Individuals and Travellers

Adoption Visas - the health requirement and health waivers

This page provides information on the health requirement and health waivers for adoptive parents applying for an Adoption (subclass 102) visa for their child. More information about Adoption of children from outside Australia is available.

The health requirement

Adoption visa applicants must meet certain eligibility criteria before they can be granted a visa. One of these criteria relates to the applicant's health and is known as the 'health requirement'.
The purpose of the health requirement is to:

  • protect the Australian community from public health risks, specifically active tuberculosis
  • contain public expenditure on health care and community services
  • ​safeguard Australian citizens' and permanent residents' access to health care and community services that are in short supply. Where a medical condition is likely to impact on whether Australian citizens and permanent residents can access health care and community services that are in short supply, it is referred to as 'prejudice to access'.

The health requirement is unlikely to prevent an adopted child's entry to Australia. For the majority of Adoption visa applicants, the process is straight-forward, with well over 90 per cent meeting the health requirement.

More information on the health requirement is available.

If I have already adopted a child from overseas, do they still need to be assessed against Australia's health requirement?

Yes, the health requirement applies to all Adoption visa applicants, even if the adoption has already occurred and is lawful in the country of adoption.

What if I adopt a child overseas under the Hague Convention on Intercountry Adoption?

Adopted children whose intercountry adoption is finalised outside Australia in accordance with the Hague Convention may be eligible to apply for Australian citizenship. If the child is granted Australian citizenship, a health condition will not prevent them from coming to Australia as Australian citizens do not have to meet the health requirement. The child can enter Australia on an Australian passport and will not need to apply for a visa.  More information about applying to adopt is available.

What health examinations do adopted children need to undertake?

All Adoption visa applicants must undergo:

  • a medical examination, HIV/AIDS test, and Hepatitis B test (Form 26)
  • a chest x-ray (if 11 years of age or older) (Form 160), and any additional tests requested by a Medical Officer of the Commonwealth (MOC).

A MOC will review the results of the health examination and assess whether your child meets the health requirement.

What medical conditions may lead to a child failing to meet the health requirement?

Any medical condition may result in a child failing to meet the health requirement if the MOC assesses that the associated costs are likely to be significant and/or that services in short supply are likely to be needed. The following list provides some examples of conditions that, if severe enough, may result in a child failing to meet the health requirement:

  • intellectual or functional impairment
  • visual or hearing impairment
  • conditions where an organ transplant is likely to be required now or in the future
  • blood disorders where a regular supply of blood or blood products is likely to be required.

This list is not exhaustive. The majority of Adoption visa applicants (over 90 per cent) meet the health requirement. 

What happens if my child fails to meet the health requirement?

If your child fails to meet the health requirement, the departmental officer who is assessing your child's visa application can consider whether to exercise a waiver of the health requirement. A health waiver is able to be exercised where a departmental officer assesses that the applicant's estimated health care and community services costs and/or likely impact on services in short supply are not excessive.

After reviewing the child's health examination reports, a MOC will determine a detailed costing of the health care and community services the child is likely to access, including if they are likely to need services that are in short supply in Australia.  The MOC's advice is based on a child with the same condition and level of severity as your child, but cannot legally take into account the individual circumstances of your family or your child.

If the estimated potential costs involved are equal to or greater than $500,000 or prejudice to access has been identified, the health waiver case will be internally referred to our national office for a recommendation on whether a waiver should be considered, prior to the delegated officer's decision. This process ensures consistency and that sensitive cases are handled with care and finalised as quickly as possible.

More information about significant costs in short supply is available.

The departmental officer can take into account your family's and child's individual circumstances when considering if a health waiver should be exercised.

The departmental officer will provide you with information from the MOC regarding your child's medical condition, estimated costs and if they are likely to require services in short supply. They will also give you an opportunity to put forward reasons and evidence in support of a health waiver being exercised in your child's case, and will consider this information when making a decision.

Important: Any condition that is a public health threat – currently only active tuberculosis (TB) - cannot be waived. Where active TB is identified, a visa cannot be granted. In some cases, however, a decision may be deferred if treatment could be successfully completed within acceptable timeframes.

The following diagram shows the health assessment process for cases where TB is not identified.

health requirements flow chart 

What will the department take into account when considering a health waiver?

Each health waiver is carefully considered on a case by case basis. The departmental officer will consider to what degree any potential costs and/or prejudice to access can be mitigated, combined with the strength of any compassionate and compelling circumstances. The department takes great care in assessing health waivers, and has supported exercising waivers in recent adoption-related cases. However, every case is assessed individually.

