Exchange Visitor Sponsorship Program (EVSP)
For J-1 Applicants/Physicians
Mandatory Medical Insurance Requirements
The U.S. Code of Federal Regulations (22 CFR § 62.14) mandates that all J-1 exchange visitors and accompanying J-2 dependents secure comprehensive health insurance effective on the program start date indicated on Form DS-2019 and maintain coverage, without interruption, for the full duration of stay in the United States in J-1 status. Any J-1 exchange visitor who willfully refuses to comply with insurance requirements will be considered to be in violation of his/her status and subject to termination from the J-1 program.
Please note that most ACGME-accredited residencies and fellowships provide health insurance options as a benefit of the training program. It is each J-1 physician’s responsibility, however, to ensure that the offered plan(s) meet(s) J-1 regulatory insurance requirements. If health insurance is not provided as part of the training program, J-1 physicians must secure adequate insurance coverage meeting J regulatory parameters for themselves and all accompanying J-2 dependents.
J visa holders are also required to hold medical evacuation and repatriation of remains insurances for the full duration of their stay in the United States. ECFMG provides required levels of both medical evacuation and repatriation of remains coverage for all J-1 physicians and accompanying J-2 dependents under its sponsorship.
Additional details about the regulatory insurance requirements can be found below.
Minimum Required Coverages:
- Medical benefits of at least $100,000 per accident or illness;
- Deductible that does not exceed $500 per accident or illness;
- Co-insurance paid by J-1 not to exceed 25% of covered benefits per accident or illness;
- Minimum repatriation of remains in the amount of $25,000;
- Minimum medical evacuation expenses in the amount of $50,000.
REMEMBER: J-1 physicians are responsible to ensure that they and their J-2 dependents have health and accident insurance that, at minimum, meets requirements #1, #2, and #3 above. ECFMG provides medical evacuation and repatriation of remains insurances, #4 and #5, to all J-1 physicians and J-2 dependents under its sponsorship.
Additional Information Regarding Health and Accident Insurance Requirements
Any policy, plan, or contract secured to fulfill J visa health and accident insurance requirements:
- May require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards; and
- Must not unreasonably exclude coverage for the perils inherent to the activities of the exchange program in which the exchange visitor participates.
- All J-1 exchange visitors and any accompanying J-2 dependent(s) may also be subject to the requirements of the Patient Protection and Affordable Care Act (see http://www.hhs.gov/healthcare/).
Furthermore, any policy, plan, or contract secured to fulfill J visa health and accident insurance requirements must at minimum be:
- Underwritten by an insurance corporation having an A.M. Best rating of “A−” or above; a McGraw Hill Financial/Standard & Poor’s Claims-paying Ability rating of “A−” or above; a Weiss Research, Inc. rating of “B+” or above; a Fitch Ratings, Inc. rating of “A−” or above; a Moody’s Investor Services rating of “A3” or above; or such other rating as the U.S. Department of State may from time to time specify; or
- Backed by the full faith and credit of the government of the exchange visitor’s home country; or
- Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
- Offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medical Plan as determined by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.
The full text of 22 CFR § 62.14 outlining J visa insurance requirements can be found at http://j1visa.state.gov/wp-content/uploads/2014/10/Subpart-A-Federal-Register-publication-8893_PublishedFR_10-6-2014.pdf.
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