Autism and Immigration: Country Rules, Medical Inadmissibility & Paths to Residency

Autism immigration isn’t one rule everywhere. Different countries weigh public health risks, projected use of healthcare and social services, and (sometimes) special‑education costs. That can create unfair outcomes — but there are real paths to study, work, and permanent residency for autistic people. The key is understanding each country’s test, preparing the right evidence, and knowing where mitigation plans or waivers exist.

Key points, in plain English

• There is no global list of “countries that accept autistic immigrants” or “countries that don’t allow autistic immigrants.” Each country applies its own immigration policies and health tests.
• Canada, Australia, and New Zealand use cost‑based health tests. Canada calls it excessive demand; Australia uses a Significant Cost Threshold; New Zealand applies an acceptable standard of health that also considers special‑education costs.
• The United States and United Kingdom do not have diagnosis‑based bans. The U.S. reverted in 2022 to a narrower public charge rule focused on cash assistance and long‑term institutionalization; disability accommodations are available for interviews and testing.
• Your evidence matters: clear medical diagnosis notes, functional summaries, therapy/support plans, and a realistic five‑year cost picture (who pays for what) can change outcomes.

“There is no specific health condition that automatically leads to inadmissibility.”

IRCC medical inadmissibility overview

Which countries “accept” autistic immigrants?

Many people search for “countries you can immigrate to with autism” or “countries that don’t allow autistic immigrants.” In practice, most approvals or refusals hinge on projected costs to publicly funded services rather than a diagnosis label. That’s why autistic adults, an immigrant couple with an autistic child, and disabled people with other conditions (for example, intellectual disability, multiple sclerosis, or an acquired brain injury) can be approved on some routes — and initially rejected on others — often on similar grounds related to projected cost, not ability to contribute.

Canada — Autism Immigration, Medical Inadmissibility, and Mitigation

Canada does not automatically refuse autistic immigrants. Immigration, Refugees and Citizenship Canada (IRCC) decides each case by asking whether the applicant is likely to create an excessive demand on publicly funded healthcare and social services. This is called the medical inadmissibility test and it sits alongside other immigration policies such as security and public health screening.

For 2025, IRCC’s benchmark is CAD 135,810 over five years (about CAD 27,162 per year). Officers compare your projected use of the health system and social services against that figure and consider potential wait‑time impacts. Some people are exempt from the excessive‑demand rules, including refugees, protected persons, and many family‑class applicants.

How the process works

• Threshold: CAD 135,810 across five years is the line IRCC uses when it estimates costs for medical inadmissibility.
• Procedure: If IRCC believes your case may exceed the threshold, they issue a procedural fairness letter outlining their concerns and inviting a response.
• Mitigation plan: Many applicants respond with a tailored plan that shows how future expenses will be managed without drawing heavily on public social services — for example, employer insurance covering outpatient prescriptions, private therapy arrangements, or community supports. You generally cannot opt out of provincial healthcare, but some costs can be handled privately depending on the province.

“The threshold for excessive demand was tripled and references to certain special‑education services were removed.”

Government of Canada policy reform backgrounder (2018)

Reality check

Canada still issues medical inadmissibility findings each year across many conditions, but most applicants do not fall into that group. Many people who are initially rejected later succeed after submitting clear, individualized evidence. Parents should document school plans, therapies, and who pays for each service. Autistic adults should describe functional needs and effective supports in plain language — without deficit framing — and include realistic five‑year cost estimates.

What to include in your file

• Current letters that summarize your medical diagnosis, supports that work, and expected service use.
• A simple five‑year cost table that separates publicly funded items from privately paid items.
• For children, school reports and education plans that show reasonable adjustments and funding sources.
• If you receive a procedural fairness letter, a point‑by‑point mitigation plan that addresses each high‑cost concern raised by IRCC.

Canada — quick answers

Can autistic people get permanent residency? Yes. There is no automatic ban. Outcomes depend on evidence and projected costs relative to the threshold.

What helps most? A precise five‑year cost table, up‑to‑date clinical and educational reports, and a mitigation plan that directly addresses any items IRCC flags as high cost.

Australia — Autism Immigration, Health Requirement, and Health Waivers

Australia assesses health alongside other immigration policies to protect the health system and community social services. For autism immigration cases, a Medical Officer of the Commonwealth estimates the applicant’s likely public costs and whether granting a visa would prejudice access to scarce services for residents. The policy benchmark is the Significant Cost Threshold.

Current benchmark: the SCT is AUD 86,000. Applications are assessed against this figure when estimating health and community service costs over the relevant period for your visa.

