What Can I Do If I Have PIC 4005 (The "No Health Waiver" Rule)?
Meeting the health requirement is mandatory for every applicant for any Australian visa. However, not all health rules are the same. In migration law, there are two main categories: PIC4007 (which allows for a health waiver) and PIC4005 (which does not allow for a health waiver).
If you are applying for a visa subject to PIC4005 and you have a medical condition, your situation is much more serious. Because there is no waiver option, a high-cost medical finding often leads to a visa refusal.
Related: How does Immigration Assess Health Costs for Australian Visa Applications?
Understanding the Strictness of PIC 4005
Under PIC 4005, the Department of Home Affairs (DoHA) has no power to consider your compelling and compassionate circumstances. Even if you have an Australian partner, children, or high-demand skills, the case officer must refuse the visa if the Medical Officer of the Commonwealth (MOC) decides you fail the health test. Visa subclasses that usually fall under PIC 4005 include, but are not limited to:
What Can I Do if My Visa is Refused under PIC4005?
The current significant cost threshold is approximately $86,000 AUD. The Department calculates this based on what a "hypothetical individual" with your condition would cost the Australian healthcare system over the next 10 years.
For example, if the MOC says your condition will cost $100,000, you need to provide specialist reports showing that your condition is stable, your medication is cheaper, or you do not require the specific treatments the Department has assumed to show that you can legally bring that estimate below $86,000 to meet the health requirement.
Challenging the Medical Opinion Via Appeal at the Administrative Review Tribunal (ART)
Since you cannot ask for a waiver of the cost, you may have the right to appeal the visa refusal decision to the Administrative Review Tribunal (ART) to prove that you meet the health requirement (PIC4005). This is your chance to address the health concerns that DoHA have and present updated medical evidence to show that you meet the health requirement today.
Switching to a Visa with a Waiver (PIC4007)
If you have a health condition that will definitely exceed the cost threshold, it may be better to apply for a visa subclass that uses PIC 4007 instead. PIC4007 allows the Department to grant a health waiver if your family’s contribution or compassionate ties outweigh the medical cost. Subclasses that often allow for a waiver include and not limited to:
Related: Which Visa Subclasses Have a Health Waiver Option?
Providing New Medical Evidence
If you receive a Natural Justice (S57) letter stating you did not meet the health test, you have this chance to provide comments. This is the time to gather new evidence, such as specialists' reports, test results showing a higher level of health and functionality than previously recorded, and others. Engage with an Accredited Specialist in Immigration Law to assist with a legal submission supported by the law and case studies and tailored specifically to your matter.
Prevention is Better than Cure: Get Professional assistance
If you have an ongoing health issue, such as diabetes, a heart issue, or autism, you must check whether your intended visa falls under PIC4005 or PIC4007 before submitting the visa application form. Applying for a PIC 4005 visa with a medical condition is a high-risk move that often leads to a non-refundable refusal. An immigration lawyer can help you check whether your specific visa subclass allows a health waiver, review your child’s medical reports to ensure they are presented correctly, and draft a robust submission explaining why your specific situation.
Related: Don't Lie to Your Immigration Lawyer! Why Honesty is Your Best Defence
Related:
Can You Still Get a Visa If You Fail the Health Requirement? Complex Cases Explained
Decoding "Complex Visa Case": What It Means and Why It Matters
How do I Overcome Health Requirements if I Have a Child with Health Issues?
How Can Agape Henry Crux Help
Addressing health concerns is a complex legal task. It is not just about medical records; it is about bridging health and law and tailoring it to your specific circumstances. At Agape Henry Crux, we specialise in complex health cases and have assisted many clients to secure their future in Australia. Consider speaking with one of our Accredited Specialists in Immigration Law, Jason Ling or Angela De Silva, as they are experts in handling highly complex matters. You can schedule an appointment with us to seek professional advice by calling 02-8310 5230 or emailing us at info@ahclawyers.com.
We speak fluent English and Mandarin. We can also help you arrange an interpreter if this isn't your language.
Our founder and principal lawyer, Jason Ling, is recognised in the 2026 edition of The Best Lawyers in Australia™ and the 2027 edition of The Best Lawyers in Australia™. Agape Henry Crux is named as Best Immigration Law Firm 2025 - Sydney by APAC Insider Awards and in the 2027 edition of The Best Law Firms™ - Australia.
This article/presentation (“publication”) does not deal extensively with important topics or changes in law and is not intended to be relied upon as a substitute for legal or other advice that may be relevant to the reader's specific circumstances. If you find this publication of interest and would like to know more or wish to obtain legal advice relevant to your circumstances, please contact our office.
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