Immigration and citizenship The island is subject to separate immigration controls from the remainder of the nation. Australian citizens and residents from other parts of the nation do not have automatic right of residence on the island. Australian citizens must carry either a passport or a Document of Identity to travel to Norfolk Island. Citizens of all other nations must carry a passport to travel to Norfolk Island even if arriving from other parts of Australia. Holders of Australian visas who travel to Norfolk Island have departed the Australian Migration Zone. Unless they hold a multiple-entry visa, the visa will have ceased; in which case they will require another visa to re-enter mainland Australia.32 - Residency on Norfolk Island requires sponsorship by an existing resident of Norfolk Island or a business operating on the island. Temporary residency may also be granted to skilled workers necessary for the island's services (for example, medical, government and teaching staff). Non-Australian citizens who are permanent residents of Norfolk Island may apply for Australian citizenship after meeting normal residence requirements and are eligible to take up residence in mainland Australia at any time through the use of a Permanent Resident of Norfolk Island visa.32 - Children born on Norfolk Island are Australian citizens as specified by Australian nationality law. Non-Australian citizens who are Australian permanent residents should be aware that during their stay on Norfolk Island they are "outside of Australia" for the purposes of the Migration Act. This means that not only will they need a still-valid migrant visa or Resident return visa to return from Norfolk Island to the mainland, but also the time spent in Norfolk Island will not be counted for satisfying the residence requirement for obtaining a Resident return visa in the future.32 - On the other hand, as far as Australian nationality law is concerned, Norfolk Island is a part of Australia, and any time spent by an Australian permanent resident on Norfolk Island apparently would count as time spent in Australia for the purposes of applying for Australian citizenship.33 - Medicare Medicare does not cover Norfolk Island.34 - All visitors to Norfolk Island, including Australians, are recommended to purchase travel insurance. Serious medical conditions are not treated on the island; rather, the patient is flown back to mainland Australia. Air charter transport can cost in the order of $25,000 AUD. This lack of medical facilities has a major impact on the health care of Norfolk Islanders. Many older residents find it impossible to remain on the Island when their health falters, many have to leave their homes and live in New Zealand or Australia to get medical care, even though the majority of islanders are Australian citizens they have been excluded from the Australian health care system.