Subclass 186 Visa Health Waiver: What If Your Medical Costs Are Too High?

Health assessment and waiver are separate legal questions

Australia’s migration health requirement does not simply ask whether an applicant can pay privately for treatment. The relevant Public Interest Criterion may involve a Medical Officer of the Commonwealth assessing projected health care or community service costs and access implications. If the applicable criterion includes a waiver mechanism, separate discretionary considerations may arise. Confirm the stream and legal requirements before assuming a waiver is available.

PIC 4005 versus PIC 4007

PIC 4005 and PIC 4007 operate differently. PIC 4007 includes a waiver mechanism in qualifying circumstances, while PIC 4005 does not offer the same pathway. Do not assume all permanent employer-sponsored visas have identical health criteria. Identify the exact criterion for the applicant and any relevant family members, the version of the regulations applying, and the terms of any waiver before making representations.

How projected medical costs are calculated

A medical opinion may assess anticipated treatment and services over the prescribed assessment period. It may not reflect only services the applicant currently uses or intends to access. Expensive biologic medications, specialist reviews or ongoing community services can raise significant issues. Obtain the adverse medical information and identify whether the assessment relies on outdated treatment assumptions or a prognosis that can be clarified by current specialist evidence.

Will private health insurance fix the problem?

Insurance, savings and employer support can be relevant to the broader circumstances, but they do not automatically change the Medical Officer’s assessment. The legal threshold and any waiver discretion are separate questions. An unsupported promise never to use public services should not be presented as a complete answer. Explain what support is credible, documented and relevant to the applicable waiver factors.

Evidence for a compelling waiver submission

Potential evidence includes updated treating specialist reports, prognosis, treatment history, employment and tax records, family circumstances, community contributions, employer support and financial documents. The submission should distinguish medical evidence challenging factual assumptions from compassionate and other circumstances supporting a waiver. Each factual assertion should refer to a specific annexure. Avoid generic claims about hardship that are not linked to the applicable legal test.

Example: costly long-term medication

A sponsored employee uses a biologic medication for a chronic condition. The first question is which health criterion applies to their subclass 186 stream. The second is whether the medical cost estimate accurately reflects current treatment. If a waiver is available, the submission can then address relevant family, employment and compassionate circumstances. An employer’s desire to retain the employee is relevant evidence in context, not a guarantee of approval.

Health requirements for family members

Health requirements can affect included family members and, in some circumstances, relevant non-migrating family members. A healthy primary applicant should not assume their application is unaffected by another person’s condition. Check precisely whose health must be assessed and how the criteria apply. Family evidence should be obtained early to avoid an incomplete or inconsistent response.

What to do after an adverse health assessment

Record the response deadline, obtain the medical information available, verify the criterion, and seek specialist evidence where it addresses a real factual issue. Prepare a structured legal submission and consider the implications of any adverse decision for review rights. Emigrate Lawyers assists with complex employer-sponsored visa matters. See our Subclass 186 Visa Lawyers guide.

Frequently asked questions