Health insurance compliance

Quick facts

Qualified insurance gives you access to better and more timely health care, and provides the only protection against the enormous costs of health care in the US. As a CCIP participant, you are required have medical insurance that meets the minimum J-1 requirements.

The Law

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

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Minimum requirements

Maintaining insurance is critical to each exchange visitor's ability to stay in visa status.

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Coverage period

All CCIP participants, regardless of individual situations or visa status, must maintain qualified "entry-to-exit health" insurance.

Your insurance coverage start date must fall on or

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Individual insurance

You may purchase your own insurance policy that meets the necessary criteria by submitting qualified proof by the specified deadline. If you fail to do

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Group insurance

We offer a group health insurance policy to participants through Tokio Marin HCC that meets the federal requirements.

Application is not required for the group insurance

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Affordable Care Act

J-1s and any J-2 accompanying spouse and dependent(s) may be subject to the requirements of the Affordable Care Act [22 CFR 62.14(a)]. Be aware that

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Health insurance proof

Submission timeline

If purchasing individual insurance, notify us within 7 days upon admission. Submit qualified proof of coverage (aligned with the program period) within 7 days of Form DS-7002 issuance (N/A to US citizens and LPRs). At least 21 days before departure to the US, submit another proof with coverage period aligned with your flight ticket itinerary.

Admission

If purchasing individual insurance, notify us within 7 days upon admission

Before visa interview

Students who purchase their own insurance must submit qualified proof with coverage aligned with the program period within 7 days upon issuance of Form DS-7002 (US citizens and LPRs please skip)

During visa interview

Bring along insurance proof to your interview; students participating in the group policy will be provided with a letter

Prior to arrival

Submit qualified proof with coverage aligned with the your flight ticket itinerary (applicable to all self-insured students)

Knowledge

Health insurance 101

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. The J regulations require the that insurance companies must pay at least 75% of covered medical expenses.

Insurance Exclusions

Most insurance policies do not cover certain conditions. The J regulations require that if a particular activity is a part of your Exchange Visitor program, your insurance must cover injuries resulting from your participation in that activity. Read the list of exclusions carefully so that you understand exactly what is not covered by the policy.

Medical claims

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.

Insurance Identification Card

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. Carry it with you at all times when you are in the US.

Generic and Over-The-Counter (OTC) Medications

Generic drugs are generally cheaper and equivalent to the corresponding brand names. 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 pain-killers 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.

Network and Out-of-Network Doctors

Know the difference between network doctors and non-network doctors; sometimes insurance will not cover visits to doctors who are "out-of-network."

Major Illnesses and Per Occurrence Maximums

Exchange Visitors must have insurance that will pay at least $100,000 for each specific illness or injury (at least a $100,000 per-occurrence maximum). Be aware that medical treatment in the US for major illnesses can significantly exceed that amount.

Pre-certification for medical conditions

Pre-certification is necessary in certain medical situations. If you are unsure whether or not an item is covered or if the condition is severe enough for a hospital visit, the best practice is to call and confirm what can be covered (and obtain a pre-certification number, if available).

Prescription Medication

Unlike in Asia, where doctors typically dispense medicine themselves, the American system involves 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.

Primary Care Physician (PCP), Specialists, and Referrals

PCP refers to your primary health doctor. For specific health issues and injuries, you may need to visit a specialist. Referrals may be required for specialist visits in order for the claims to be covered.

Health Care 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.

Health Insurance Deductables

It covers your medical bills after a certain amount is met. Your portion is called the deductible, before the company pays anything. Under the J regulations, the deductible cannot exceed $500 per accident or illness.

Got questions?

  We've got answers!

Students can easily get sick for various reasons, for example, a change in weather or an unhealthy lifestyle. There are many doctors around our residence. For minor medical issues, see a family doctor. In some cases, your family doctor may refer you to a specialist. Depending on the severity of your sickness, you may also visit an urgent care clinic (a few of them are located along Northern Blvd) or visit a hospital.
Unlike in Asia, where doctors typically dispense medicine themselves, the American system involves 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, separately from the doctor's expense.

There are many pharmacies located within walking distance of our residence. You are free to use the pharmacy of your choice. Regardless of which pharmacy you choose, ensure that your write down the address of the pharmacy ahead of time and give it to the doctor for electronic prescription transmission

Prescription is not covered in many insurance plans. As such, you may consider signing up for the Rite Aid Rx Savings Program, which allows you to save 15% or more on many both brand name and generic prescription drugs.
Yes. Students are obligated to read the manuals and handle claims on their own. Regarding health insurance, our services are limited to group insurance purchasing, giving regulation related advices, and providing necessary resources. Our policy refrains us from referring you to specific doctors. However, we are more than happy to provide assistance within our service parameters.
The law requires that all J-1s have qualified health insurance coverage. Willful failure to comply will result in program termination and immediate deportation from the country.