How the process works

• Health requirement: You must be free from a condition that is likely to cause a significant healthcare and community‑service cost, or that would limit residents’ access to scarce services. This is where autism‑related supports, therapies, and special‑education needs are considered.
• SCT test: The medical officer compares projected costs to the SCT. If costs are above the benchmark, the health requirement is not met unless a waiver is available and granted.
• Waivers (PIC 4007): Some visa subclasses allow a health waiver considering your circumstances (skills, community contribution) and whether access for residents would be prejudiced. Other routes (PIC 4005) have no waiver.

“Significant cost is interpreted as a cost that is higher than the average health and community services cost for an Australian… The current value of the SCT is $86,000.”

Australian Department of Home Affairs — health requirement

Reality check

Outcomes turn on visa choice, evidence, and whether a waiver is available. An applicant with autism may be initially rejected if projected public costs exceed the threshold; on PIC 4007 routes a well‑argued waiver submission can still succeed. Be precise about therapies, frequency, and who pays, and address whether any requested service is in short supply.

What to include in your file

• Clear summaries of medical diagnosis and functional needs (communication, sensory profile, daily living). Avoid deficit‑only framing; explain effective supports.
• A realistic cost table for the assessment period (often five years for permanent visas), separating private funding (insurance, employer programs) from public funding.
• Evidence that your plan will not draw on scarce services needed by residents (for example, private therapy with wait‑time confirmations where relevant).
• If your visa has PIC 4007, a waiver submission that explains benefits to Australia and why any risk to the health system is minimal.

Australia — quick answers

Can autistic people get permanent residency? Yes. There is no automatic ban. Approval depends on the health requirement, the SCT comparison, and — where available — the strength of a PIC 4007 waiver case.

What helps most? A believable cost plan; statements from providers; clarity on who pays; and, on waiver‑eligible visas, evidence of contribution and no prejudice to resident access.

New Zealand — Autism Immigration and the Acceptable Standard of Health (ASH)

New Zealand uses the Acceptable Standard of Health (ASH) test. Officers check whether an applicant is a public health risk, likely to add significant cost or demand on the health system, or — crucially for children — likely to qualify for ORS (Ongoing Resourcing Scheme) special‑education funding. This framework applies across conditions, including autistic spectrum disorders, intellectual disability, physical disability, multiple sclerosis, and acquired brain injury.

Current benchmark: the significant cost to the health system threshold is NZD 81,000 over five years (or over the predicted course of the condition). This replaced the former NZD 41,000 figure.

How the process works

• ASH criteria: For residence and many temporary visas, INZ considers risk to public health, significant cost/demand on health services, and likelihood of ORS eligibility for students with high learning‑support needs.
• Ability to pay privately: For residence decisions, private payment cannot be used to bypass significant‑cost findings in health or ORS special‑education. This is why some families are initially rejected even when they offer to self‑fund.
• Medical waivers: Some categories allow waivers; ministerial intervention exists but is rare and discretionary.

“Where it has been determined that there is a relatively high probability that an applicant would be entitled to ORS funding, the following factors have no bearing… the ability of a person or organisation to pay for education services.”

Immigration New Zealand — Operations Manual A4.10

Reality check

The ASH test is one of the strictest for education‑related costs. An autistic child who is likely to receive ORS may face refusal for residence because private funding is not considered. For adults, outcomes hinge on whether projected healthcare costs exceed the five‑year threshold or involve services in unmet demand. Advocacy and precise evidence still matter: show functional needs, supports that work, and realistic costings.

What to include in your file

• Up‑to‑date clinical letters describing supports (communication, sensory regulation, daily living) and likely service use.
• For a child, a clear education plan: mainstream with reasonable adjustments versus high‑needs special education. If ORS is likely, state why — and be realistic about the policy implications.
• A five‑year cost table for therapies and health services; note when services are privately funded.
• If a waiver may apply, address INZ’s waiver factors (benefit to New Zealand, family links, duration, and the nature/extent of support needed).

New Zealand — quick answers

Can autistic people get residence? Sometimes, but the ASH test can be hard to meet, especially if ORS funding is likely or projected health costs exceed NZD 81,000 over five years.

What helps most? Plain‑language functional summaries, realistic costings, and (where available) a targeted medical‑waiver submission. Private payment does not offset ORS for residence decisions under New Zealand’s rules.

United States — Autism Immigration and the Public Charge Rule

The United States does not bar people because they are autistic. There is no medical‑cost inadmissibility test. Instead, the U.S. applies the public charge rule, which looks at whether someone is likely to become primarily dependent on government cash assistance or long‑term institutional care at government expense.

In 2019, the public charge rule was broadened to include non‑cash benefits (for example, Medicaid), creating fear and confusion. That rule was rescinded. The 2022 Final Rule, effective December 23, 2022, narrowed the definition. Today, the public charge assessment focuses only on cash benefits (such as SSI or TANF) and long‑term institutionalization at government expense.

