical specialists explaining the condition, prognosis, likely treatment requirements, and the nature of ongoing care needs. Vague or incomplete medical evidence significantly weakens the case.
Financial Evidence
Bank statements, investment statements, and other evidence of the applicant’s and sponsor’s financial capacity to cover likely medical and community service costs without drawing on public resources.
Private Health Insurance
A policy schedule and evidence of comprehensive private health coverage. While insurance does not override the MOC assessment, it is a strong indicator of reduced burden on the public system.
Sponsor Support Evidence
A statutory declaration from the sponsor (or a supporting assurer) committing to financial and personal support. For family visas, this is a particularly important component.
Compassionate and Personal Circumstances
Evidence of family connections in Australia, the dependency of Australian family members on the applicant, the best interests of any children affected, and the personal impact of refusal. These factors are weighed by the delegate alongside the cost considerations.
Legal Submissions
A written submission addressing each element of the PIC 4007 test, citing relevant case law and Departmental policy where applicable, and directly addressing the specific concerns raised in the MOC assessment.
Review Options if the Waiver Is Refused
If a health waiver is refused, the applicant generally has review rights at the Administrative Review Tribunal (ART). The ART can remit the case on the basis that the costs or impacts are not “undue” – effectively substituting its own decision. If the ART remits the matter, additional health examinations may be required before the visa is finalised.
If the ART affirms the refusal, Ministerial Intervention remains a theoretical avenue, though it is rarely successful in health waiver cases without extraordinary circumstances.
Frequently Asked Questions
How long do I have to respond to a health waiver invitation from the Department?
The Department typically specifies a response period in the invitation letter. These deadlines are strict and cannot easily be extended. Acting immediately upon receipt of a “does not meet” assessment notification is strongly advisable.
Can I submit new medical evidence after the initial waiver decision is made?
Not at the primary decision stage once a refusal has been issued. However, new and more recent medical evidence can be submitted as part of an ART review. In some cases, a change in the applicant’s medical condition since the original assessment may assist the review.
Does the Significant Cost Threshold change?
Yes. The Department reviews and adjusts the Significant Cost Threshold periodically. It was increased to AUD 86,000 in July 2024.
What if I disagree with the Medical Officer's cost projection?
The MOC’s costing methodology is not publicly disclosed in detail, which makes challenging the projection difficult. The most practical approach is to accept the assessed cost as a given and instead focus the waiver submission on demonstrating that the cost would not be “undue” given the specific circumstances.
Is a health waiver more likely to succeed for family visas than skilled visas?
Generally yes – family and humanitarian visas tend to have the most successfully exercised waivers, partly because the compassionate circumstances are more compelling and partly because the relationship to an Australian citizen or resident provides a strong basis for discretion. Between July 2023 and November 2023, 41% of visa refusal appeals were set aside by the tribunal.
My child has a condition that will need ongoing therapy. Can we still get a family visa?
Possibly, depending on the visa subclass and the projected costs. Under PIC 4007 visas such as the Partner Visa, a carefully prepared waiver submission with strong evidence of private therapy funding, specialist reports, and sponsor support has a realistic prospect of success. Each case is genuinely different and requires individual assessment.