The visa medical examination: what is checked, where, and what happens if something is found

MARN 1576536

When and how it is arranged

The Department issues a Health Assessment Portal identifier, the HAP ID, either when the application is lodged and the health checks are generated in ImmiAccount, or earlier if you choose to complete My Health Declarations before lodging. The HAP ID is the reference the clinic uses to know which examinations you need and where to send the results. Without it, a clinic cannot examine you for a visa. The referral letter that comes with it lists the examinations required, and that list, not a general expectation, is what you attend for.

Who conducts it

Inside Australia, Bupa Medical Visa Services is the only approved provider; you book online or by phone with the HAP ID, attend with your passport and any glasses or medication you use, and pay the clinic directly. Outside Australia, the examination is done by a panel physician approved by the Department for that country, listed on the Department's website, and results travel through the same electronic system. You cannot use your own doctor for the visa examination, and a report from your own doctor is not a substitute, although specialist reports are often asked for later if a finding is referred.

What is tested

The set of examinations depends on four things: the visa and whether it is permanent or temporary, your age, the length of the intended stay, and the tuberculosis risk of the countries you have lived in or visited. In broad terms:

• Medical examination for most applicants: history, physical examination, height, weight, blood pressure, urinalysis, vision.
• Chest X-ray for permanent applicants aged 11 and over, and for temporary applicants depending on length of stay and country risk. Pregnant applicants may defer it or use shielding.
• HIV test for permanent applicants aged 15 and over, and in some temporary cases.
• Hepatitis B and C and syphilis tests in defined cases: pregnancy, intending work as a doctor, dentist, nurse or paramedic, children for adoption, and some others.
• Further tests where the examining doctor or the Department asks for them: specialist review, repeat imaging, sputum tests after an abnormal X-ray.

What the Department is assessing

The health requirement is a public interest criterion, not a fitness test. The question is whether you have a condition that is a threat to public health, chiefly active tuberculosis; whether your condition is likely to result in significant cost to the Australian community in health or community services, assessed against the significant cost threshold, currently AUD86,000; and whether it would prejudice the access of Australians to services in short supply. The cost is estimated with standard costings over the period of stay for temporary visas and a capped period for permanent ones, not from your actual circumstances or insurance. Which criterion the visa carries decides the rest: visas under PIC 4007, including partner, child and the employer-sponsored 482, 186 and 494, allow the requirement to be waived; visas under PIC 4005, including the points-tested 189, 190 and 491, visitor visas and most student visas, do not. The detail is in the health waiver guide.

Results and validity

The clinic sends results to the Department electronically, usually within days where nothing needs a report. You are not given a copy of the assessment, although the clinic will tell you if something needs follow-up. Results are generally valid for twelve months. For a visa with a long processing time, that means the examination is done when the Department asks for it, or timed so that it will not expire before decision; done too early, it is repeated at your cost.

If something is found

A result outside the normal range is referred to a Medical Officer of the Commonwealth, who may ask for specialist reports, further tests or treatment records, usually through a request for more information with a response date. The Medical Officer forms an opinion on whether the health requirement is met, and the decision-maker is bound by that opinion on the medical facts. If the opinion is that the requirement is not met, what follows depends on the visa. Under PIC 4007 you are invited to put forward the case for a waiver, and that case, built on mitigation, contribution and compelling circumstances, is where the application is won or lost. Under PIC 4005 there is no invitation, because there is no waiver, and the realistic questions are whether the opinion was properly reached and whether a different visa is open.

Tuberculosis

Active tuberculosis must be treated and shown to be no longer infectious before a visa can be granted; it is the one condition that is a bar on public health grounds rather than cost. Evidence of past or inactive tuberculosis, usually from the chest X-ray, commonly leads to a health undertaking: the visa is granted on the condition that you report to a health authority after arrival for monitoring. An undertaking is not a refusal and not a mark against you, but it is a condition of the visa and must be kept.

Family members

For most permanent visas, every member of the family unit must meet the health requirement, including a spouse or child who is not migrating, and one person failing it fails the whole application. That is the one-fails-all rule, and it is why a non-migrating child with a significant condition is the commonest reason a family's permanent application reaches the waiver stage. Temporary visas generally apply the requirement to the applicants on the application only.

Before the appointment

• Take the passport used in the application and the HAP ID letter.
• Take records of any existing condition and its treatment. A condition that is documented and managed reads better than one the examination discovers.
• Declare conditions truthfully. An omission found later is a false or misleading statement, which is a separate and worse problem than the condition itself.
• If a condition is known and significant, have the visa choice reviewed before lodging, because whether a waiver exists depends on it.

Book a consultation — $330 inc. GST, credited

General information only, current at October 2026; not advice on your own case. Examination requirements are set by the Department of Home Affairs and vary by visa, age, stay and country; the referral letter is authoritative for your application. Outcomes depend on the Department’s assessment of each application; no registered migration agent can guarantee a result (Code of Conduct, Migration Agents Regulations). Keshab Chapagain, MARN 1576536.