“This final rule implements a different policy than the 2019 Final Rule.”

U.S. Federal Register, Public Charge Ground of Inadmissibility (2022)

Disability accommodations

USCIS provides reasonable accommodations for applicants with disabilities, including autistic immigrants. Examples include extended time, a quiet interview room, written instead of oral questions, and allowing a support person to be present. Request these when you schedule biometrics or interviews.

United States — quick answers

Can autistic people immigrate to the U.S.? Yes. Autism is not a refusal ground. Decisions focus on standard visa eligibility and whether someone is likely to rely primarily on cash benefits or long‑term institutionalization.

Do non‑cash benefits count? No. Under the 2022 rule, non‑cash benefits such as Medicaid, food assistance, or housing aid are not counted against you in the public charge test.

United Kingdom — Autism Immigration, Health Screening, and Legal Framework

The United Kingdom does not bar autistic people from immigrating. There is no medical‑inadmissibility rule like Canada’s excessive‑demand test or New Zealand’s acceptable‑standard‑of‑health test. Instead, the UK focuses on public health screening and general “suitability” grounds for refusal under the Immigration Rules.

Health screening and suitability

• Tuberculosis testing: Applicants from certain countries must complete a TB test before applying for a UK visa longer than six months.
• Suitability (Part 9): Refusals can occur for reasons such as criminality, deception, unpaid NHS debts above a set amount, or national‑security concerns. Autism and other disabilities are not refusal grounds.

United Kingdom — quick answers

Can autistic people immigrate to the UK? Yes. There are no autism‑specific restrictions. Immigration depends on meeting the visa route rules (for example, Skilled Worker points or family‑visa income thresholds).

Is there a medical cost threshold? No. Aside from TB screening where required, there is no cost‑based test like in Canada or New Zealand.

What actually drives approvals or refusals?

Across Canada, Australia, New Zealand, the U.S., and the UK, the central question is not whether someone is autistic but whether they are expected to place a high cost or excessive demand on publicly funded healthcare and social services. In practice, immigration officers build an actuarial forecast — a spreadsheet of projected costs and service use — and then compare it against a legal threshold or policy test. This forecast is what drives most approvals or refusals.

That approach has two major consequences:

• It can feel deeply ableist. By reducing a person to an immigrant’s cost, the model ignores lived experience, resilience, and contributions autistic people and their families bring to society. It also means that an applicant’s ability to pay privately is often not considered, especially in New Zealand where ORS education funding cannot be offset.
• Outcomes vary between countries. The same immigrant couple with an autistic daughter might be approved in Canada (with a mitigation plan) but initially rejected in New Zealand under the Acceptable Standard of Health. Families have spent years challenging these decisions before reforms or waivers gave relief.

For autistic immigrants, success usually depends on three factors:

• Evidence: Clear, recent medical diagnosis reports, functional summaries, and five‑year cost tables.
• Visa choice: Some visas allow health waivers (for example, Australia’s PIC 4007), while others do not.
• Mitigation or waivers: Where permitted, a well‑structured plan showing how costs will be managed privately can turn an initial rejection into an approval.

How to Strengthen Your Autism Immigration Application

Immigration decisions often turn on paperwork, not potential. These practical steps can strengthen your application, reduce medical‑inadmissibility risk, and present your case clearly.

• Build a five‑year plan: Prepare a simple table showing projected costs for therapy, assistive technology, mental health services, and community supports. Include frequency (for example, weekly speech therapy), the provider, and who pays (public insurance, employer insurance, out‑of‑pocket). This mirrors how officers estimate immigrant’s cost to the health system and social services.
• For children: Clarify education access. Will your child attend mainstream school with reasonable adjustments, or require intensive supports? In New Zealand, potential ORS (Ongoing Resourcing Scheme) eligibility is often decisive — and private payment cannot offset it. Be transparent and specific about support needs.
• For interviews: Ask for accommodations in advance. Request a quiet room, extra time, or written questions. Explain that reduced eye contact or delayed responses can be sensory regulation, not evasiveness.
• For Canada: If you receive a procedural fairness letter, respond on time with a tailored mitigation plan. Address each high‑cost item IRCC lists (for example, therapy hours). Show how those costs will be covered privately or why they fall under the annual benchmark.
• For Australia: If your visa is eligible under PIC 4007, use the health waiver option. Show your benefit to society (skills, community contribution) and how you will avoid prejudicing resident access to scarce services. Name private providers, employer coverage, or community supports.
• For New Zealand: Understand the ASH rules. If INZ suggests likely ORS eligibility or high projected costs, prepare a waiver submission (where possible) that addresses contribution, family links, and functional independence. Be realistic: private funding does not remove ORS findings for residence.
• For the United States: Autism is not a refusal ground. The public charge test looks only at cash benefits and long‑term institutionalization. If relevant, highlight independence, family support, or employer insurance; non‑cash benefits like Medicaid do not count against you under the 2022 rule.
• For the United Kingdom: There is no excessive‑demand rule. Focus on meeting visa category requirements (for example, income thresholds). Request reasonable adjustments during appointments, and remember the Equality Act 2010 protects you once in the UK.
• Show contribution, not just cost: Use personal statements, employment contracts, or letters of support to demonstrate how you will add value to your new community. This framing matters for waivers and appeals.

