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Highlights:
  • In Australia, the ‘significant cost threshold’ for immigration health requirements is currently $86,000 over 10 years.
  • Although some types of visas, such as a couple’s visa, allow for applicants to seek a ‘medical waiver’ the process is long and complex.
  • An attorney from the HIV/AIDS Legal Centre warns that people with HIV are often rejected without being properly informed of their legal rights or alternatives.
When Carlos Araya Perez arrived in Australia in 2018 from Chile with an industrial engineering degree and a postgraduate visa, he hoped to improve his English, find a fulfilling job and grow professionally.

“I had lived in Ireland for a year and wanted to continue travelling. Among the options I looked for was Australia. I wanted something that aligned with my profession and would give me more opportunities,” Perez told SBS Spanish.

Carlos Araya Perez.jpeg

Carlos Araya Perez arrived in Australia in 2018 from Chile. Credit: Supplied by Carlos Araya Perez

But when he arrived, his lack of local experience and contacts led him away from the engineering field and into informal employment.

After the COVID-19 pandemic hit, Perez says he was out of a job and out of savings, living without benefits at a friend’s studio.
It was then that a HIV diagnosis made his situation even more precarious.
HIV, or human immunodeficiency virus, is a virus that attacks the body’s immune system, and can lead to AIDS if untreated.
“It was the icing on the cake, but I saw it as an opportunity to grow,” he said.

“I am resilient, and from the first week I felt like it was something I couldn’t change. I focused on what I could do: take care of my health and change my perspective on myself.”

He began his treatment through a compassionate access program, albeit with a level of uncertainty.

“I was concerned about access to medication. It wasn’t free, and the program was renewed from time to time. That insecurity scared me the most.”

What is the ‘significant cost threshold’?

What Perez didn’t realise initially was that his diagnosis would have migratory consequences.

When he applied for permanent residency, he discovered that his medical condition would exclude him because he exceeded the government’s ‘significant cost threshold’ of $86,000 over 10 years.

Image by Michal Jarmoluk from Pixabay.jpg

According to Vikas Parwani, a lawyer at the HIV/AIDS Legal Centre, there is a lack of information about visa options for migrants with chronic health conditions.

“The cost of HIV was estimated at approximately $11,000 per year (by a Medical Officer of the Commonwealth). Across 10 years, that’s $110,000. That exceeds the limit and is a reason to refuse a permanent visa,” he explained.

The threshold, which is reviewed biannually, was increased from $51,000 to $86,000 in July 2024.

“The Australian Government administers the health requirement to protect the community from public health and safety risks, contain public expenditure on health care and community services, and safeguard the access of Australian citizens and permanent residents to health care and community services in short supply,” a Home Affairs spokesperson said.

The spokesperson said having a health condition does not always mean an individual will not meet the health requirement due to significant costs, and the “majority” of visa applicants who are required to undertake Immigration Medical Examinations meet the health requirement.
“The estimated costs are based on the health care and community services a hypothetical person with the same condition and level of severity as the visa applicant would require while in Australia.”

Learning this, Perez chose to extend his student visa, while seeking alternatives.

An ‘intrusive’ process

That’s when his Australian boyfriend proposed to sponsor him for a partner’s visa, and Perez began the process of applying for a medical waiver.
He said he had to gather letters of support, demonstrate economic stability and present compassionate reasons.
“They asked me for letters from friends, from family members, from organisations where I volunteer. I had to prove that I wouldn’t burden the system,” he said.
“It was a super-intrusive process … it makes you question why you want to stay in a country that treats you like that.”
According to Vikas Parwani, a lawyer at the HIV/AIDS Legal Centre who handled Perez’s case, many migrants with chronic health conditions are left out of the system due to lack of information and the complexity of the process.

“Carlos was lucky to be able to apply for a couple’s visa, which does allow for a waiver. For other people with Carlos’s condition, a waiver is often not even offered.”

According to a Home Affairs spokesperson, “the decision to limit health waiver provisions to certain visas is in recognition that waiving the need to meet the health requirement can have significant implications for Australia’s health care and community services.”
Parwani said Perez’s social ties, community work, income shared with his partner and compassionate care that his partner provides weighed heavily to build a “strong case”.
“Although we (the HIV/AIDS Legal Centre) have a high success rate, the process is not easy. A lot of personal and medical documents are required, and it can take years,” he said.
“Not all lawyers know how to do this. And there are a lot of people who can’t afford private counsel or access free help.”
According to the HIV/AIDS Legal Centre, over the past four years, it has provided around 508 legal services related to health waivers, including direct representation for at least 59 clients navigating the waiver process.

The centre said all clients who reached the health waiver stage during this period were successful. However, in earlier years, success rates were lower — particularly when the significant cost threshold was set lower than it is today.

Approval and a fresh start

In May 2025, Perez received the news he had been waiting for: the waiver was approved and he was granted a temporary partner visa.

At the end of the year, he can apply for permanent residency.

I was super-happy and felt a lot of relief. As the process took so long, it was about a week before it sunk in.

Carlos Araya

“This was the most difficult visa to obtain. The next one, in theory, is automatic. I just have to prove that my relationship is still genuine. But you have to send photos, letters, joint accounts … all over again,” he said.
Perez now works for Living Positive Victoria, a non-governmental organisation that supports people with HIV.
He guides newly diagnosed migrants, and promotes access to information and connection networks.
“Connecting with other migrants, speaking from a shared experience, helps you feel less alone. We often feel responsible, but if the same thing happens to all of us, maybe the system is the one that has failed,” he said.

“If you’re going through the same thing and don’t know what to do, don’t be afraid to ask for help. There are communities and organisations that we are here to support.”

People seeking support in the event of a crisis can contact Lifeline at 13 11 14, Suicide Call Back Service at 1300 659 467 and Kids Helpline at 1800 55 1800 (for young people up to 25 years old).
More information and mental health support are available at beyondblue.org.au and 1300 22 4636.
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