New Zealand Health Standard Update 2026: What AIP and BIV Applicants Need to Know

On 5 August 2026, Immigration New Zealand (INZ) issued Amendment Circular No. 2026-20, updating the health standard screening guidance for New Zealand residence applications — effective retroactively from 3 August 2026. The update applies across all pathways to New Zealand permanent residence, including New Zealand investment immigration (the Active Investor Plus Visa, AIP) and the Business Investor Visa (BIV).

This change doesn’t touch investment amounts, processing timelines, or any other core New Zealand investment immigration requirement — but for applicants or family members with certain medical histories, it’s genuinely good news.

The Basic Framework for New Zealand’s Health Standard

To successfully apply for New Zealand permanent residence — through any visa category — the applicant and all accompanying family members must meet the “acceptable standard of health.” Under INZ’s definition, meeting the standard means:

Not posing a danger to public health

Not being likely to impose significant costs on New Zealand’s health or special education services

Being able to perform the work or meet the requirements of the visa being applied for

Current medical cost threshold: if a health condition is likely to generate expected medical costs exceeding NZD 81,000, the applicant will be assessed as not meeting the health standard, unless granted a medical waiver.

INZ maintains a list, in section A4.10.1 of its Operational Manual, of conditions presumed by default to impose significant costs — and it’s precisely this list that Amendment Circular 2026-20 updates.

4 Key Changes Effective 3 August 2026

Change 1: Hepatitis B and Hepatitis C Removed From the List

Before: Hepatitis B and Hepatitis C were listed under A4.10.1, and applicants with either condition could face automatic refusal at the health screening stage.

Now: Both conditions have been removed entirely from the list and are no longer automatically treated as failing the health standard.

What this means in practice: This is the most significant of the four changes. Hepatitis B carrier rates in Hong Kong and across Asia are notably higher than in Western countries. Previously, many applicants or family members who fully met the financial and investment criteria were held up — or refused — at the health screening stage purely because of Hepatitis B. From 3 August 2026, these cases default back to the general standard: assessed on whether expected medical costs exceed NZD 81,000, rather than being refused automatically upon detection.

Note: removal from the list doesn’t mean a full exemption from review. If Hepatitis B or C has progressed to serious complications such as cirrhosis or liver cancer, INZ may still assess the case against the general medical cost standard — the difference is that it’s now a case-by-case assessment rather than an automatic refusal.

Change 2: A History of Psychiatric Hospitalisation No Longer Automatically Triggers Refusal

Before: A past hospitalisation for psychiatric illness was used as an automatic trigger for determining that an applicant imposed a significant burden on the health system.

Now: The reference to past hospitalisation as an automatic trigger has been removed from the guidance. INZ now only considers “major psychiatric illness and/or addiction where significant support is required” — i.e. a currently serious condition requiring substantial support, not a historical hospitalisation record.

What this means in practice: Applicants who were once hospitalised for anxiety, depression, or moderate mental health conditions — but are now stable and no longer require significant support — will no longer be automatically flagged as failing the standard. This reflects a more modern, humane approach to mental health assessment.

Change 3: Kidney and Liver Disorders Must Now Be Both Severe AND Chronic/Progressive

Before: Renal disorders and hepatic disorders were listed under A4.10.1, but without clearly defined severity thresholds.

Now: INZ has clarified that only kidney or liver disorders that are simultaneously severe AND chronic or progressive are treated as imposing a significant financial burden. Meeting only one of the two criteria is no longer sufficient for automatic refusal.

What this means in practice: Mild to moderate kidney or liver conditions — or ones that are stably managed and not progressing — will no longer trigger automatic disqualification. This matters especially for middle-aged applicants, who make up a large share of investment migration cases and are more likely to present with these conditions.

Change 4: Expanded List of Exempt Medications for Severe Autoimmune Disease

Before: Patients with severe autoimmune disease requiring immunosuppressant treatment could only claim exemption if using specific low-cost medications named on the list.

Now: INZ has added the phrase “or similar cost immune-suppressant medications” to the exemption list. This means patients on alternative medications with costs comparable to the listed drugs (Prednisone, Methotrexate, Azathioprine, Salazopyrin) can also qualify for the exemption.

What this means in practice: This resolves the problem of an overly rigid medication list — many cost-equivalent newer drugs have entered the market since the original list was compiled. Autoimmune patients stably managed on low-cost medication will no longer be refused simply because their specific drug wasn’t named.

What Hasn’t Changed

The rest of the A4.10.1 list remains unchanged: cancer, serious heart disease, progressive neurological conditions, severe vision/hearing impairment, and serious developmental disorders all remain on the list

The NZD 81,000 threshold is unchanged: even conditions removed from the list can still be assessed if expected medical costs exceed this threshold

Medical waivers still apply: applicants who don’t meet the standard can still apply for a medical waiver, with INZ weighing the applicant’s contribution to New Zealand, degree of reliance on the health system, and other humanitarian factors

Doesn’t apply to PR renewal cases: this A4.10 guidance doesn’t apply to existing permanent residents applying for a Permanent Resident Visa or a second or subsequent resident visa

What This Means for AIP and BIV Applicants

For the principal applicant: if you have Hepatitis B, a stable history of mental health treatment, or a non-severe, non-progressing kidney or liver condition, these are no longer automatic barriers to a New Zealand residence application from 3 August 2026.

For family members: spouses and accompanying children included in the same application must also pass health screening — all four changes apply to every family member, not just the principal applicant.

Important reminder: the updated list doesn’t mean medical examinations are skipped. Every permanent residence application still requires a full medical examination as required by INZ. What’s changed is how the results are assessed, not whether an examination is required.

How the Health Assessment Process Actually Works

Medical examination at a designated facility: the applicant and all accompanying family members must be examined by an INZ-approved panel physician; Hong Kong has several INZ-designated medical facilities, and results are submitted directly to INZ

Review by an INZ medical assessor: if any condition of note is identified, the case is referred to an INZ medical assessor for detailed review, applying the updated A4.10.1 criteria

Assessment outcome: three outcomes are possible — meets the health standard, doesn’t meet it but may be considered for a medical waiver, or doesn’t meet it and isn’t granted a waiver

Medical waiver (if needed): for cases that don’t meet the standard, INZ considers the overall application — including the applicant’s economic contribution to New Zealand — which particularly benefits large-scale AIP or BIV investment cases

To see whether your own or a family member’s health condition benefits from this update, review New Zealand’s Active Investor Plus visa details for the full requirements; applicants considering New Zealand residence via business investment can also see an overview of the Business Investor Visa (BIV).