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OISSS > For International Students > J-1 > Health Insurance

J-1
Health Insurance

In addition to the requirements listed in the section on Health Insurance Requirement, students in J-1 visa status have additional health insurance requirements which must meet federal regulations governing J-1 Exchange Visitors and their dependents. These requirements are listed below.

J-1 Insurance Requirements

• Deductible amounts: Most insurance policies require you to pay part of your health expenses yourself (your part is called the deductible), before the company pays anything. The J regulations limit the deductible to $500 per accident or illness.
• Co-Insurance: Even after you have paid the deductible, an insurance policy usually pays only a percentage of your medical expanses. The policy might pay 80%, for example, and the remaining 20%, which you would have to pay is called the co-insurance. Thus, if you were injured and incurred $3,000 in medical expenses, a policy with a $400 deductible and 20% co-insurance would cover $2,080 (80% of $2,600). The J regulations require the insurance company to pay at least 75% of covered medical expenses.
• Lifetime/per-occurrence maximums: Many insurance policies limit the amount they will pay for any single individual's medical bills for any specific illness or injury. Exchange visitors must have insurance with a maximum no lower than $50,000 for each specific illness or injury, which should be enough for most conditions. Major illnesses, however, can cost several times that amount.
• If you should die in the United States, the policy must provide at least $7,500 in benefits to send your remains to your home country for burial. This is also known as "repatriation".
• If, because of serious illness or injury, you must be sent home on the advice of a doctor, the policy must pay up to $10,000 for the expenses of your travel. This is sometimes referred to as "medical evacuation".
• The policy may establish a waiting period before it covers pre-existing conditions (health problems you had before you bought the insurance), as long as the waiting period is reasonable by current standards in the insurance industry.
• Any policy, plan, or contract secured to fill the above requirements must, at a minimum, be:
  1. Underwritten by an insurance corporation having an A.M. Best rating of "A-" or above, or a Weiss Research, Inc. rating of B+ or above; 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 (HCFA) of the US Department of Health and Human Services.