Health Insurance Requirements
According to immigration regulations (22 CFR S62.14), J-1 exchange visitors and accompanying J-2 dependents are required to maintain comprehensive medical insurance with evacuation and repatriation coverage that meets U.S. government minimum requirements. Coverage must begin on the start date of the EV program (indicated in item 3 of the DS-2019) and continue to the end of the EV program. There cannot be any breaks or lapses in insurance coverage, even if traveling outside the U.S for an extended period of time during the J program.
- Minimum medical benefit of $100,000 per person per accident or illness;
- Deductible that does not exceed $500 per accident or illness;
- Minimum repatriation of remains in the amount of $25,000;
- Minimum medical evacuation expenses in the amount of $50,000; and
- Co-insurance paid by J1 not to exceed 25% of covered benefits per accident or illness.
- May require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards; and
- Must not unreasonably exclude coverage for the perils inherent to the activities of the exchange program in which you participate.
Any policy, plan, or contract secured to fill the J insurance requirements must at minimum be underwritten by an insurance corporation having:
- An A.M. Best rating of “A-“ or above; or
- A McGraw Hill Financial/Standard & Poor Claims-paying Ability rating of “A-“ or above; or
- A Weiss Research, Inc. rating of “B+” or above; or
- A Fitch Ratings, Inc. rating of “A-“ or above; or
- A Moody’s Investor Services rating of “A3” or above; or
- Be backed by the full faith and credit of the exchange visitor’s home country; or
- Be part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
- Be offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medical Plan as determined by the Centers of Medicare and Medicaid Services of the U.S. Department of Health and Human Services.
It is dangerous to be in the United States without adequate health insurance. Although in many countries the government bears the expense of health care for its citizens, and sometimes even for visitors, individuals and families in the United States are responsible for these costs. Since a single day of hospitalization and medical treatment can cost thousands of dollars, many hospitals and doctors refuse to treat uninsured patients except in life-threatening emergencies. Most Americans rely on insurance, and you should do the same. Insurance gives you access to better and more timely health care, and provides the only protection against the enormous costs of health care in this country.
When you purchase health coverage, the money you pay (your premium) is combined with the premiums of others to form a pool of money. That money is then used to pay the medical bills of those participants who need health care. Your coverage remains valid only as long as you continue to pay your insurance premiums.
Once you purchase insurance, the company will provide you with an insurance identification card for use as proof of your coverage when you are seeking health care from a hospital or doctor. The company will also provide written instructions for reporting and documenting medical expenses (filing a claim). The company will evaluate any claim that you file, and make the appropriate payment for coverage under your particular policy. In some cases the company pays the hospital or doctor directly; in others the company reimburses the policy holder after he or she has paid the bills.