Background

As of late 2025, Australia's resident population is approaching 28 million people, and includes more than 2.9 million temporary residents. Department of Home Affairs data show there are currently (November 2025) 736,000 New Zealand (NZ) citizens (who can enter Australia on special category visas (SCV) - 444 visas), 405,000 people on bridging visas, 634,000 international students, and more than 532,000 work and temporary graduate visa holders. These populations are working age, and also reproductive age, and there are increasing numbers of non-resident children born in Australia, or migrating with their families.

Most of these cohorts will not have Medicare access and are not part of reciprocal health care agreements (RHCA). While health insurance is recommended for all temporary residents, and may be required for some temporary visas, such as student visas, in reality, gaps are common, especially for children. This guideline is intended to provide a brief overview of healthcare, disability service and education access for non-resident children in Victoria, and recent changes to migration law affecting family applications for permanent residency, and NZ citizens' applications for Australian citizenship. See separate guidelines for asylum seekers.

Healthcare access

Medicare eligibility

Medicare eligibility is governed by the Health Insurance Act 1973, and generally restricted to people who are permanently residing in Australia, who are either:

• Australian citizens or permanent visa holders - in which case the Medicare card is green with an expiry date of 10 years.
• NZ citizens, or in certain circumstances, applicants for permanent residence visas - in which case the Medicare is blue, and has an expiry date that is linked to their visa expiry date (or a maximum 3 years).

Reciprocal health care arrangements

Australia has reciprocal health care agreements (RCHA) with 11 countries: Belgium, Finland, Ireland, Italy, Malta, Netherlands, New Zealand, Norway, Slovenia, Sweden and the United Kingdom. Arrangements for student visa holders, care outside of hospitals and medication access vary for these countries (check country details). For individuals with RCHA Medicare, the Medicare card is yellow, or individuals can show their passport at public hospitals. 

Private insurance arrangements

All visitors to Australia are recommended to make their own arrangements for private health insurance, and temporary visa holders may be required to hold adequate health insurance as a condition of their visa grant (see condition 8501 for list of visas). International students and their dependents (including spouses and children) are required to have overseas student health cover (OSHC) for the duration of their study in Australia.

Victorian hospital and healthcare costs for Medicare ineligible patients

Victorian hospitals are directed to set their own fees for patients who are not covered by Medicare, although the Department of Health (DH) provides guidelines on charges.

Disability supports

The NDIS has residence requirements, and is only available for citizens, permanent residents or protected SCV holders (arrival before 26 February 2001). Alternative pathways for disability support for non-residents are available in Victoria as follows:

• Age 0-6 years/school entry - early childhood intervention is available through the Department of Education Early Childhood Intervention Services - Continuity of Support (ECIS-CoS) Program, announced in the 2017-18 Victorian Budget. The process for non-resident children is to i) apply for NDIS through their local ECP, ii) confirm they not eligible for NDIS (through application to NDIS and  formal rejection), and iii) progress the ECIS-CoS application with ECP assistance. In practice we have found advice from ECP has been variable, and it is helpful to explain the 3-step process to families ahead of time. Inquiries - eciscos@education.vic.gov.au.
  
  
• Age 5-65y - there is a small program to support people who are ineligible for NDIS under the Disability Act, 2006. This program is called VIN-CoS (Victorians Ineligible for NDIS, Continuity of Support) and is run through Statewide Disability Services, Department of Families, Fairness and Housing (DFFH). VIN-CoS is only available if there are no other options for support, and is not available for student visa holders. For school-aged children, the program will assess what services are in place (i.e. through school) and if there are service gaps. VIN-CoS has access and eligibility criteria (against the Disability Act, 2006) and all alternative funding/supports need to be explored/exhausted prior to submitting a request. See Registration and Request form, and Consent form - email VINCOS.enquiries@dffh.vic.gov.au (as of 2023).
  

Other - the Victorian Statewide equipment program (SWEP) provides subsidised funding towards the cost of assistive equipment - see eligibility criteria. SWEP also has a re-issue program - which can be accessed by SWEP registered prescribers (either physiotherapists or occupational therapists). Purchase of re-issue equipment may be possible, and support from charities like MAD can assist with cost. 

