Australian 457 Visa Insurance Requirements

By Liisa Vexler

Health insurance for travel visa457 Visa Insurance for Temporary Relocation to Australia

For those who want to move to Australia temporarily, a popular option is the Temporary Work (Subclass 457) visa. This visa allows skilled workers to enter the country for up to four years for full-time work. It also allows for the skilled worker to bring their family dependent’s to Australia as well. Dependents are then able to work or study while in the country.

The visa allows for Australian employers to sponsor overseas skilled workers and is the most common way for employers to bring qualified international workers into the country. This type of visa is also popular because there is a possibility of gaining permanent resident status in Australia after being a visa holder for a certain period of time and meeting certain specifications.

One of the requirements of the 457 visa is to purchase and provide proof of independent health insurance. In Europe, the Schengen Visa insurance requirements are similar. The need to purchase health insurance is easy to understand – it is a requirement and it protects you. At the same time it protects the government from having to care for large numbers of uninsured international workers.

For the applicant, it is good to have a basic understanding of how healthcare works in Australia. There are two components of the Australian healthcare system. The first is a universal health care system, administered by the Australian Government, called Medicare. The second is the private health system. Learn more about Health Care in Australia.

Insurance and 457 Visa Applicants

Before entering Australia, all 457 visa applicants need to purchase health insurance that will cover them and any dependents with them for the time they will be in the country. Insurance can be purchased from either an Australian insurance provider or an overseas provider. All health insurance must meet the Department of Immigration and Border Protection (DIBP) requirements for the visa (Details Below).

All visa applicants are required to provide a letter or a certificate indicating that they have purchased sufficient health insurance. If family members are applying separately, they must provide their own evidence.

To learn more about the Temporary Work (subclass 457) visa and the visa requirements, visit the website of the Australia Department of Immigration and Border Protection, www.border.gov.au.

457 Via Insurance Requirements: Benefits at Least Equivalent To

a) Public hospital – admitted patient treatment, a benefit equal to the State and Territory health authority gazetted rates for ineligible patients for:

  • overnight and day only hospital accommodation (all costs including: all theatre, intensive care, labour wards, ward drugs);
  •  emergency department fees that lead to an admission;
  • admitted patient care and post operative services that are a continuation of care associated with an early discharge from hospital.

Note:  for the purpose of clarity this includes all admitted treatments covered by the Medicare Benefit Schedule.

b) Surgically implanted prostheses – no gap prostheses and gap permitted prostheses as listed in the Private Health Insurance (Prostheses) Rules 2007:  Benefit at least equal to 100% of minimum benefit amount listed.

c) Pharmacy – all PBS listed drugs that are prescribed according to the PBS approved indications, that are administered during and form part of an admitted episode of care – a benefit equal to the PBS listed price in excess of the patient contribution.

Note:  For the purpose of clarity, this definition is intended to include the cost of PBS listed drugs administered post discharge – if they form part of the admitted episode of care.

d) Medical services – admitted medical services with an MBS item number – 100% of the Medicare Benefits Schedule fee, or less if the patient is charged less.

e) Ambulance services – 100% of the charge, that is not otherwise covered by third party arrangements, for transport by ambulance provided by, or under an arrangement with, a government approved ambulance service when medically necessary for admission to hospital, emergency treatment on-site, or inter-hospital transfer for emergency treatment.

Note:  For the purpose of clarity, this definition is intended to include inter-hospital transfers that are necessary because the original admitting hospital does not have the required clinical facilities.  It does not extend to transfers due to patient preferences.

Other Minimum Health Insurance Policy Features

f) Informed Financial Consent

Insurers will make available membership eligibility checking to hospitals to enable the provision of informed financial consent to members on admission.

g) Waiting periods

To comply with the minimum level of health insurance, the only waiting periods that maybe imposed are:

  • 12 months for pregnancy related conditions;
  • 12 months for pre-existing conditions applied in a way that is consistent with Section 75-15 of the Private Health Insurance Act 2007.
  • 2 months for psychiatric, rehabilitation and palliative care, regardless of whether or not the condition is a pre-existing.

h) Excluded treatments

To comply with the minimum level of health insurance, the only admitted patient treatments that may be excluded are:

  • Assisted reproductive treatments;
  • Elective cosmetic treatments;
  • Bone marrow and organ transplants;

Insurance policies may also exclude the following:

  • Treatment rendered outside of Australia including treatment necessary en route to or from Australia;
  • Treatment arranged in advance of the insured’s arrival in Australia;
  • Services and treatment which are covered by compensation and damages provisions of any kind

Note:  insurers are not required to exclude these treatments.   A decision to cover them is at the discretion of the insurer.

i) Global annual benefit limits

To comply with the minimum level of health insurance, the per person per annum, benefit must not be less than $1 million dollars.

j) Portability

To comply with the minimum level of health insurance, when determining waiting periods, insurers must recognize previous length of membership on a policy held with another Australian insurer that meets the minimum standards.  That is:

  • When transferring between Australian based insurers where the customer has been a member of the previous fund for greater than 12 months, waiting periods of no greater than 12 months will apply to the higher level of benefits.
  • When transferring between Australian based insurers where the customer has been a member of the previous fund for less than 12 months, any unserved waiting periods will need to be completed with the new fund and if increasing the level of cover or benefits, additional waiting periods of no greater than 12 months will apply to the higher level of benefits.  These waiting periods are served concurrently.

To comply with the minimum level of health insurance an insurer must agree to:

  • grant a member who seeks to transfer between Australian based insurers, continuity of cover for up to 30 days from the date they leave the previous insurer; and
  • provide members, who terminate their policy, with a clearance certificate, approved by the Department of Immigration and Border Protection, within 14 days of the date of termination or the date of notification of the termination, whichever is the later.

k) Buy out clauses

To comply with the minimum level of health insurance, a policy must not contain a buy out clause that has the effect of terminating the insurers liabilities in exchange for a pre-determined lump sum payment.

l) Arrears

To comply with the minimum level of health insurance an insurer will allow for acceptance of premiums for 60 days from the last financial date of membership without terminating the membership.  Insurers are not obligated to pay for treatments received during any arrears period until and unless the arrears are paid for the relevant period.

Buying a Qualified 457 Compliant Insurance Plan

Some insurance companies offer coverage specific to the 457 visa requirements. Minimum coverage may include in-hospital treatment, prescription medication and emergency ambulance transportation. Typically, more comprehensive insurance is also available.

As with all insurance purchases, it is important to adequately research and compare insurance options and plans. When you have examined all the options, it puts you in the position to purchase the plan best suited to your needs.

Countries with Reciprocal Health Care Agreements with Australia

There are some countries whose residents are covered for some essential medical treatment under the Australian Government’s Reciprocal Health Care Agreements.

Countries with Reciprocal Heath Care Agreements are New Zealand, the United Kingdom, the Republic of Ireland, Sweden, the Netherlands, Finland, Italy, Belgium, Malta, Slovenia and Norway.

While these Agreements mean that residents of these countries can get some essential medical treatment in Australia, the reciprocal agreement isn’t designed to replace private health insurance.

Residents of all other countries are completely responsible for their own health insurance. Health insurance is important to cover overseas visa holders for emergency and non-emergency health issues.