Health Insurance & Health Care Information for J-1 Exchange Visitors
HEALTH INSURANCE
The Department of State (DOS) requires all participants of the J-1 Exchange Visitor Program to have and maintain health insurance which covers the exchange visitor and all accompanying family members for the entire duration of their J status. Please note that this requirement holds even if you or your family members are temporarily abroad. The health insurance plan must cover all participants for accidents, sickness, medical evacuation and repatriation: minimum coverage must provide at least $50,000 per accident or illness, $500 maximum deductible per illness, $10,000 provision for medical evacuation and $7,500 maximum repatriation coverage.
Visit this link to find a list of health insurance providers which offer the above coverage.
Please note that failure to maintain adequate health insurance is considered to be a violation of the Exchange Visitor Program regulations, which results in termination from the program.
HEALTH CARE IN THE U.S.
Routine health care in the U.S. will be provided by physicians in a clinic, not a hospital. If you need medical attention (which is not of an emergent nature), please visit a health clinic first. It is best practice to find a physician upon arrival in the U.S., to avoid having to search for a physician when you need medical attention. The best way to find a physician is to go to the website of your health insurance provider: by selecting a physician from their lists, you are sure that this doctor will accept your health insurance policy.
For each visit to a clinic or hospital, make sure to bring your health insurance card with you. It is recommended to carry this card with you at all times, in case of emergency. For most visits, you will be required to pay a co-pay to cover the costs of your visit (the amount of the co-pay should be listed on your health insurance card).
You can purchase medications, both prescription (=medication which needs a note from your physician to purchase) and non-prescription (=also referred to as ‘over-the-counter’) medication can be obtained from a pharmacy (CVS, Walgreens, Rite-Aid) or a larger store (Wal-Mart, Target) or even some larger grocery stores. Most prescription medication will require a co-pay (the amount of the co-pay should be listed on your health insurance card).
Definitions of commonly used health care and insurance related terms:
Co-Pay: The amount of money you are responsible for before your health insurance will pay (usually paid for a visit to a clinic or hospital or for purchasing a prescription medication).
Deductible: The portion of money in your insurance plan that you are responsible for paying each year (if you are in need of medical attention).
Co-Insurance: The amount you have to pay after paying your deductible of a medical claim (this is a set percentage, e.g. “80/20” means the insurance will pay 80%, you are responsible for 20%).
Limitations & Exclusions: Health related items that your health insurance provider will not pay for.
Pre-existing condition: A physical condition or illness you had before you enrolled in this health insurance plan. Most U.S. health insurance providers will not cover expenses related to illnesses you had before your enrollment.
Premium: The (monthly) payment to buy the health insurance plan.
Preferred Care Provider / In-Network Provider: A physician who is on your health insurance provider’s list of physicians to visit. If you visit this provider, your out-of-pocket costs are usually lower.
Referral: When a doctor suggests that you visit another, more specialized doctor for further health attention.
Primary Care Physician: General Physician
Outpatient: A procedure at a hospital or clinic which does not require an overnight stay.
Inpatient: A procedure at a hospital/clinic which requires an overnight stay.
For more information about your health insurance benefits or to find a local physician (who will accept your health insurance), please consult the website of your health insurance plan.