The health requirement: what the significant cost threshold actually measures
Current as at 11 September 2026. The significant cost threshold is $86,000, last updated on 1 July 2024, and is reviewed every two years. Older Departmental material published during the 2023 public consultation still quotes the previous $51,000 figure, so check the date on anything you read. This is general information, not legal advice.
Most people preparing a visa application think about the health requirement as a medical: a chest x-ray, some blood tests, a form. That is the visible part. The decision that actually matters happens afterwards, when a Medical Officer of the Commonwealth (MOC) converts your medical history into a dollar figure and compares it against a single threshold.
Understanding what that figure covers, and just as importantly what it does not, is the difference between panicking about a diagnosis and preparing a case properly. This article explains the mechanics. Its companion covers what happens when you do not meet the requirement and a health waiver is available.
What the health requirement is actually for
The Migration Regulations 1994 set three aims for the migration health requirement, and every assessment traces back to one of them:
- Protect the Australian community from public health and safety risks.
- Contain public expenditure on health care and community services.
- Safeguard access for Australian citizens and permanent residents to health care and community services that are in short supply.
The significant cost threshold is the policy that delivers the second aim. The third is narrower than most people expect: the services currently treated as in short supply are organ transplants and dialysis, and nothing else.
The threshold: $86,000
Significant cost is defined as a cost higher than the average health and community services cost for an Australian. That average is calculated over a five year period using two published Australian Institute of Health and Welfare datasets, health expenditure and welfare expenditure, with a projection applied to bring historical data up to the current year.
The resulting figure is the significant cost threshold. It was last updated on 1 July 2024 and currently sits at $86,000. It is reviewed every two years, so anyone planning an application more than a few months out should confirm the figure rather than assume it.
What is counted in the number
This is the part that surprises people. The threshold is not a hospital bill. It bundles health spending and welfare spending together, which is why conditions requiring ongoing support, rather than acute treatment, can produce large estimates.
| Health spending included | Welfare spending included |
|---|---|
| Hospital care | Aged care: residential, home and community services |
| Primary health care, including GP services | Disability services funded through the NDIS, employment support, youth support, social and protection support |
| Referred and unreferred medical services, specialists, pathology | Specialised education support, including early intervention for children with disability |
| Research and public health programs | Cash welfare payments: carers payments, Disability Support Pension, Child Disability Assistance Payment and similar |
| Pharmaceuticals under the PBS |
The practical consequence is that a condition with modest medical costs but significant support needs can still exceed the threshold, because NDIS-funded services and cash welfare payments sit inside the same number.
The period your costs are measured over
The threshold is a total, not an annual figure, so the period matters enormously. It depends on what you have applied for:
| Application type | Period the MOC assesses |
|---|---|
| Temporary visa | Your intended period of stay in Australia |
| Provisional or permanent visa | Generally five years |
| Provisional or permanent, applicant aged 75 or over | Three years |
| Permanent or ongoing condition with a reasonably predictable course | Remaining life expectancy, capped at ten years |
That last row is where most adverse assessments come from. A stable, well-managed lifelong condition can be assessed across a full ten years, and a modest annual cost multiplied by ten clears $86,000 without difficulty. A short temporary stay with the same condition may not come close.
A diagnosis is not a refusal
Having a medical condition does not automatically mean you exceed the threshold. The Department is explicit that the estimate depends on what the condition is, how severe it is, and how long you intend to stay. Two applicants with the same diagnosis and different clinical pictures routinely receive different assessments.
It follows that the quality of the medical evidence matters. A specialist report setting out current management, stability, prognosis and realistic service needs gives the MOC something concrete to cost. A bare diagnosis invites a conservative estimate, and conservative estimates are expensive.
Who is assessed, and how
For the majority of applicants, completing a health declaration is enough. Everyone else undertakes an immigration medical examination, and that includes all provisional and permanent visa applicants. The examinations required vary with the visa, your age, your intended activities in Australia and where you have lived.
Two separate questions are then answered. First, do your estimated costs exceed the threshold? Second, is your condition likely to prejudice access for Australians to a service in short supply, meaning organ transplants or dialysis? Failing either limb fails the health requirement.
If you do not meet it
Where the health requirement is not met, a visa will not be granted unless one of two things applies:
- You are an eligible child born and ordinarily resident in Australia, in which case a separate assessment applies and no application for special consideration is needed. A processing officer considers it.
- A health waiver is available for your visa subclass and a decision is made to exercise it.
Whether a waiver exists at all depends on which public interest criterion attaches to your subclass. That distinction, and how waiver submissions are actually decided, is covered in our guide to health waivers.
Getting this right before you lodge
The health requirement is one of the few parts of a visa application where preparation before lodgement changes the outcome more than advocacy afterwards. In practice that means obtaining current specialist evidence, understanding which assessment period will apply, and knowing in advance whether your subclass carries a waiver. If it does not, the choice of subclass itself becomes the strategic decision.
If you or a family member has a condition that may be costed above the threshold, our health requirement practice assesses the exposure before an application is lodged rather than after a refusal. Book a consultation to talk it through.