| Health policy changes effective 28 November 2005: FAQs
Tuesday, November 01, 2005
General questions about the new health policy What are the new health requirements?
The main changes to the health screening requirements which take effect in November are: the definition of an Acceptable Standard of Health will be based on significant costs and demand thresholds for public funded health and special education services
all people intending to stay in New Zealand for longer than 12 months will be required to provide a Medical and Chest X-ray Certificate (NZIS 1007). Why are the health requirements changing?
The aim of the policy is to protect public health and minimise the costs and demands of immigration on New Zealand’s health and special education services and to do so without discouraging potential migrants. What are the benefits to New Zealand of introducing these changes?
There are potential long-term cost savings to New Zealand’s health and education services. Do the changes affect existing permanent residents?
No. Do the changes affect people who are currently in New Zealand on a temporary permit (work, student or visitor’s permit)?
Once the changes have been implemented, they will affect people extending their stay beyond 12 months who have not already supplied a medical certificate within the last 24 months. Who is exempt from the health requirements?
Temporary entry policy allows some visitors to enter New Zealand for medical treatment or medical consultation. Such applicants are exempt from the requirement to be of an acceptable standard of health. Questions about the Medical Certificate and the medical examination Which Medical and Chest X-Ray certificate should applicants use?
Applicants should use the form Medical and Chest X-Ray Certificate (NZIS 1007), dated August 2005. From 28 November 2005, only the new certificate will be accepted. If an applicant completes a copy of the Medical and Chest X-Ray Certificate dated March 2005, it will be accepted only if the application is lodged before 28 November 2005. What will happen if an applicant completes an old Medical & Chest X-Ray Certificate dated March 2005 and lodges the application on or after 28 November 2005?
The application and any application fee enclosed will be returned to the applicant, who will be asked to complete a new certificate (NZIS 1007 August 2005). Who needs to complete a medical?
Anyone intending a stay in New Zealand of more than 12 months must include a fully completed Medical and Chest X-Ray Certificate (NZIS 1007) that is less than three months old. However, if the applicant is applying for a temporary stay in New Zealand and has provided a medical certificate as part of a previous application for temporary entry in the 24 months before their current application, they can provide details of the previous application to Immigration New Zealand. Immigration New Zealand may consider this to be sufficient, or may ask the applicant to complete a new medical certificate.
Immigration New Zealand may, in some cases, request a medical certificate from applicants intending to stay less than 12 months.
Pregnant women and children under 11 years of age are not required to have an X-ray examination, but do have to complete a medical examination. If an applicant submits a Medical and Chest X-Ray Certificate completed outside of New Zealand as part of an application for temporary entry, and later submits a residence application when they are in New Zealand, do they have to complete another examination?
Applicants for residence must provide a Medical and Chest X-Ray Certificate completed in the last 3 months. How much did a medical examination cost, and how much does it cost now?
The cost of the examination is set by the Medical Examiner conducting the examination.
Why is it more expensive now than it was before?
The cost of the examination is set by the Medical Examiner conducting the examination. Some extra tests are required by the new form.
Does Immigration New Zealand specify at which lab or hospital the blood tests have to be processed?
No. The Medical Examiner will use their own laboratory processes to analyse blood tests. The applicant may be referred to a reputable laboratory service of the Medical Examiner’s choosing and recommendation. What blood tests does an applicant have to undergo?
An applicant is required to do the following mandatory blood tests: HIV 1 and 2
Hepatitis B surface antigen test
Syphilis
Liver function tests
Full blood count
Serum Creatinine
The applicant may be required to undergo further tests should the Medical Examiner consider that there is a clinical indication for them. The tests may include, and are not limited to: Hepatitis C antibody test
Fasting lipids
Fasting glucose
HBA1c
Trypanosoma cruzi antibody test
Immigration New Zealand reserves the right to ask for whatever documentation is needed to enable the case officer to come to a decision on an application. How does an applicant make an appointment for a medical examination?
The applicant may contact their preferred medical practitioner or Panel Doctor to set up an appointment. Who can perform the Medical Examination?
Applicants outside of New Zealand should look at our list of approved Panel Doctors who can perform their medical examination, or consult the nearest Immigration New Zealand branch for details of their nearest Panel Doctor. For countries with no Panel Doctors, a registered or board certified or licensed medical practitioner or physician may conduct the medical examination. In this case, Immigration New Zealand may require evidence of the examining physician’s registration and qualifications. Within New Zealand, any registered medical practitioner holding a current annual practising certificate issued by the New Zealand Medical Council may conduct the medical. What preparations are required prior to the medical examination?
