Health screening is a standard part of New Zealand's immigration process. INZ requires health checks for two broad reasons: to protect public health by screening for communicable diseases like tuberculosis, and to assess whether an applicant's health conditions are likely to place significant or ongoing demands on New Zealand's publicly funded health services.
When You Need a Medical Examination
Most applicants for visas of more than 12 months' duration need a medical examination. This includes all residence visa applicants (Skilled Migrant, Accredited Employer Work Visa holders applying for residence, family-based residence, and partnership visas), as well as applicants for work or student visas with an intended stay of 24 months or more. Visitor visa applicants generally don't require a medical unless INZ specifically requests one based on their country of origin or the planned duration of stay.
Each person included in the application — including dependent children — must individually meet the health standard. A health concern with one family member cannot be resolved by excluding that person from the application; if the concern affects their ability to meet the standard and no waiver applies, it affects the whole application.
INZ will tell you whether a medical is required when you apply. Don't get one speculatively before you know it's needed.
The Examination Process
Who Conducts the Examination
You cannot use your own general practitioner for an immigration medical. You must use an INZ-approved panel physician — a doctor specifically approved and trained to conduct immigration health assessments and submit results in the required format. The list of approved physicians is available through the INZ website and at panelphysicians.com. Panel physicians are available in New Zealand and in most countries where significant numbers of applicants come from.
Most examinations are now processed through the eMedical system, which allows your panel physician to submit results directly to INZ electronically. This is faster and reduces the risk of documents being lost or delayed.
What the Examination Involves
A standard immigration medical includes a physical examination, a review of your medical history, a chest X-ray (required for applicants aged 11 and over), and blood tests. The specific blood tests vary depending on your age, health history, and country of origin but typically include tests for HIV and other conditions. The physician will ask about your medical history and any ongoing conditions or medications — answer honestly and completely, as non-disclosure of a known condition is treated as misrepresentation.
If you have a known condition, bring relevant specialist letters, treatment records, and medication lists to the appointment. This context helps the physician complete their assessment accurately and can support a more favourable assessment by demonstrating that a condition is well-managed.
Cost and Validity
Medical costs are your responsibility and are not reimbursed by INZ. Expect to pay between NZ$350 and NZ$600 in New Zealand, depending on the physician and the tests required. Costs in other countries vary significantly. Additional specialist tests — for example if your chest X-ray shows something requiring follow-up — will add to the total.
Most medical results are valid for 36 months from the date of examination. This is long enough that timing your medical relative to your application lodgement is rarely a strategic concern. The exception is if INZ requires updated results because your earlier medical showed something requiring monitoring, or if your application takes an unusually long time to be decided.
How INZ Assesses Your Health
The standard INZ applies is whether you meet an "acceptable standard of health." This has two main components.
Communicable Disease
Active tuberculosis is the most significant communicable disease concern. A positive chest X-ray for active TB will prevent a visa from being granted until the TB is treated and confirmed as inactive. Latent or previously treated TB is assessed differently — the fact you had TB in the past does not automatically disqualify you, but INZ will want evidence of treatment completion and clearance.
If your chest X-ray is flagged as abnormal, you'll be referred for further investigation before a result is lodged with INZ. This can add weeks to the process.
Healthcare Cost Assessment
INZ assesses whether your condition is likely to impose significant costs on New Zealand's publicly funded health system over a five-year period. There is a defined cost threshold in immigration policy — conditions whose expected costs exceed that threshold are treated as failing the acceptable standard of health. This is an actuarial exercise: INZ considers the nature of the condition, the likely treatment required, and what that treatment costs in the New Zealand context.
Conditions that commonly attract this scrutiny include chronic conditions requiring ongoing specialist care or medication (kidney failure requiring dialysis, conditions requiring transplants, some cancers), conditions requiring intensive disability support services, and conditions where the long-term cost burden on the health system is likely to be substantial.
Importantly, this assessment is about projected future costs — not your current level of health. Someone who is currently well but has a condition that is expected to deteriorate and become expensive may be assessed as not meeting the standard even if they feel fine today.
What Doesn't Disqualify You
Many common health conditions do not cause health-standard issues. Well-managed diabetes, controlled hypertension, depression or anxiety managed with medication, a history of cancer with no current signs of recurrence — these are not automatic problems. HIV-positive status, which historically was treated very restrictively, is now assessed on the same cost-and-risk framework as other conditions; someone with HIV who is on effective antiretroviral treatment and whose condition is well-managed may meet the health standard.
Mental health conditions are individually assessed. A history of mental illness that is stable and well-treated is generally not disqualifying. Active, severe conditions that require intensive or long-term residential treatment are assessed differently.
Waivers
If INZ determines you don't meet the acceptable standard of health, you may be able to apply for a waiver. Waivers are discretionary — there is no right to one — and are assessed against factors including the nature and severity of the condition, the potential costs to the health system, any humanitarian or compassionate factors, and the overall contribution you and your family would make to New Zealand.
Waivers are more likely to be granted when the cost concern is borderline rather than severe, where there is strong humanitarian reason (family reunification, for example), or where you can demonstrate that private health insurance or other arrangements will substantially offset public costs. They are rarely granted where the projected costs are significantly above the threshold or where there are public health risks involved.
If you're in a situation where a waiver might be relevant, get specialist immigration advice before your application is lodged. The way health information is presented and contextualised can affect both the initial assessment and any subsequent waiver consideration.
Preparing for Your Appointment
Gather your medical records before attending — particularly if you have a known condition. This means specialist letters, treatment summaries, recent test results, and a current medications list. You don't need to bring everything, but relevant documentation helps the physician complete their assessment accurately.
You are entitled to request a physician of a particular gender if that matters to you. You can also bring a support person.
After your appointment, confirm with the physician that your results have been submitted to INZ through eMedical. Keep copies of any reports given to you. If follow-up tests are required, attend them promptly — delays in completing the medical process delay your entire application.
Frequently Asked Questions
My condition isn't serious — do I still need to disclose it?
Yes. The examination form asks about your health history completely, not just conditions you consider serious. Failing to disclose a known condition — even one that would not affect your application — is treated as misrepresentation if INZ discovers it later, which is far more damaging than the condition itself.
What if INZ's medical assessor gets it wrong?
You can provide additional specialist reports and evidence to challenge or supplement the assessment. INZ medical assessors consider new information you provide. If the health-related decline leads to a visa refusal, some appeal options may be available depending on the visa type.
Can I get health insurance to offset the cost concern?
Having private health insurance can be a factor in a waiver application, but it doesn't remove the health standard requirement or automatically resolve a failed medical. It's one consideration among several, not a solution in itself.
Will a health condition affect my children's applications?
Children are individually assessed. A health condition affecting one child doesn't automatically affect other family members' applications, but if a child doesn't meet the standard and no waiver is granted, it will affect the family application as a whole.
Concerned about a health condition and how it might affect your visa? Find a licensed immigration adviser who can help you understand your options before you apply.