The departmental officer will consider all the relevant factors and information available, although some factors (outlined below) carry more weight than others.

Factors which might weigh against a health waiver

Factors which might weigh against a health waiver include (but are not limited to):

  • identified prejudice to access
  • very high estimated potential health costs
  • where an adoptive family is very unlikely to be able to substantially mitigate the potential health costs identified (for example where the adoptive family has low income/assets or is already supporting sick family members).

Factors which might support a health waiver

Factors which might support a health waiver include but are not limited to) where:

  • the adoptive family has already formed a close bond with the child

Note: This could include evidence of the adoptive family's preparations for and expectations of the child, particularly in circumstances where personal contact with the child is not permitted.

  • there is a good chance that the potential health costs can be sufficiently mitigated. For example:
  • where the adoptive family has significant assets and income and proposes to fund the care themselves
  • where the family has appropriate private health insurance cover
  • the family seek to make private care arrangements where supportive care is needed.
  • there is a good chance that the potential prejudice to access can be mitigated. For example, where the child would require regular blood products, the adoptive family is willing to become blood donors, even if not directly compatible
  • the family has already adopted a sibling/related child, who is already residing in Australia
  • the family has skills or qualifications which would help the child successfully settle in Australia (such as experience in nursing, teaching, or other field relating to the child's medical condition).

What evidence can I provide in support of a health waiver?

You can provide the following evidence:

  • any qualifications and work history of the adult adoptive family members
  • current employment and salary detail of the adult adoptive family members including details of how long the position has been held
  • assets held by the adult adoptive family members (including home ownership, other property, investments, social security payments from overseas government, private superannuation etc.)
  • skills or other contributions made by the adoptive family to the community
  • any negative impact on another Australian child should a health waiver not be exercised
  • the adoptive family, extended family members, and any other person or organisation's willingness and ability to provide care and support for the adopted child (for example statutory declarations, letters of support)
  • the existing or proposed care arrangements for the child
  • where prejudice to access is identified, arrangements and capacity for its mitigation.
  • any other compassionate and compelling circumstances of your case.

Who decides whether to exercise a health waiver?

The decision to exercise a health waiver will be made by a senior departmental officer delegated by the Minister. The same officer will also make the decision on your adopted child's visa application. 

How long do health assessment and waiver processes take?

Once the required health examinations have been undertaken and any additional medical advice or reports provided (if needed), in most cases it only takes up to a week or two to determine if the applicant meets the health requirement. This is in addition to the time it will take to process the other visa requirements.

Where an applicant fails to meet the health requirement the time it takes to decide whether to exercise a health waiver will depend on whether sufficient information has been provided. Cases which require a recommendation from our national office take, approximately, an additional ten working days, provided that all the necessary information has been submitted.

Note: All other visa criteria must be assessed before a health waiver can be considered.

If a health waiver is not granted and my adopted child's visa application is refused – can I appeal the decision?

Yes, you can appeal the decision if your adopted child's visa is refused by applying to the Administrative Appeals Tribunal (AAT) for a review of the decision. The visa decision-maker will provide you with advice about your AAT rights and the strict timeframes that apply for making a review application at the time you are advised of the visa refusal.

Additional information

Tuberculosis (TB)

Tuberculosis is prescribed as a public health risk in the Migration Regulations 1994 and the purpose of these tests is to determine whether there is any evidence of either active or previous TB.

Where there is evidence of possible TB, the applicant will be asked to undergo more specific tests.  If active TB is found, Australian migration law does not allow a visa to be granted.  A person can be effectively treated for TB. This normally takes 6–9 months.  If there is evidence of inactive TB, the applicant may be asked to sign a health undertaking in order to meet the health requirement. A MOC will make this assessment. 

Panel doctors and Medical Officers of the Commonwealth (MOCs)

Applicants applying for an Adoption visa are required to undertake medical examinations with overseas panel doctors or panel radiologists who are appointed by the department.

MOCs are doctors appointed by the Minister for Immigration and Border Protection under Australian migration law.  In making an assessment of whether a visa applicant meets the health requirement, a MOC is required by legislation to take into account the potential health care costs and community services likely to be required by a hypothetical person with a condition of the same level and severity as the applicant.  This includes the need for medical, pharmaceutical and community services, such as assisted accommodation, home and community care, income support such as Special Benefit, Disability Support Pension and Carer's Pension and special educational needs.

The Migration Regulations also require MOCs to assume that applicants granted a visa to enter Australia will utilise fully all entitlements to public health care and community services.

A list of available panel physicians is available on our website.

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