Health Insurance Requirements for J-1 Exchange Visitors

Overview

Federal regulations governing the J-1 Exchange Visitor Program requires all exchange visitors to carry insurance meeting specific coverage amounts, which have been outlined below. 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 must 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 $100,000 per accident or illness;
  2. Repatriation of remains in the amount of $25,000;
  3. Expenses associated with the medical evacuation in the amount of $50,000; and
  4. 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 for pre-existing conditions which is reasonable as determined by current industry standards. This is currently determined to be a 6 month waiting period.
    1. NOTE: Although the J-1 requirements might allow for a 6 month grace period for preexisting conditions, the USHIP comparable coverage requirements indicate that preexisting conditions must be covered – no waiting period.
  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.
  3. Shall not unreasonably exclude coverage for perils inherent to the activities 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; a McGaw Hill Financial/Standard & Poor's Claims-paying Ability rating of "A-" or above; a Weiss Research Inc. rating of "B+" or above; a Fitch Ratings Inc rating of "A-" or above; a Moody's Investor Services rating of "A3" or above; or such other rating as the U.S. Department of State 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, p. 15201, revised October 6, 2014, p. 60317