The applicant may be required to fast or temporarily discontinue some medications in preparation for the medical examination. Applicants that may be required to do a fasting blood test include: males over 45 years of age,
females over 55 years,
overweight,
hypertensive (on and off treatment) and
applicants with risk factors in their personal or family histories such as premature cardiovascular disease, diabetes or hyperlipidaemia.
The Medical Examiner will advise the need for the test. In some circumstances a repeat specimen may be advisable. Applicants travelling significant distances to Medical Examiners should consider whether they may be required to give a fasting blood specimen. Can a photocopy of the Medical Certificate be used instead of a printed one?
Yes, a photocopy of the Medical Certificate can be used for the medical examination. The applicant must ensure that the photocopy is clear and legible. However, the applicant must not submit a photocopy of the completed and signed examination to Immigration New Zealand. Where can applicants obtain the forms they need to complete?
The most recent versions of forms are available to download here. Alternatively, applicants or doctors can contact the nearest Immigration New Zealand branch for a form. Does the Medical Examiner need to send the completed medical certificate in a sealed envelope to Immigration New Zealand, or is this the responsibility of the applicant?
The doctor should put the completed medical into the envelope and give it to the applicant directly. The applicant is responsible for sending the certificate to INZ. Does the applicant need to send the X-ray film to Immigration New Zealand?
No, not usually. However, if the radiologist has noted an abnormality on the X-ray the applicant should submit the X-ray film along with the certificate to Immigration New Zealand. The applicant is responsible for submitting the X-ray film if the Immigration New Zealand Medical Assessor requests it. Questions about the Acceptable Standard of Health What is an ‘Acceptable Standard of Health’?
On 28 November 2005, when the new policy takes effect, the assessment criteria for medicals will change and an acceptable standard of health will be re-defined to mean someone who is: unlikely to be a danger to public health
unlikely to impose significant costs or excessive demands on New Zealand’s health or special education services
able to perform the functions for which they have been granted entry. How can an applicant tell if they have an acceptable standard of health?
By completing a medical examination. If the applicant is applying for residence, they should firstly look at the list of conditions under Appendix 10 of the new policy. These conditions are deemed to impose significant costs and/or demands on New Zealand’s health and/or education services. What main areas will be considered by the Medical Assessor in evaluating whether an applicant’s standard of health is acceptable?
The role of the Immigration New Zealand and Ministry of Education Medical Assessors is to provide opinion(s) to a Visa/Immigration Officer regarding: whether an applicant is likely to be a danger to public health
whether an applicant has a condition that is likely to exceed cost or demand thresholds
whether an applicant is able to undertake the work or study that is the basis for their application Who decides whether an applicant can undertake the work on the basis of which they are applying?
When the applicant has a medical examination, the Medical Examiner passes the information onto Immigration New Zealand. Immigration New Zealand makes the decision as to whether the applicant is able to undertake the work on the basis of which they are applying, and whether they have an acceptable standard of health, taking into account the opinion of the Immigration New Zealand Medical Assessor or the Ministry of Education. If an applicant is healthy and has an acceptable standard of health, but another member of their family does not, will the principal applicant be granted residence?
If any of the family members included in the application do not have an acceptable standard of health, the whole application will be declined. What happens if I want to challenge the Medical Assessor’s opinion that I do not have an acceptable standard of health?
If an applicant does not have an acceptable standard of health in the opinion of the Medical Assessor, the applicant will be informed before the application is declined. The applicant may then wish to provide more information or another medical opinion. If the Medical Assessor is still not satisfied that the applicant has an acceptable standard of health, an opinion from a second Medical Assessor will be sought by Immigration New Zealand. This opinion will be considered final. Questions about the cost and demand threshold What is considered a significant cost for residence applications?
A significant cost is considered to be $25,000 over four years for acute conditions or $25,000 over the predicted course of a chronic recurring condition. Some of the medical conditions deemed to impose significant costs and/or demands on New Zealand’s health and/or education services are listed in Appendix 10 of the new policy. NOTE: Those conditions deemed to impose significant costs and/or demands on New Zealand’s health and/or education services apply to applications for residence in New Zealand. An applicant may have a condition listed in Appendix 10, but this does not mean that they cannot come to New Zealand temporarily. Immigration New Zealand will assess the likelihood of such an applicant needing medical treatment (such as hospitalisation, high-cost pharmaceuticals, residential care or high-cost disability services) during their period of intended stay. What are the conditions listed in Appendix 10?
