The Australian visa system includes strict health requirements designed to protect public health and contain healthcare and community service costs. One key measure in assessing whether an applicant meets the health requirement is the Significant Cost Threshold (SCT), which currently stands at AUD $86,000.
What is the Significant Cost Threshold?
The SCT represents a benchmark for determining whether an applicant’s medical condition may lead to excessive costs to Australian healthcare and community services. A Medical Officer of the Commonwealth (MOC) assesses the applicant’s health and projects the estimated cost of their condition. If the projected expenses exceed the SCT, the applicant is considered not to meet the health requirement.
How is the SCT Determined?
The SCT is based on the average health and welfare service costs for an Australian citizen over five years. It is derived from the Australian Institute of Health and Welfare (AIHW) reports on health and welfare expenditure, adjusted for inflation and current economic conditions. The SCT is reviewed every two years to reflect changes in government healthcare spending.
Key Cost Components Considered in the SCT
The SCT encompasses costs associated with both health spending on goods and services and welfare spending on payments and services, including:
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Hospital care – inpatient and outpatient services.
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Primary health care – general practitioner (GP) visits and allied health services.
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Specialist medical services – pathology, diagnostic tests, and specialist consultations.
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Pharmaceuticals – medications under the Pharmaceutical Benefits Scheme (PBS).
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Aged care services – residential and home care services.
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Disability support – funding under the National Disability Insurance Scheme (NDIS).
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Specialised education support – early intervention services for children with disabilities.
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Cash welfare payments – such as the Disability Support Pension and Carer Payments.
How the SCT Affects Visa Applications
Applicants must undergo a health assessment as part of the visa process. The duration over which an applicant’s health costs are projected depends on the visa type:
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Temporary visas – costs assessed over the intended period of stay.
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Permanent and provisional visas – costs typically assessed over a five-year period (or three years for applicants aged 75 and above). If the condition is permanent or ongoing, costs may be projected for up to 10 years.
What Happens If You Exceed the SCT?
If the MOC determines that an applicant’s estimated healthcare and community service costs exceed the SCT, the applicant fails to meet the health requirement. However, this does not necessarily lead to automatic visa refusal. There are two primary considerations:
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Health Waiver Availability
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Certain visa subclasses, such as Partner visas, some Employer-Sponsored visas, and Humanitarian visas, allow for a health waiver under Public Interest Criterion (PIC) 4007.
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If a waiver is available, the Department of Home Affairs will assess the applicant’s ability to mitigate healthcare costs and consider compelling and compassionate circumstances.
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Prejudicing Access to Healthcare
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If an applicant’s condition is likely to prejudice access to critical services, such as organ transplants or dialysis, they may still be refused a visa, even if a waiver is available.
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Health Waiver Considerations
If a health waiver is available, applicants may be asked to provide evidence demonstrating:
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Their ability to cover healthcare costs privately (e.g., through private health insurance).
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The availability of family or community support to reduce reliance on government-funded services.
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Any compelling personal circumstances that justify granting the visa despite health costs.
If a health waiver is available, applicants may be asked to provide evidence demonstrating:
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Their ability to cover healthcare costs privately (e.g., through private health insurance).
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The availability of family or community support to reduce reliance on government-funded services.
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Any compelling personal circumstances that justify granting the visa despite health costs.
A family applies for a Partner Visa (Subclass 820) where one member has a health condition exceeding the SCT. The Department requests additional evidence, such as medical reports and financial documents, to assess whether the visa can be granted under PIC 4007.
The family demonstrates their ability to cover costs through private health insurance and provides evidence of strong family ties to Australia. Despite the initial concern, the visa is granted based on compelling and compassionate circumstances, showcasing the flexibility of the health waiver process.
Special Considerations for Children
Children born in Australia who do not meet the health requirement may still be eligible for a visa under the ‘child born and ordinarily resident in Australia’ provision. In such cases, the Department will assess their eligibility before deciding on visa refusal.
Conclusion
The Significant Cost Threshold is a critical factor in determining whether a visa applicant meets Australia’s health requirements. While exceeding the SCT can result in visa refusal, applicants may still qualify for a health waiver if available. Understanding the SCT and preparing strong supporting evidence can improve the chances of a successful visa application.
Please feel free to contact me for a consultation. Together, we can discuss your options and work towards securing the right outcome.
