Does OVHC satisfy Public Interest Criteria 4005 and 4007?

No. OVHC does not satisfy Public Interest Criteria 4005 and 4007, replace a required health examination or assessment, or remove the possibility of a health undertaking. The Department of Home Affairs says the Medical Officer of the Commonwealth can consider only the medical situation, not other personal circumstances, and cannot consider whether private health insurance or enough money to pay for treatment would affect use of available public services. The Department’s Protecting health care and community services guidance sets the current Significant Cost Threshold at $86,000; estimated costs above that amount exceed it (checked 1 October 2026).

OVHC may help with eligible treatment costs under the terms of the selected policy. That is a separate question from whether an applicant meets Australia’s visa health requirement.

What do Public Interest Criteria 4005 and 4007 assess?

The Department of Home Affairs explains that the health requirement protects the Australian community from public health and safety risks, especially active tuberculosis, helps control spending on services and preserves access to health and community services that are in short supply.

For a significant medical condition, the Medical Officer advises whether the condition is likely to:

• threaten public health;
• result in significant healthcare or community-service costs; or
• place demand on healthcare or community services that are in short supply.

Having a medical condition does not automatically mean an applicant has exceeded the Significant Cost Threshold. The estimated cost depends on the type and severity of the condition and the intended period of stay in Australia.

Why doesn’t OVHC satisfy the health requirement?

The Medical Officer estimates the services that a hypothetical person with the same type and severity of condition would need. This is not an assessment of how much an insurer may reimburse or whether the applicant can personally afford treatment.

The Medical Officer cannot use the following to offset estimated community costs:

• private health insurance or visitor health cover;
• enough personal money to pay for treatment; or
• the effect those resources might have on the applicant’s use of available public services.

Therefore, holding an OVHC policy does not establish that the health requirement has been met. It also does not prevent Home Affairs from requesting a health examination or recommending a health undertaking.

What does the $86,000 Significant Cost Threshold mean?

A significant cost is defined as higher than the average health and community-services cost for an Australian. The current Significant Cost Threshold is $86,000.

Home Affairs calculates the average using health and welfare expenditure reports from the Australian Institute of Health and Welfare. It uses spending over a 5-year period, projects historical data into the current year and reviews the threshold every 2 years. The Department says the threshold was last updated on 1 July 2024.

The Medical Officer estimates costs differently depending on the visa:

Application type	Cost-assessment period
Temporary visa	The applicant’s intended period of stay in Australia
Provisional or permanent visa	Generally 5 years, or 3 years if the applicant is aged 75 years or older
Permanent or ongoing condition with a reasonably predictable course	Remaining life expectancy, up to a maximum of 10 years

The resulting estimate is compared with the Significant Cost Threshold. If estimated costs are above $86,000, the applicant exceeds the threshold and does not meet the health requirement on the significant-cost ground.

Is the threshold only about medical treatment?

No. The estimate can include broader healthcare, support and community-service needs:

Cost area	Examples identified by Home Affairs
Medical services	Medical specialists and pathology or laboratory testing
Disability services	Support funded by the National Disability Insurance Scheme, Employment Support, Youth Support, Social Services and Protection Support
Research and public health	Public-health research and communication programs supporting health awareness
Specialised education	Early-intervention support for children with disability
Cash welfare payments	Carers Payment, Disability Support Pension and Child disability Assistance Payment, among others
Pharmaceuticals	Prescribed treatments and therapies under the Pharmaceutical Benefits Scheme

This is why the Significant Cost Threshold is not simply a comparison against one insurer’s treatment estimate.

What can happen if the Medical Officer identifies a concern?

The possible consequences depend on the medical assessment and the visa subclass:

• Estimated costs above $86,000: Home Affairs says the applicant does not meet the health requirement because the condition is likely to be a significant cost. A visa will not be granted on that basis, subject to any applicable exception or waiver.
• Demand for short-supply services: The Medical Officer also considers whether the condition is likely to prevent Australian citizens or permanent residents from accessing services in short supply. Home Affairs calls this “prejudicing access”.
• Health undertaking: The Medical Officer might recommend that the applicant be asked to sign one. Buying OVHC does not remove this possibility.
• Health waiver: If a waiver is available for the visa subclass, the decision maker can consider personal circumstances to mitigate costs and potentially waive them. The visa processing officer must consider an available waiver and may request further information.
• Eligible child: Special consideration for children born and ordinarily resident in Australia who do not meet the health requirement under Public Interest Criteria 4005 and 4007 came into effect on 16 October 2024. Home Affairs says a child born in Australia who does not meet the requirement for a temporary or permanent visa does not need a separate special-consideration application; a visa processing officer considers the child’s eligibility.

A health waiver and a health undertaking are not substitutes for each other, and eligibility for an exception must be assessed rather than assumed.

What should I check for my visa?

• Confirm the health requirement and any examination requirement for your exact visa subclass on the Home Affairs health page.
• Check whether family members must also meet the requirement, even if they are not migrating to Australia.
• Complete any requested health examination or assessment.
• Respond if Home Affairs requests more information for an available health waiver.
• Review the OVHC policy documents separately to understand which treatment costs the policy covers and on what terms.
• Check the Significant Cost Threshold again before making a decision because Home Affairs reviews it every 2 years.

This is general information, not a visa or policy decision. Check the policy documents and the Home Affairs page for your visa before relying on either.

Sources

• Department of Home Affairs — Health
• Department of Home Affairs — Protecting health care and community services

FAQ

Does OVHC satisfy Public Interest Criteria 4005 and 4007?

No. OVHC may help with eligible treatment costs, but it does not satisfy the visa health criteria or replace the health assessment.

Does OVHC remove the need for a health examination?

No. Home Affairs may require a health examination as part of processing a visa application, regardless of whether the applicant holds visitor health cover.

Can the Medical Officer offset estimated costs because I have insurance or savings?

No. The Medical Officer cannot consider whether private health insurance or enough money to pay for treatment would affect the applicant’s use of available public services.

Is a health waiver available for every visa?

No. A health waiver must be available for the particular visa subclass. If one is available, the visa processing officer must consider it and may request further information.

Could Home Affairs still ask me to sign a health undertaking?

Yes. The Medical Officer might recommend a health undertaking, and holding OVHC does not prevent that recommendation.