Medical waivers and the acceptable standard of health for NZ visas

The health requirement at a glance

Residence cost threshold

NZ$81,000

Acute condition, costs counted over

5 years

Temporary visa waiver classes

5

1. 1
   Medical certificatesWith the application

   A General Medical Certificate and a Chest X-ray Certificate for every person included in a residence application, or the Limited Medical Certificate where the instructions allow it.

2. 2
   Medical assessor's opinionIf an officer is not satisfied

   An officer who is not satisfied that an applicant meets the standard must refer the matter to an INZ medical assessor, or to the Ministry of Education where special education is in question. Referral is not needed for a partner or dependent child of a New Zealand citizen or residence class visa holder, or for a 2021 Resident Visa or Ukraine Resident Visa applicant, unless A4.60(a) or (b) applies.

3. 3
   Your comment on the assessmentBefore any decline on health grounds

   INZ must seek your comment on the medical assessment before declining, in practice through a PPI letter.

4. 4
   Waiver consideredOnly if every other requirement is met

   A residence applicant who fails the standard but meets every other requirement may be considered for a medical waiver, unless an absolute exclusion applies.

5. 5
   Decision

   If a person included in the application fails the standard and no waiver is granted, the application must be declined.

What the acceptable standard of health is

The requirement comes from immigration instructions made under the Immigration Act 2009: chapter A4 of INZ's operational manual, with A4.10 governing residence and A4.15 temporary entry. For residence, an applicant has an acceptable standard of health if they are:

• Unlikely to be a danger to public health
• Unlikely to impose significant costs or demands on New Zealand's health services or special education services
• Able to undertake the work the visa is based on

Three points surprise people:

• The special education limb is real. A child with a relatively high probability of qualifying for Ongoing Resourcing Scheme funding fails the standard on that ground alone.
• Significant demands covers scarce services regardless of cost: needing health services for which New Zealand demand is already unmet.
• The usual mitigations do not count. Ability to pay for treatment, private healthcare, medical insurance, and the capacity of family or charity to provide care are all irrelevant to the assessment.

The $81,000 threshold and how it is counted

The figure has been in force since 4 September 2022, when it doubled from $41,000. The counting window is the detail that gets misstated everywhere:

The high-cost conditions list and the August 2026 changes

Instruction A4.10.1 deems anyone with a listed condition not to meet the standard, and the list is expressly not exhaustive. The version in force from 3 August 2026 includes:

• Malignancies, including a past history, except treated minor skin malignancies and those where the probability of recurrence is under 10 percent
• A need for an organ transplant, or immune suppression after one (corneal grafts excluded)
• Severe renal or hepatic disorders that are chronic or progressive
• Musculoskeletal disorders, such as osteoarthritis, with a high probability of surgery in the next five years
• Severe, chronic or progressive neurological disorders
• Cardiac diseases, such as severe ischaemic heart disease, or valve disease or aortic aneurysm with a high probability of intervention in the next five years
• Chronic respiratory disease, such as severe or progressive lung disease and cystic fibrosis
• Significant or disabling hereditary disorders
• Severe autoimmune disease needing immune-suppressant medication beyond the lower-cost ones the instruction names
• Severe hearing loss or vision impairment where significant support is required
• Severe developmental disorders or cognitive impairments where significant support is required
• Major psychiatric illness or addiction where significant support is required
• Drug-resistant tuberculosis (MDR-TB or XDR-TB) without clearance by a New Zealand specialist

INZ announced the hepatitis change on 5 August 2026, noting that modern treatment costs sit well below the $81,000 threshold. The same update reworded several entries: major psychiatric illness or addiction is now listed only where significant support is required, and the autoimmune and renal or hepatic entries were clarified.

Medical waivers for residence

A residence applicant who fails the health standard but meets every other requirement of their category may be considered for a medical waiver, except where the instructions shut the door entirely. The instructions sort applicants into three groups:

Temporary visas and the narrower waiver door

Temporary entry runs on the same standard, assessed against the intended stay (hospitalisation, residential care or high-cost treatment during the visa period), with no dollar threshold. Screening scales with time:

The waiver door is nearly closed for temporary applicants. Only five classes can be considered at all:

• Seconded business personnel whose employer guarantees all medical costs
• Refugee and protection claimants
• Recognised refugees and protected persons
• Partners and dependent children of New Zealand citizens or residents staying to be with them
• Under-21 dependants of work or student visa holders caught only by the severe developmental disorder limb

Certificates, forms and the 36-month rule

Certificate age at lodgement

Under 3 months

Reuse of an assessed certificate

Under 36 months

X-ray exempt age

Under 11

Certificates are normally submitted electronically through an eMedical-linked physician or as paper forms, and must be less than three months old at lodgement, unless a certificate less than 36 months old was already assessed as meeting the standard in an earlier application, in which case it can generally be reused.

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