Printable version of fact sheet (PDF 296 KB)

What is the purpose of this health assessment?

The purpose of the assessment is to develop a detailed history and undertake a physical examination of the patient to identify immediate and long term health care needs and to initiate treatment. Patients can also be introduced to preventative health care in Australia, in particular immunisation, maternal and child health care and breast and cervical screening.

How can a patient be identified as eligible for a refugee and other humanitarian entrants health assessment?

This health assessment is a voluntary service and applies to refugees and other humanitarian entrants who are resident in Australia with access to Medicare services.

If the patient comes from a country which has a history of conflict and human rights violations, eg Sudan, Burma, Iraq, Afghanistan, Sri Lanka, they are likely to be from a refugee background. A country of asylum or transit, eg. Kenya, Jordan, Pakistan or Thailand can also suggest a refugee background. Patients from refugee backgrounds can also be identified by their visa number which indicates the category of Australia’s Humanitarian program under which they arrived – see fact sheet for visa details.

This information may also be provided by the settlement service if they refer the patient to the GP.

What proof is there that a patient is a humanitarian entrant and eligible for a health assessment?

A humanitarian entrant should be able to provide proof of their visa status and date of arrival or residence (date of visa grant). Doctors can check that a patient holds an eligible visa in one of the following documents:

• A travel card known as a Document for Travel to Australia (DFTTA);
• A travel document including a Passport, a Titre de Voyage or a Certificate of Identity;
• A Visa Evidence Card identified by the numbers PLO56 or M56 at the bottom of the card or
• A Permanent Resident Evidence ImmiCard

The date of entry to Australia is stamped in the patient’s travel document or card. The date of visa grant for Protection visas is printed on the visa label. Doctors may telephone Medicare Australia on 132 011, with the patient present (with their Medicare card), to check whether the patient is eligible for this health assessment.

What medical records do refugees and other humanitarian entrants have on them when they arrive in Australia?

Most refugees arrive in Australia with medical records provided at a departure health check. The Health Manifest which includes personal and health information and the Pre Departure Results form are provided to refugee and humanitarian entrants and the HSS settlement service provider. Doctors should ask refugee or humanitarian patients if they have brought medical documents with them at the consultation.

What health checks are undertaken offshore?

Visa medical examination: All refugee and humanitarian entrants undergo a medical examination, chest x-ray, HIV and syphilis testing with a medical doctor approved by the Department of Immigration and Border Protection during the visa application process. This examination determines if they have any diseases or conditions which would represent a threat to public health, be a significant cost to the public health system or prejudice the access of Australian citizens to health care services. For more information see Department of Immigration and Border Protection (DIBP) Fact Sheet 22, The Health Requirement.

Departure Health Check (DHC): The primary purpose of the DHC is to determine fitness to fly and provide pre-departure interventions and is undertaken within 72 hours of departure. This consists of a symptom review, second-dose MMR vaccination and empirical treatment of parasites. Rapid diagnostic testing or malaria is also offered in malaria-endemic locations, with treatment provided to those found to be positive. Chest x-rays are undertaken for persons known to have past TB history or finding, or persons who present with clinical signs of TB at time of departure.

What is a Health Undertaking?

As part of the visa medical assessment, a refugee may be required to sign a Health Undertaking where they have been found to have specific health issues such as hepatitis or inactive tuberculosis that need follow-up and monitoring in Australia. By signing the Health Undertaking, the refugee agrees to report to the Health Undertaking Service and follow-up with their respective State or Territory health authority. Doctors should ask patients if they have a Health Undertaking. See DIBP Form 815.

Some pregnant refugees may be placed on a Pregnancy Health Undertaking (DIBP Form 1392) as the Australian government does not recommend pregnant women undertaking a chest x-ray while pregnant.

What is a Red or General Alert?

Red or general alerts ensure entrants granted a visa but identified with significant medical conditions are provided with suitable medical attention during travel and upon arrival in Australia. Refugee Health Network.

What interpreting services are available to doctors and patients?

Free interpreting services are available to eligible medical practitioners providing Medicare-rebateable services in private practice to patients who are Australian citizens or permanent residents and who do not speak English. The Department of Social Services (DSS) through the Translating and Interpreting Service (TIS National) provides the following free interpreting services:

• The Doctors Priority Line (DPL), a free phone interpreting service available 24 hours a day, 7 days a week. Calls to the DPL are given preference over other calls to TIS National.
• on-site interpreting service during business hours (8am to 6pm), Medical practitioners registered with TIS National pre-book on-site interpreting on the TIS National website.

Eligible Medical practitioners can register for the Free Interpreting Service on the TIS National website. For more information please visit the DSS website or call the TIS National Language policy liaison team on 1300 575 847 or email TIS Language Policy Liaison.

The Department of Social Services also provides a Free Translating Service to permanent residents and Australian citizens within their first two years of arrival in Australia. Documents that can be translated into English include patient medical reports or vaccinations certificates. More information about this service is available on the DSS website.

Does the health assessment need to be completed in a single consultation?

No. The assessment may be conducted over more than one consultation to ensure all elements of the assessment, including investigations, results and management plan can be undertaken. The GP claims only after the final session. In this situation, doctors should add the time taken in each consultation to determine which time-based MBS health assessment item applies.

Are patients eligible for other types of health assessment?

Only one refugee and other humanitarian entrant health assessment can be undertaken per patient within 12 months of arrival or grant of visa. If clinically indicated and with patient consent, other health assessments may be undertaken eg. a type 2 diabetes risk evaluation.

What tests are eligible for a Medicare rebate?

Medicare pays for clinically relevant services. This means services that are generally accepted by the medical profession as being necessary for the appropriate treatment of the patient and which are listed in the MBS.

Can the GP order pathology tests if there is no consultation item claimed for that day?

Yes.

Does Medicare have rules in regard to follow-up testing?

The principle of ‘clinical relevance’ applies to repeat pathology services.

What settlement support is available for new arrival refugees?

The Department of Social Services provides intensive settlement services through Humanitarian Settlement Strategy (HSS) to new arrivals holding visa class subclass 200, 201, 203 and, 204. Services are generally provided for 6 months but may be extended for vulnerable clients. They include:

• on-arrival reception and initial orientation
• information about and referral to other service providers and mainstream agencies
• assistance with accommodation and basic household goods
• short term torture and trauma counselling (12 months)

Who is a proposer?

A proposer is a friend, relative or community organisation who has agreed to assist the person to settle in Australia. Proposers only apply to visa class 202, Global Special Humanitarian. Any proposer who accompanies a patient may be able to provide useful information about the patient on matters such as physical, psychological and social function but should not be used as an interpreter.