A South African chef fears immigration authorities' decision to decline her residency application may equate to a death sentence if she's forced to leave.

Boipelo Sebate, 39, has called New Zealand home for a decade, and has the resources to pay for her medical bills, but she's been told she's too big a burden on the health system and is therefore ineligible for residency.

"I'm just begging that I'm still given the opportunity to continue to live here, to continue to work here, to continue to pay my taxes as I have before ... and not just be thrown out because I'm a little broken right now."

The executive chef at Taupō's Wairakei Resort was diagnosed with a kidney condition in late 2018. While her immigration paperwork shows officials raised some concerns about her health across various work visa applications, she was was approved for a work visa in December 2021.

In 2022 she applied for the 2021 Resident Visa — but her application was declined in January this year. Officials deemed her kidney condition meant she did not meet the acceptable standard of health. A subsequent bid to the Immigration Tribunal ended with it ruling against allowing her stay.

The decision seen by 1News shows officials did balance her long-standing employment here against the question of whether she could continue to pay for her care if she returned to South Africa. But it decided on the balance of probabilities it was likely she'd find a job in South Africa and would therefore be able to access the care she needs.

While it acknowledged she had health insurance, it noted because she'd be eligible for public health care, she couldn't be enforced to pay.

"The tribunal notes the ironic circumstances of the burden that the appellant's health presents: she holds private medical insurance that would cover her medical expenses ... paid for by her employment here.

"... in contrast should she be required to return to South Africa the appellant submits she would no longer be in a position to fund her medical insurance premiums which are crucial to ensuring that she can access dialysis."

Now that her medical history is on record, officials say if the chef applied for a new work visa, her medical situation would now be taken into account — making that an unlikely option now.

Immigration New Zealand (INZ) said when assessing a person's immigration requirements the ability to pay is "not a consideration".

INZ's visa director Jock Gilray said there is no ability to opt out of the health system because a person has insurance coverage or can pay privately.

"Eligibility for publicly funded health care is determined by the Ministry of Health."

A Ministry of Health spokesperson said the public system is unable to charge private payments for those who are eligible for public health care unless there is a standard payment, or co-payment system in place already.

Turner Hopkins Immigration specialist Paul Janssen said giving the patient the ability to pay for their care even if entitled to it publicly would require legislative change, but that could "open up a whole can of worms".

"You can't contract yourself out of public healthcare. The risk is we approve that person based on them having access to those funds. But once we've approved them, they can literally go walk into a hospital and cost it an enormous amount of money."

He said officials will also be looking at the burden on the system, not just the financial cost.

"It's often about the resources, whether we have the resources, and if we don't should we be letting people in to stretch that system further."

A spokesperson for Immigration Minister Erica Stanford said any changes to the acceptable standard of health requirement is not currently under active consideration.

Sebate said she understands this is the law in Aotearoa, but is pleading with authorities to look at her case compassionately.

"It's heartbreaking, and it crushes your soul," she said. "I've been dedicated to this country, been dedicated to my work. I aim to not take anything, but it's still not good enough.

"I know this is the rule, and this is the law, but just have a bit of heart."

She said anyone in her position would be willing to pay for their care as required — if it allowed them an opportunity to stay.

Her plea is backed by her employers, who've written a letter of support for their employee of 10 years. They asked authorities to consider both the humanitarian aspects and the role Sebate plays in enriching the local community in Taupō.

"Boipelo has been an integral part of our team for a decade, currently excelling in her role as Head Chef. Her experience, leadership, and mentorship of many trainee chefs over the 10 years in New Zealand have made her an asset to the industry.

"She has trained many junior chefs over the years which have gone on to contribute to the hospitality industry in the country."

The chef's also been supported by her local MP Louise Upston who has asked immigration authorities to re-consider her case.

"Boipelo's return to South Africa has only highlighted the dire circumstances prevailing in her home country, including escalating crime rates, limited employment opportunities and unreliable access to essential services.

"Given her health condition and the current state of affairs in South Africa, Boipelo faces an uncertain future if she is compelled to return."

As it stands the chef is facing going back to South Africa within the month, where she has no work, will lose her ability to pay for her health insurance, and questions if she'll even be eligible for public health funds.

"Honestly, if I had to go home at this stage, six months on my adult savings, and I would have to consider palliative care," she said. "Because I can not put that burden on my mother."

With her current visa due to expire on January 7, unless the Associate Minister of Immigration Chris Penk chooses to intervene, she'll have little choice but to return to South Africa.

In a statement the minister acknowledged he's accepted Sebate's case for consideration, but that it could take six months for the process to be completed.

In the meantime he advised the chef to work with INZ to find a solution — to ensure she remains lawful while she awaits the outcome of the decision.