Pre-visa interview briefing

Applying for the J-1 intern visa

Visa interview briefing

Health insurance

Potential J-1 intern visa holders are required to purchase of qualified health insurance and show proof upon request at the visa interview. This section indicates information concerning the health insurance regulations, plan selection, claiming procedures, and more.

What is the reason for health insurance?

In the US, a single day of hospitalization and medical treatment can cost thousands of dollars. Health insurance provides you protection against the potential immense costs of health care in this country.

What are the immigration requirements?

According to immigration regulations (22 CFR S62.14), J-1 exchange interns and their dependents are required to maintain comprehensive medical insurance with evacuation and repatriation coverage that meets US government minimum requirements.

What is the coverage period?

Our program requires "entry-to-exit" coverage. Exchange interns' insurance coverage start dates must fall on or before their US arrival and end dates must be on or after the date they leave the US. They cannot have any breaks or lapses in insurance.

What if I fail to comply?

Exchange interns' willful failure to carry the required insurance for themselves and, if applicable, their dependents, or material misrepresentation of insurance coverage will result in the termination of their J-1 programs and legal status in the US.

How medical insurance is necessary?

When you purchase health coverage, the money you pay goes to a pool of money with others. That money is then used to pay the medical bills when the insured file medical claims. Once purchased, you will receive an insurance identification card and declaration of coverage, or equivalent, from our insurance provider. The latter is required when attending a visa interview.

Where to buy qualified insurance?

Students may choose their own insurance provider, as long as it meets the US government's minimum requirements and is purchased before the visa interview. Here are two options: (a) IMG's Patriot Travel Medical Insurance or (b) HCC's StudentSecure.

What are the minimum coverage requirements?

The J-1 insurance coverage must provide the following minimum coverage: (A1) minimum medical benefit of $100,000 per person per accident or illness; (A2) deductible that does not exceed $500 per accident or illness; (A3) minimum repatriation of remains in the amount of $25,000; (A4) minimum medical evacuation expenses in the amount of $50,000; and (A5) co-insurance paid by J-1 not to exceed 25% of covered benefits per accident or illness.

What are the policy requirements?

Additionally, qualified J-1 insurance policies (B1) may require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards; and (B2) must not unreasonably exclude coverage for the perils inherent to the activities of the exchange program in which you participate.

What are the requirements for the insurance carriers?

Additionally, qualified J-1 insurance policies must be underwritten by an insurance carrier with: (C1) an A.M. Best rating of ‘‘A-’’ or above; (C2) a McGraw Hill Financial/Standard & Poor’s Claims Paying Ability rating of ‘‘A-’’ or above; (C3) a Weiss Research, Inc. rating of ‘‘B+’’ or above; (C4) a Fitch Ratings, Inc. rating of ‘‘A-’’ or above; or (C5) a Moody’s Investor Services rating of ‘‘A3’’ or above.

What is the alternative?

Alternative options include policies that are (C6) backed by the full faith and credit of the exchange visitor’s home country; or (C7) part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or (C8) offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medial Plan as determined by the Centers of Medicare and Medicaid Services of the US Department of Health and Human Services.

What is the Affordable Care Act?

Exchange interns and their accompanying spouse and dependent(s) may be subject to the requirements of the Affordable Care Act [22 CFR 62.14(a)]. Generally speaking, an individual’s tax residency status is determined by the Internal Revenue Service. Non-residents for tax purposes are not subject to ACA, whereas residents for tax purposes are subject to ACA and such requirements may exceed the US Department of State requirements. Further details about ACA can be found
HERE
, while penalties for lack of coverage can be found
HERE
.

How does the validation process work?

Before the visa interview, students will submit their tentative "entry-to-exit" periods, which must be within 21 days before and after the authorized program periods. After reviewing available options and details, they will proceed with their purchase and submit proof. If they purchase one of our suggested plans, they must circle and annotate the minimum coverage requirements (A1-A5), their name, coverage period and declaration of coverage or equivalent. If they choose their own plans, they must circle B1, B2 and one of the C fields, in addition to the stated fields.

