Understanding the Significant Cost Threshold for Visa Health Requirements
When applying for a visa to Australia, meeting the health requirement is a crucial step in the process. One of the key factors that the Medical Officer of the Commonwealth (MOC) considers is whether an applicant has a condition that may impose a significant cost on the Australian community. This is known as the Significant Cost Threshold (SCT).
What is the Significant Cost Threshold?
The SCT is a policy designed to contain public expenditure on healthcare and community services. According to the Migration Regulations, a significant cost is interpreted as a cost that exceeds the average health and community services cost for an Australian.
How is the ‘Average Cost’ for an Australian Calculated?
The 'average cost for an Australian' is determined by analysing the average spending on health and welfare services that an Australian would require over a five-year period. This calculation is based on data from two Australian Institute of Health and Welfare (AIHW) reports—Health Expenditure and Welfare Expenditure. The SCT value is then reviewed biennially to ensure it reflects current costs.
The SCT calculation includes a variety of cost items, such as:
Health Spending on Goods and Services:
Hospital care, including in-patient treatments and surgeries.
Primary health care delivered in the community, including General Practitioner services.
Medical specialist services, including pathology and laboratory testing.
Pharmaceuticals under the Pharmaceutical Benefits Scheme.
Public health research and communication programmes.
Welfare Spending on Payments and Services:
Aged care services, including residential, home, and community care.
Disability services, including those funded by the National Disability Insurance Scheme (NDIS).
Specialised education support for children with disabilities.
Cash welfare payments, including Carer Payments and Disability Support Pension.
As of 1 July 2024, the SCT has been increased from $51,000 to $86,000.
How is the SCT Applied to Visa Health Requirements?
Having a medical condition does not automatically mean that you will exceed the SCT. The MOC assesses the estimated costs of your condition based on its severity and your intended period of stay in Australia.
Temporary Visa Applicants: The MOC will assess your estimated health and community service costs for your intended period of stay in Australia.
Provisional or Permanent Visa Applicants: The MOC generally assesses these costs over a five-year period. However, if you are 75 years or older, the assessment period is reduced to three years. For conditions that are permanent or ongoing, the MOC may assess costs over your remaining life expectancy, up to a maximum of 10 years.
If your estimated costs exceed the SCT value of $86,000, you may not meet the health requirement for your visa.
What Happens if You Don’t Meet the Health Requirement?
If the MOC determines that your condition is likely to exceed the SCT, your visa may not be granted. However, some visa subclasses offer the possibility of a health waiver. A health waiver allows the decision-maker to consider your personal circumstances and potentially waive the additional costs if it is determined that granting the visa would not result in significant costs to the Australian community or prejudice the access of Australian citizens or permanent residents to essential health care or community services.
The MOC also considers whether your condition might prevent Australians from accessing health care or community services that are in short supply, such as organ transplants and dialysis. If your condition is likely to prejudice access to these services, you may not meet the health requirement unless a health waiver is available and exercised.
Need Guidance on Meeting the Health Requirement?
Navigating the health requirements for an Australian visa can be complex, especially when dealing with the SCT and potential health waivers. One Planet Migration Law is here to assist you every step of the way. Our team of experts can provide personalised advice and help you understand how the SCT might impact your visa application.
Contact One Planet Migration Law today for expert guidance on meeting Australia’s health requirements for visas.
Note: The information provided in this article is meant for general informational purposes only and should not be interpreted as legal advice. Although we strive to provide accurate and useful information, the nuances of Australian immigration law demand personalised advice from legal professionals. Given the dynamic nature of migration regulations, it is essential to consult with experienced immigration experts for up-to-date insights tailored to your individual circumstances. We strongly advise seeking professional guidance to navigate the complexities of Australian immigration law effectively and to achieve the most favorable outcomes for your immigration journey.
