Navigating Australia’s visa system can feel overwhelming—especially when medical conditions are involved. Many applicants are unaware that even manageable health issues may affect their visa outcome due to Australia’s strict health requirements.

At Kris Ahn Lawyers, we’re committed to providing clear, practical immigration guidance and tailored legal support. In this guide, we walk you through key concepts such as the Significant Cost Threshold (SCT), how health costs are assessed by visa type, and the distinctions between Public Interest Criteria (PIC) 4005 and 4007—to help you prepare confidently and make informed decisions about your future in Australia.

Introduction

In Australia, most visas require applicants to satisfy the ‘Migration Health Requirement’, also formally referred to as Public Interest Criteria (PIC) 4005 OR 4007 of Schedule 4 to the Migration Regulations 1994.

Do you have a Medical Condition? Navigating the Significant Cost Threshold in Australia’s Migration Health Requirement

The Migration Health Requirement seeks to address public health and safety concerns, ensure the availability of services to Australian citizens and permanent residents, and to contain public expenditure on health care and community services.

If you have a medical condition, navigating such requirements often requires more than completing a Health Declaration (for most temporary visas) or Immigration Medical Examinations (for provisional or permanent visa applicants).

This article introduces the concepts and considerations relevant to understanding the Migration Health Requirement.

What Is the Significant Cost Threshold (SCT)?

The Significant Cost Threshold (SCT) refers to the threshold utilised by a Medical Officer of the Commonwealth (MOC) to assess whether your medical condition will impose significant costs on Australia’s healthcare system. The current SCT is set at $86,000.

How the SCT Is Assessed Based on Visa Type

Regardless of your visa type, your estimated health costs are assessed in relation to the SCT. Identifying your visa type simply helps you understand how your estimated health costs are assessed.

Temporary Visas

For temporary visas, the estimated costs for their proposed stay in Australia are assessed based on the length of stay the visa processing officer intends to grant.

(health care cost x length of visa grant) = resulting amount/estimated health costs

If your estimated health costs are lower than the SCT ($86,000), you meet the health requirement – nothing to be done here.
If the amount is higher than SCT ($86,000), you do not meet the health requirement – identify the health requirement criterion that applies (PIC 4005 or PIC 4007) to your visa to see if you can get the requirement waived.

Note: assessments may differ based on the type and severity of your condition.

Provisional or Permanent Visas

For these visa types, the estimated health care costs will generally be evaluated over a 5-year period, or 3 years if you are 75 years of age or older.

However, if you have a permanent or ongoing medical condition with a reasonably predictable progression, the Medical Officer of the Commonwealth (MOC) will assess your costs based on your remaining life expectancy, up to a maximum of 10 years.

If the MOC determines that your estimated costs exceed the Significant Cost Threshold (SCT) of $86,000, you will be considered to have exceeded the SCT and will not meet the health requirement.

Identifying Your Health Requirement Criterion

It is also essential to determine which of the two, PIC 4005 or PIC 4007, applies to your specific visa. This is crucial as PIC 4007 provides for a health waiver, whereas PIC 4005 does not.

PIC 4007 – Health Waiver Available

Per PIC 4007, even if you are deemed to exceed the $86,000, you might nevertheless qualify for a health waiver (if conditions are so met) unless the granting of your visa is likely to prejudice access of Australian citizens or permanent residents to health care or community services in short supply OR result in significant costs to the Australian community.

Thus, PIC 4007 evidently offers more flexibility and can often result in a promising outcome if your case is well-established (e.g., if you have compassionate and compelling circumstances or the capacity to mitigate the costs).

Note: Each health waiver case is considered on its merits, with all relevant factors taken into account.

PIC 4005 – No Health Waiver Available

Despite its stringent and complex demands, seeking legal assistance at Kris Ahn Lawyers can help you explore the available options to consider other issues that may be relevant. For example, challenging the validity of a MOC opinion or providing additional medical evidence for the MOC to consider in response to Natural Justice (section 57) letter.

Note: These options are also available for PIC 4007 if necessary.

Regardless, our legal team is here to help you meet your health requirements to achieve a positive visa outcome.

How Kris Ahn Lawyers Can Help

At Kris Ahn Lawyers, we understand that health-related refusals can feel overwhelming. Whether you are applying for a temporary, provisional, or permanent visa, our team can assist you in:

Identifying whether your visa is subject to PIC 4005 or 4007
Preparing robust submissions to challenge MOC assessments
Supporting PIC 4007 health waiver applications
Creating personalised strategies to protect your future in Australia.

Our goal is to help you meet health requirements and achieve a positive visa outcome, no matter how complex your circumstances. If you’ve had any visa issues, don’t risk delay. Contact Kris Ahn Lawyers today to book a consultation and explore your legal options.

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Disclaimer: Not Legal Advice

The information provided in this blog post/article is for general informational purposes only. It does not constitute legal advice or create a representative-client relationship. While we strive to provide accurate and up-to-date information, the content may not reflect the most current legal developments or specific circumstances.

Do not rely solely on the information presented here – but please book in a consultation with us to see how you this information applies to you and may benefit you. Any reliance on the material in this post is at your own risk.

Australian immigration law is arguably one of the most complex laws in Australia. Seek professional legal advice tailored to your individual needs before making any decisions based on the content of this post.

Navigating Australia’s Visa Health Requirement: How the Significant Cost Threshold (SCT) Affects Your Visa?