Education access

The Victorian Department of Education international student program provides policy, guidance and outlines fees by visa type. For students on bridging visas - fee status ties to the visa they held immediately prior to bridging visa grant. Increasingly we have seen overseas-born non resident children who have missed long periods of school due to being unable to afford school fees. Also see Education Services for Overseas Students Act 2000. Contact details International Education Division on 03 7022 1000, or at international@education.vic.gov.au. 

Permanent residency and citizenship applications

There are two major recent changes to visa and citizenship applications with direct applicability to paediatric care. 

Special consideration for children born and usually resident in Australia - came into effect from October 2024, so children born and usually resident (spending >50% of their time) in Australia to non-resident parents, and who do not meet the health requirement of the Migration Act. do not need to apply for special consideration. These children can be granted a health waiver (their health conditions or disability will not affect their families' permanent residence application).

Overseas-born children in families applying for permanent residency (PR) still need to meet the health requirements of the Migration Act, including the significant cost threshold (SCT). The SCT is currently set at $86,000 over 5 years, a shorter period of 3 years is used for applicants 75 years and older. If estimated healthcare costs are assessed to be above the SCT, individuals will not meet the health requirement and will not be granted a PR visa.

Changes for New Zealand citizens applying for Australian citizenship. NZ citizens can enter Australia on special category visas (SCV) or 444 visas. From July 2023, NZ citizens holding a 444 visa living in Australia for 4 years or more became eligible to apply directly for Australian citizenship (without needing permanent residency first). These changes also mean any child born in Australia on or after 1 July 2022 to an SCV holder may automatically acquire Australian citizenship at birth (also see citizenship certificates).

Other notes

New Zealand-Australia migration

NZ citizens with a valid NZ passport do not need to apply for a visa before coming to Australia. They are granted a Special Category visa (subclass 444)(SCV) on entry to Australia. The 444 visa allows them to stay indefinitely, study and work, with access to Medicare, and some Centrelink payments. 

• NZ citizens are only eligible for full Centrelink or the NDIS if they are a protected SCV holder (in Australia on 26 Feb 2001 with an SCV, so minimum age is 24 years).
• SCV holders arriving after 2001 do not have access to the NDIS as they are not considered permanent residents.
  
• Non protected SCV holders are eligible for some Centrelink payments, including neonatal supplements, single parent supplements, childcare subsidy, family tax benefit and a healthcare card (without waiting periods). They are not eligible for carer allowance/payment. 

Pacific Australia Labour Mobility (PALM) Stream

The Pacific Australia Labour Mobility (PALM) stream enables workers from Pacific countries to fill specified roles (typically agricultural) in regional and rural Australia. PALM visas are either 9 months (seasonal short term) or 4 years (long term). The scheme started in April 2022, although there is a longer history of similar programs.

• Employers must be approved by the Department of Employment and Workplace Relations (DEWR) to hire workers from participating countries.
  
• Countries participate in the PALM scheme by entering into a memorandum of understanding (MOU) with Australia. Participating countries are Fiji, Kiribati, Nauru, Papua New Guinea, Samoa, Solomon Islands, Timor-Leste, Tonga, Tuvalu and Vanuatu.
• Applicants must be 21 years and older, and hold health insurance, they must be sponsored by an employer and be endorsed by the Australian Government.
  
• There is currently no pathway to PR for PALM visa holders, although they are able to apply for a protection visa. 

Multiple concerns have been raised around aspects of the scheme, including the impact on labour force in source countries and lack of skill development. Other concerns include poor working conditions, debts to recruiting agencies, that workers cannot initiate a workplace transfer, and the impact on family - long-term PALM visa holders can only bring family members with employer approval, short term visa holders are not permitted to bring family with them. The Australian Anti-Slavery Commissioner has recently (Oct 2025) raised concerns over the removal of minimum hours guarantee for these workers.

^{Immigrant health clinic resources, Author Georgie Paxton, November 2025, Contact: georgia.paxton@rch.org.au}