Frequently Asked Questions about Autism and Immigration

Which countries deny autistic immigrants?

There is no global ban on autistic immigration. New Zealand and Australia sometimes refuse residence visas if projected healthcare or education costs exceed set thresholds. Canada historically refused some applicants on medical‑inadmissibility grounds, but 2018 reforms eased the rules. The United States and the United Kingdom do not deny visas on the basis of autism.

What is medical inadmissibility?

Medical inadmissibility is an immigration concept used in Canada and a few other systems. An applicant may be refused if they are expected to create an excessive demand on publicly funded health or social services. In 2025, Canada’s threshold is CAD 135,810 over five years.

What is considered “excessive demand” in immigration?

An applicant creates excessive demand if projected costs for treatment, mental health services, or disability supports exceed a legal cost threshold, or if they may limit resident access to scarce services. In New Zealand, for example, a child likely to qualify for ORS special‑education funding may be refused on this ground.

Can autistic people immigrate to Canada?

Yes. There is no automatic ban. Cases are approved or refused based on projected costs compared to the threshold. Many families succeed after submitting a mitigation plan showing how high‑cost services will be covered privately.

Can autistic people immigrate to Australia?

Yes, but approvals depend on the health requirement. If projected costs exceed the Significant Cost Threshold, the application may be refused unless the visa allows a PIC 4007 health waiver. Strong waiver submissions often succeed if they show contribution and no prejudice to resident access.

Can autistic people immigrate to New Zealand?

It is possible, but the ASH test is strict. Private payment does not remove findings of high cost in residence decisions, especially for ORS eligibility. Some categories allow medical waivers.

Can autistic people immigrate to the U.S.?

Yes. The U.S. does not use medical cost thresholds. The public charge rule applies if someone is likely to rely primarily on cash benefits (SSI, TANF) or long‑term institutional care. Autism, intellectual disability, or physical disability are not grounds for refusal.

Can autistic people immigrate to the UK?

Yes. The UK does not apply a medical‑inadmissibility test. The primary health requirement is tuberculosis screening for certain applicants. Autism and other disabilities are not refusal grounds.

What is a mitigation plan?

A mitigation plan shows how you will manage high‑cost services privately, reducing impact on public systems. In Canada, it is often submitted after a procedural fairness letter.

What is a health waiver?

A health waiver (for example, Australia’s PIC 4007) allows approval even if health costs would normally be too high. Officers weigh contribution, family ties, and whether resident access would be harmed. Waivers are discretionary and require strong evidence.

Country comparison (quick reference)

Editor’s note

This article does not replace legal advice. Thresholds index over time, visa subclasses change, and discretionary policies evolve. Always confirm at the official links below and consider independent legal guidance, especially for cases that were initially rejected or remain borderline on projected costs.

References

• IRCC — Medical inadmissibility overview & current threshold
• IRCC — Mitigation plans for excessive demand
• Government of Canada — 2018 policy change (tripled threshold; changes to counted services)
• Australian Dept. of Home Affairs — Health requirement & Significant Cost Threshold
• Immigration New Zealand — Significant‑cost health threshold increased to NZD 81,000
• Immigration New Zealand — Health requirements (ASH overview)
• INZ Operations Manual A4.10 — Acceptable standard of health (residence)
• U.S. Federal Register — Public Charge Ground of Inadmissibility (2022 Final Rule)
• U.S. DHS — Fair and Humane Public Charge Rule
• USCIS Policy Manual — Disability accommodations
• UK Immigration Rules — Part 9: Grounds for Refusal
• Gov.uk — Tuberculosis tests for UK visa applicants
• Sky News — 12‑year‑old autistic girl initially refused under NZ ASH
• NZ media coverage — Arianna Alfonzo residency case
• Auckland University of Technology — Opinion on disability & immigration policy
• NZ Government (MBIE) — Response to petition “Let Arianna stay in New Zealand”

Language note: We use identity‑first language (“I am autistic”) because many in our community prefer it. Wherever you apply, you have the right to dignity, accessibility, and clear communication.