Deductible

Some health insurance companies cover your medical bills after a certain amount is met. Your portion, before the company pays anything, is called the deductible.

Coinsurance

After you have paid the deductible, the insurance company usually only pays a percentage of your medical expenses. For example, the policy pays 80% and you pay the remaining 20% of the expense. This is called the coinsurance.

Co-pay

The co-pay is a small, flat fee you pay for some covered care at the time of service (for example, $25 for an office visit). Some plans do not require a co-pay.

Monthly premiums

Health insurance companies typically charge fees on a monthly basis. The fee is called the premium. It 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 healthcare.

Insurance exclusions

Some conditions are not covered by your insurance. Read the list of exclusions carefully so that you understand exactly what is not covered by the policy.

Healthcare premium

Health insurance companies typically charge fees on a monthly basis. The fee is called the premium. It 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.

PPO network

Both policies have the PPO network requirement. You pay less when visiting a medical provider within the PPO network. HCC uses the First Health PPO network. IMG allows both UnitedHealthcare PPO and First Health PPO networks.

Benefits

HCC: Up to USD 200K, 500K, 600K or 1 million. IMG: Between USD 50K and 2 million. Make sure you select USD 100K or more to meet the requirement.

Deductible

HCC: USD 25, 35, 45 or 50 per injury/illness. IMG: USD 0 to 2,500. Make sure you select USD 500 or less to meet the requirement.

Repatriation of remains

HCC: Up to USD 50K or 25K lifetime maximum. IMG: Up to USD 50K for return of mortal remains or ashes to the country of residence or up to USD 5K for cremation or local burial at the place of death. The regulation requires a minimum of USD 25K.

Emergency medical evacuation

HCC: Up to 500K, 300K, 250K or 50K. IMG: Up to USD 25K (be sure you select Patriot International). The regulation requires a minimum of USD 25K.

Coinsurance

HCC: You pay USD 0 or 20% (PPO) plus special terms. IMG: USD 0 (PPO) or 20% (non-PPO). The regulation requires J-1 visa holders pay no more than 25% of covered benefits per accidents or illness.

Seeing a doctor

Students can get sick for various reasons, for example, a change in weather or an unhealthy lifestyle. For minor medical issues, see a regular family doctor. In some cases, s/he may refer you to a specialist. Depending on the severity of your sickness, you may also visit an urgent care clinic or a hospital. Learn the filing procedures and special terms before coming to the US. When seeing a doctor or visiting a hospital, carry your insurance ID with you.

Paying direct or receiving reimbursement

In some cases, your insurance company pays the hospital or doctor directly; in others it reimburses the policy holder after you have paid the bills.

Network versus out-of-network doctors

Know the difference between network doctors and non-network doctors. Some insurance companies have contracts with some medical providers (also called in-network doctors or Preferred Provider Organizations). You pay less if you use providers that belong to your plan's network.

Prescription medication

Unlike in Asia, where doctors typically dispense medicine themselves, the American system involves separate pharmacies that distribute the proper medications. At the end of your doctor visit, the doctor will send a prescription to the pharmacy, which you will then retrieve and pay for yourself, separate from the doctor's expense.

Generic and Over-the-Counter (OTC) medications

Generic drugs are generally cheaper and the equivalent to a corresponding brand name. If saving money is most important to you, ask the doctor to prescribe generic drugs. OTC medications can be bought by anyone at a pharmacy without a doctor's prescription. These include basic painkillers and allergy treatments. Prescription drugs are more powerful and are designed to combat infectious illnesses. These require a doctor's authorization before they are dispensed at a pharmacy.

Filing medical claims

After seeing a doctor, keep the receipts and file a claim for the medical expenses within the specified period. Your insurance company will evaluate your claim and make the appropriate payment for coverage. In some cases, the insurance company pays the hospital or doctor directly; in others, the company reimburses the policy holder after he or she has paid the bills. Be sure that you use your home address when filing a claim as your claim may take a while to process.