Appendix 10 contains the schedule of high cost and high demand conditions. This is what Appendix 10 of the new health policy says: Appendix 10: Medical conditions deemed to impose significant costs and/or demands on New Zealand’s health and/or education services HIV infection
Hepatitis B surface antigen positive, with abnormal liver function
Hepatitis C, RNA positive, with abnormal liver function
Malignancies of solid organs and haematopoietic tissue, including past history of, or currently under treatment
Exceptions are:
a) treated minor skin malignancies (not melanoma)
b) malignancies where the interval since treatment is such that the probability of cure is > 90%, e.g.: early stage (I & IIA) breast cancer at 5 years; low risk prostate cancer at 5 years; early stage (Dukes A & B1) colorectal cancer at 5 years; childhood leukaemia at 5 years
Solid organ transplants, excluding corneal grafts more than 6 months old
Chronic renal failure or progressive renal disorders
Diseases or disorders such as osteoarthritis with a high probability of arthroplasty in the next four years
Central Nervous System disease, including motor neurone disease, complex partial seizures, poorly controlled epilepsy, prion disease, Alzheimer’s and other dementia, and including paraplegia and quadriplegia
Cardiac disease including ischaemic heart disease, cardiomyopathy or valve disease requiring surgical and/or other procedural intervention
Chronic obstructive respiratory disease with limited exercise tolerance and requiring oxygen
Genetic or congenital disorders: muscular dystrophies, cystic fibrosis, thalassaemia major, sickle cell anaemia if more than one sickle crisis in 4 years, severe haemophilia, and severe primary immunodeficiencies
Severe autoimmune disease, currently being treated with immuno-suppressants other than prednisone
In a person up to the age of 21 years, a severe (71-90 decibels) hearing loss or profound bilateral sensori-neural hearing loss
In a person up to the age of 21 years, a severe vision impairment with visual acuity of 6/36 or beyond after best possible correction, or a loss restricting the field of vision to 15-20 degrees
In a person up to the age of 21 years, a severe physical disability, where they are unable to stand and walk without support, and cannot independently dress, eat, hold a cup, or maintain their stability when sitting. Will residence be granted if the applicant is diagnosed with HIV, Hepatitis B, or any other medical condition on the schedule of high cost and high demand conditions (Appendix 10)?
Applicants who have any of the conditions listed in Appendix 10 will be deemed to have an unacceptable standard of health. However, they may be considered for a medical waiver. What will happen if an applicant does not include on their application a partner or dependent child who has a medical condition which is deemed to impose excessive costs and demands on New Zealand’s health and education services?
If that partner or dependent child applies to join the applicant in New Zealand later, any consideration of a medical waiver will be assessed as if their partner or family member were not resident in New Zealand. What if an applicant has a medical condition that is above the cost threshold, but can prove that they will use private healthcare?
There is no provision for people to “opt out” by paying for medical insurance for pre-existing conditions. What are high-cost pharmaceuticals?
Whether a pharmaceutical or a group of pharmaceuticals is considered to be high cost will be assessed on a case-by-case basis. The applicant’s usage of a pharmaceutical (for example the volume and frequency of use) will be taken into consideration, as will the current cost of the pharmaceutical. Questions about medical waivers Who qualifies for a medical waiver?
To be considered for a medical waiver, an applicant for residence must first have been assessed as having an unacceptable standard of health. The applicant must meet all other requirements for approval under the relevant category to be considered for a medical waiver. An applicant will not qualify for a medical waiver if they: require dialysis treatment, or if the medical assessor indicates that the applicant may need dialysis treatment within four years after the date of the medical assessment
have active pulmonary tuberculosis (TB)
have severe haemophilia
have a physical incapacity that requires full-time care.
Medical waivers may also not be granted to people applying for residence under Family Category policy who were eligible to be included on an earlier application as the spouse, partner or dependent child of a principal applicant and they were not included on that application. Are Long Term Business Visa applicants and other temporary entry applicants eligible to apply for a medical waiver?
LTBV applicants are temporary entry applicants. Temporary entry applicants will only be considered for a medical waiver if they are applying for visas or permits as seconded business personnel, or
they have submitted a claim for refugee status in New Zealand, or
they are the partner or dependent child of a New Zealand citizen or resident, and
the purpose of their stay is to be with that citizen or resident, AND
if they were applying for residence they would meet the category specific criteria. Where do I go for more information?
In New Zealand (outside of Auckland) you can telephone, free, our call centre on 0508 558 855. If you are in the Auckland region, telephone 914 4100. Our hours of operation are 0700-1900 Monday to Friday. Alternatively, you can contact your nearest Immigration New Zealand branch. |
