Please Note: This information is specifically written for J-1 Exchange Visitors as valid health insurance is a legal requirement for their status. ISSS encourages all international scholars to invest in health insurance. ISSS holds information on various health insurance providers. For more information please contact us
Access to adequate health care for Exchange Visitors and their families is a major concern to the U.S. Department of State (DOS) and program sponsors. Although in many countries the government bears the expense of health care for its citizens and even for visitors, individuals and families in the U.S. are responsible for these costs themselves. Since a single day of hospitalization and medical treatment can cost thousands of dollars, many hospitals and doctors will refuse to treat uninsured patients except in the case of life-threatening emergencies. Health insurance gives visitors to the U.S. access to better and timely health care and provides protection against its enormous costs. To ensure such access, DOS has made health insurance a requirement for participation in a J-1 program. Exchange Visitors are requires as a condition of their J-1 status, to carry health insurance for themselves and their accompanying dependents. Sponsors of J-1 programs are authorized to terminate the stay of any exchange visitor who willfully fails to comply with such requirements. You must be prepared to provide proof of health insurance upon arrival for check-in at ISSS. Read the following requirements for minimum coverage.
Minimum Insurance Coverage
By government regulations, minimum healthcare insurance coverage must provide:
Insurance policies, plans or contracts that are part of a group benefits program offered to employees will satisfy these requirements, as will health maintenance organizations (HMOs) and Competitive Medical Plans (CMP), policies that are federally qualified as determined by the Health Care Financing Administration (HCFA). Insurance coverage backed by the full faith and credit of the Exchange Visitor¿s home government is also deemed to meet the minimum requirements.
Since most international visitors are not familiar with the way health insurance works in the United States, the following brief explanation may be helpful.
When you purchase health insurance coverage, the money you pay (called a Premium) is put into an account with others¿ premiums to form a pool of money. The money is then used to pay the medical bills of those participants who need health care. Your coverage remains valid as long as you pay your insurance premiums or until the policy expires (if a specific date is mentioned). Once you purchase insurance, the insurance company provides you with an insurance identification card to use as proof of your coverage when you are seeking health care from a provider (a physician or hospital). The insurance company will provide information for reporting and documenting medical expenses (known as filing a claim). The insurance company will evaluate any claim that you file, and then make the appropriate payment. In some cases, the insurance company will pay the hospital or doctor directly; in other cases the company will reimburse you after you have paid the bills. Usually you will be asked to pay a portion of the cost incurred in your medical treatment (usually around 20%) while the insurance company pays the remaining percentage. The portion of the bill you must pay is called the co-payment.
Most insurance policies require you to pay for part of your health expenses yourself before the insurance company is obligated to pay anything; this is called the deductible. Under some policies, the deductible is annual, and you pay only once each year if you use the insurance; under other policies, you must pay the deductible each time you have any illness or injury.
If you do not have health insurance, or if you are not sure which insurance to purchase, ISSS can recommend a good insurance company to you. Contact ISSS for more information.