Health Insurance Requirements for J-1 Exchange Visitors

Overview

A federal regulation, part of which is quoted in the list below, makes health insurance a condition of Exchange Visitor status in the United States, and specifies the types and levels of coverage. The requirement applies to all exchange visitors and their J-2 dependents. Under this regulation, if you fail to carry the required insurance, for yourself or your J-2 dependents, the University must terminate your participation in its Exchange Visitor program, and report that termination to the State Department. Termination would end your J-1 status and your eligibility, and that of your J-2 dependents, for employment, and would jeopardize your affiliation with the University. Compliance is your responsibility. Some medical plans, those offered through the University or perhaps your national health insurance, meet the requirements. If you are considering coverage from a source other than the University, for yourself or your dependents, you should ask a representative of the provider for confirmation that that insurance meets the government requirements quoted below. If it does in all respects except for "medical evacuation" (the cost of transportation home in case of serious illness) or "repatriation of remains" (shipment of a body to the home country in case of death), you may purchase that coverage from a separate source.

Students in J-1 status must also meet the University’s requirements for adequate insurance coverage, either by enrolling in the University’s student health insurance plan (U-SHIP) or by providing proof of active coverage in an alternate plan that is comparable to U-SHIP. To review the criteria for comparable coverage to U-SHIP, the the University Comparable Coverage chart.

Insurance Requirements for Exchange Visitors

Minimum coverage shall provide:

  1. Medical benefits of at least $50,000 per accident or illness;
  2. Repatriation of remains in the amount of $7,500;
  3. Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $10,000; and
  4. A deductible not to exceed $500 per accident or illness.

An insurance policy secured to fulfill the requirements of this section:

  1. May require a waiting period of 6 months or less for pre-existing conditions, which is reasonable as determined by current industry standards
  2. May include provision for co-insurance under the terms of which the exchange visitor may be required to pay up to 25% of the covered benefits per accident or illness; and
  3. Shall not unreasonably exclude coverage for perils inherent to the activities of the exchange program in which the exchange visitor participates.

Any policy, plan, or contract secured to fulfill the above requirements must, at a minimum, be:

  1. Underwritten by an insurance corporation having an A. M. Best rating of "A-" or above, an Insurance Solvency International, Ltd. (ISI) rating of "A-" or above, a Standard & Poor's Claims-paying Ability rating of "A-" or above, a Weiss Research, Inc rating of B+ or above, or such other rating as the Agency may from time to time specify; or
  2. Backed by the full faith and credit of the government of the exchange visitor's home country; or
  3. Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
  4. Offered through or underwritten by a federally qualified Health Maintenance Organization (HMO) or eligible Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration of the U.S. Department of Health and Human Services.

Quoted from the Federal Register, March 19, 1993, page 15201, revised July 7, 1994, page 34761