Fermilab

Medical Insurance Requirements for J-1 and J-2

The U.S. Department of State requires all J-1 and J-2 Exchange Visitors to have medical insurance coverage. Regulations set the minimum values and types of coverage. In all cases, the medical insurance must be maintained throughout your stay in the US. Please review our Presentation Explaining US Temporary Medical Insurance.

Legal Requirements for Insurance
All insurance must satisfy two conditions, relating to (1) minimum coverage requirements and (2) the insurance provider, as shown below. The Visa Office will verify that both conditions are met by reviewing the terms of your insurance and the standing of the insurance company, and insurance that does not meet these two conditions will not be accepted.

(1) Minimum Coverage Requirements
(2) Insurance Provider
  • medical benefits of at least $100,000 per person
  • deductible of less than $500 per accident/illness
  • co-insurance of no more than 25%
  • Provided by Fermilab:
    • repatriation of remains up to $25,000
    • medical evacuation expenses of up to $50,000
  A. The insurance company:

  • Is Backed by the full faith and credit of the J Visitor’s home country;
  • Holds one of the following ratings:
    • A.M. Best rating of “A-“ or above.
    • Insurance Solvency International, Ltd. (ISI) rating of “A-i” or above
    • Standard & Poor’s “Financial Strength” rating of “A-“ or above.
    • Weiss Research, Inc. rating of “B+” or above.

OR
B. The insurance is:

  • 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); or
  • Provided by a federal, state or local government agency, state college or university, and public community college may, if permitted by law, self-insure any or all of the above-required insurance coverage.

For more information regulatory information on the medical insurance, please visit Code of Federal Regulations.

Insurance Options for Employees
Many (but not all) Fermilab employees receive medical insurance as a benefit provided by Fermi Research Alliance, LLC. This insurance satisfies the DOS’ requirements. You need not purchase any other insurance before your arrival. You must select an insurance plan for the options presented to you within 30 days of hire. Regardless of when you select it, the insurance coverage is retroactive to the date of hire.

Insurance Options for Users
All other users and visitors, including summer Interns visiting the U.S. in J-1 status, must arrange for their own medical insurance.

In some cases, the medical coverage you already have in your home country might satisfy the regulatory requirements. You cannot present the Visa Office with an insurance certificate in a language other than English – we must be able to read it. The insurance must satisfy the two conditions listed above. We strongly recommend that you ask your home country insurer to complete a Medical Insurance Attestation in English to enable the Visa Office confirm that the insurance acceptable. If we do not receive a Medication Insurance Attestation, we will undertake our own verification that the insurance satisfies the two legal conditions.

U.S. insurance companies sell medical insurance that satisfy the regulatory requirements for J visitors’ medical insurance. There are two types of such medical insurance: (1) temporary insurance, which is also called travel insurance, and “full coverage” insurance, which is more comparable to that received by Fermilab employees. See the chart below for explanations and links to several insurance providers.

Temporary Insurance Plans

  • Low cost
  • Intended for shorter coverage periods
  • Not intended for maintaining wellness – intended only to treat serious illness or injury
  • No dental or vision coverage
  • Excludes coverage for “pre-existing conditions” – any illness or injury that occurs before arrival in the U.S., or that is related to an injury or illness that occurred before arrival here
  • If the dates of your visit might change, check the company’s policy for renewals or extensions of insurance before you buy!
 “Full Coverage” Insurance Plans

  • Offers wellness care as well as emergency treatment
  • Optional dental or vision riders in some cases
  • Fewer “excluded” pre-existing conditions.

Gateway offers several temporary insurance plans, including “Gateway USA,” which is temporary medical insurance for a minimum of 15 days to a maximum of 36 months.  This is primarily emergency care for illness or injury – NOT wellness care. Dental and vision coverage is not included.  “Pre-existing conditions” are excluded – see “Highlights” under “Exclusions”. Insurance is underwritten by IMG / Sirius, which is rated A by A.M. Best.

Offers “CitizenSecure” worldwide medical insurance that includes coverage in the U.S.  Requires use of “network” medical service providers. An optional Dental rider is available. View the terms of coverage at http://www.hccmis.com/citizen-secure-insurance-coverage-us/. Rated A- by A.M. Best. Not truly “full” coverage, but comes much close than the temporary plans. Cost is comparable to that paid by Fermilab employees – ~$300+ per month for a married couple with 1 child.

NYIG offers several temporary insurance plans, including “Patriot America” which is temporary U.S. medical insurance for a minimum of 10 days up to a maximum of 12 months.  This is primarily emergency care for illness or injury – NOT wellness care.  Dental and vision coverage is not included.  “Pre-existing conditions” are excluded – see “Exclusions”. Insurance is underwritten by IMG / Sirius, which is rated A by A.M. Best.

Seven Corners offers an “Inbound Guest” insurance plan that is temporary medical insurance coverage for a minimum of 5 days to a maximum of 6 months. Dental and vision coverage is not included.  “Pre-existing conditions” are excluded – see page 6, Definitions, the Inbound Guest Program Summary. Insurance is underwritten by Lloyd’s, which is rated A by A.M. Best.
Fermilab’s Visa Office makes no recommendations about any company listed above.  Please make your selection of medical insurance provider based on your review of the plan details and limitations and your own circumstances.

List of Insurance Companies that Do Not Satisfy J-1 Legal Requirements

  • Ingosstrakh Insurance Company – rating does not satisfy J-1 legal requirements.

 

Questions? Comments? Contact the Visa Office!