J-1 & J-2 Visa Student Insurance Requirements

Students coming to the US to study on a J-1 Student Visa, and their family members that are joining them are required by the US government to carry medical insurance for the full duration of their stay in the US.  Colleges and universities are required to provide the government requirements for this insurance, however the information provided usually only illustrates some of these requirements. 

Here are some plans that meet or exceed the US government requirements on medical insurance for J-1 Visa holders.

Below you will find the full text of the US government requirements for students coming to the US and their family members on a J-1 & J-2 Student Visa:

§ 62.14 Insurance.

(a) Sponsors shall require each exchange visitor to have insurance in effect which covers the exchange visitor for sickness or accident during the period of time that an exchange visitor participates in the sponsor’s exchange visitor program.

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.

(b) 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;
  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.

(c) 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, an Insurance Solvency International, Ltd. (ISI) rating of ‘‘A–i’’ 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 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.

(d) Federal, state or local government agencies, state colleges and universities, and public community colleges
may, if permitted by law, self-insure any or all of the above-required insurance coverage.

(e) At the request of a non-governmental sponsor of an exchange visitor program, and upon a showing that such sponsor has funds readily available and under its control sufficient to meet the requirements of this section, the Department of State may permit the sponsor to self-insure or to accept full financial responsibility for such requirements.

(f) The Department of State, in its sole discretion, may condition its approval of self-insurance or the acceptance
of full financial responsibility by the non-governmental sponsor by requiring such sponsor to secure a payment bond in favor of the Department of State guaranteeing the sponsor’s obligations hereunder.

(g) An accompanying spouse or dependent of an exchange visitor is required to be covered by insurance in
the amounts set forth in paragraph (a) of this section. Sponsors shall inform exchange visitors of this requirement, in writing, in advance of the exchange visitor’s arrival in the United States.

(h) An exchange visitor who willfully fails to maintain the insurance coverage set forth above while a participant in an exchange visitor program or who makes a material misrepresentation to the sponsor concerning such coverage shall be deemed to be in violation of these regulations and shall be subject to termination as a participant.

(i) A sponsor shall terminate an exchange visitor’s participation in its program if the sponsor determines that the exchange visitor or any accompanying spouse or dependent willfully fails to remain in compliance with this
section.

[58 FR 15196, Mar. 19, 1993, as amended at 59 FR 34761, July 7, 1994. Redesignated at 64 FR 54539, Oct. 7, 1999]

 

 

Patient Protection and Affordable Care Act (“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.