If you have a medical condition, it may be necessary to make submissions to INZ to gain a health "waiver" if the condition imposes costs or demands on the New Zealand health system

To determine whether you meet health requirements, INZ will require you to undergo medical checks, usually every three years until you secure a residence class visa. These checks will include a chest x-ray, a general check up, a urinalysis and a full screen of blood tests. These will be reviewed by a contracted panel physician, who will advise INZ if the medical checks demonstrate anything that is likely to impose a cost or burden to our health system. If nothing is found, you will be determined ASH (Acceptable Standard of Health). If issues are identified, INZ will request further information or issue a letter highlighting these concerns and requesting comment (PPI letter). 


Medical Thresholds

The threshold for triggering a request for further information or a PPI letter differs for temporary and residence applications.  


For concerns to be raised during a temporary visa application, there would need to be a relatively high probability that you would require hospitalisation, residential care, high cost pharmaceuticals and/or high cost disability services, during the term of the visa to be granted. 


Residence visa applications have a stricter threshold, as INZ are looking at the possible demand for or cost of health services over a far longer period. As such, INZ have an extensive list of health conditions that will automatically lead to a finding that the applicant is not-ASH, while other conditions may also trigger such a finding if:


  • there is a high probability of the condition requiring health services in excess of $41,000 within a five year period or for chronic illnesses, over the course of the illness;


  • there is a high probability of the condition imposing a demand on a particular health service for which current demand is already not being met; or


  • there is a high probability of the condition entitling the applicant to ongoing and reviewable resourcing (ORRS) funding


Where a health issue is identified that may trigger any of these thresholds, INZ will outline its concerns and give applicants the opportunity to provide further comment, which can include further tests, specialist reports and/or commentary on the costs and demands of the condition. That information is then reviewed by two medical professionals and a final finding as to whether an applicant is ASH or not-ASH is made. 


If there is a finding of "not-ASH", applicants under certain categories will be eligible to be considered for a medical waiver, whereby a balancing exercise is undertaken by INZ in relation to considering whether or not the circumstances of the applicant and their potential benefit to New Zealand, outweigh the negative implications (being the cost and burden on New Zealand’s health care system) of them remaining here.


There is a fair amount of discretion exercised in the decision making process by Immigration in these matters, and we have extensive experience in preparing submissions for applicants with health conditions, including successfully obtaining medical waivers for clients with chronic conditions such as HIV and autoimmune conditions.

How Saunders & Co can add value:

  • We will advise you prior to lodging an application, as to whether any health issues are likely to arise, so that you can plan accordingly
  • We will liaise with you, medical specialists and other third parties to collate supporting documentation to refute any findings that you are not of an acceptable standard of health
  • We have a proven track record of drafting substantial waiver submissions to secure visas in these types of situations

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