J-1 Scholars/Exchange Visitors
All exchange visitors and accompanying dependents entering the United States on a J visa are required to be covered from the day they arrive by accident and health insurance that meets the levels of coverage set by the Department of State. Exchange visitors in the J visa category must have coverage at all times while in the exchange program. If the exchange visitor chooses to have accident and health insurance from a company other than the group plan offered to exchange visitors by Florida State University (FSU) through the Thagard Student Health Center, a certificate of coverage verifying the following information should be provided by the company with whom the exchange visitor wishes to have accident and health insurance coverage. The certificate of coverage can be provided to the scholar and/or faxed to Florida State University, International Student and Scholar Center, Attn: Tanya Schaad, Fax No. +(850) 644-9951.
» Click here for the Exchange Visitor Program Health Insurance Evaluation Form
(All forms are available in alternative format upon request.)
Health insurance which covers one in the U.S. is required of everyone in J status, both scholars and their J-2 dependents. Insurance is required at all times of one's J program, from the time of arrival. The U.S. Department of State places strong importance on maintaining continuous insurance coverage and requires the sponsor of the J program to terminate the immigration status of anyone willfully failing to maintain or making material misrepresentations regarding health insurance for themselves or their family members.
» Click here to view the law regarding health insurance for those in J status, including the minimum coverage requirements
The minimum requirements for insurance are also listed on page 2 of the DS-2019 form. All exchange visitors must sign the certification on the front page of their DS-2019 form indicating that they have read all of page two. Therefore, not knowing about the insurance requirement is not a valid reason for failing to maintain coverage. If a scholar has forgotten to renew a policy or otherwise made a mistake, though, the Center for Global Engagement will be glad to help the scholar regain compliance with this regulation.
Often, scholars can obtain sufficient and, in most cases, superior health insurance coverage from abroad which covers them while in the U.S. As long as this coverage meets the minimum federal requirements, this type of coverage is acceptable.
Thagard Student Health Center does provide insurance coverage which meets the federal requirements, but scholars will have to determine whether the billing periods offered will meet their needs based upon the period of time they intend to stay. Once a scholar purchases Thagard's plan by quarterly payment or semester payment, the scholar must continue to purchase renewal periods of coverage according to that particular billing cycle. It is important to note that Spring and Summer semesters are combined for billing purposes and cannot be split. Monthly billing can only be instituted in August and requires a one year contract.
Other plans which may provide appropriate coverage for both the scholar and their dependents and may provide more flexible billing options are at:
- www.travelinsure.com - Visit USA plan (not Study USA)
- www.bcbs.com (separate evacuation and repatriation insurance will also be required if Blue Cross-Blue Shield is chosen, Thagard offers evacuation and repatriation insurance only for $20/annually per person)
The above sites are provided for informational purposes only; the Center for Global Engagement cannot endorse or recommend any particular insurance plan, as this is not our area of expertise. You must make a determination as to which plan is most appropriate for your particular circumstances. To do so, you should consider the following:
Eligibility - Is the applicant's (scholar or dependent) particular immigration status covered by this plan? Does the plan require the applicant to be enrolled or registered at a university? If so, the plan is meant for students and an alternate plan which covers scholars should be sought. Although insurers will accept applications and premiums without checking on enrollment, later claims for reimbursement or payment for treatment may be rejected without documentation of the scholar's enrollment status.
Renewal options - Check to see if the plan can be continuously renewed. Some plans do not allow renewal. So, each time the policy is re-purchased a period of non-coverage of pre-existing conditions begins again. This means that if a scholar or their J-2 dependent becomes pregnant at the end of one period of paid coverage, the continuing care, the birth, and the pre-natal care will not be covered under the new period of coverage. The condition will be considered pre-existing. Try to chose plans that allow for renewal, and be sure to renew within the specific period outlined in the insurance plan details.
Pre-existing conditions exclusions - Every insurance plan, other than some employer-based group plans, exclude pre-existing conditions. These are generally defined as any condition which manifested itself prior to the beginning of the insurance policy, regardless of whether or not one was treated for the condition. So, if a doctor determines that a scholar may have had untreated diabetes for a year before the scholar began their insurance coverage, all treatment for that condition will be the scholar's responsibility for at least the first six months of the insurance policy, if not more. Be sure to read carefully and understand all language regarding pre-existing conditions, and if you have a condition which will require continuing care during your stay, avoid switching insurance plans.
Exclusions - Be sure to understand all exclusions. Regulations for the J program require that an exchange visitor's insurance plan covers all risks inherent to the scholar's main activity. So, chemistry scholars will want to be sure that their plan does not exclude contact with dangerous chemicals or machinery. Many plans do exclude such activities. If the scholar is involved in amateur sports or other types of hobbies like scuba diving, climbing, or motor biking, they will want to be sure that injuries resulting from these activities are covered, or that they have purchased an additional "rider" or extra coverage which will provide for treatment of such injuries. Some plans exclude children's ear infections, pregnancy and pre-natal care, leukemia, and mental health issues. Be aware of these exclusions and make the best decision based upon your and your family's needs.
Provider Network - If you chose an on-line plan, be sure that you look at the provider network used by the plan. This is the list of doctors, hospitals, specialists, and laboratories that have contracted (at some point) to provide service for the insurer. You will want to make sure that there are available providers in Tallahassee and that these listed providers are still accepting your insurance plan or are still part of that provider network. Many doctors move, do not renew the contract, or contract with other agencies which disallow their participation in any other network. So, it is always best to check. If you prefer a certain doctor, be sure that your doctor is in the network. Out-of-network care often involves a higher deductible and co-payment.
Costs - Be sure that you understand what costs you will incur if you must be treated. Here is an example. A healthy 30 year old male is outside in the hot Tallahassee sun walking, falls and loses consciousness due to dehydration, and an ambulance is called before he awakes. He is placed in the ambulance, taken to the hospital, and treated at the hospital because the man acts confused upon waking up. The costs are:
$700 - ambulance
$500 - doctor evaluation
$1,500 - x-rays and review of the x-ray by an x-ray technician
$2,500 - CT Scan and review to rule out aneurism or other issues
Total medical bill: $5,200
The insurance company determines that $3,000 is "usual and customary". The scholar is responsible for the remaining $2,200, plus a $100 deductible, plus 20% of the remaining $3,000.
Total billed to scholar: $2,900
If it seems worthwhile to go with a plan that provides less comprehensive coverage but lower premiums, keep in mind what you might actually pay in the end should you need care. Also, keep in mind that the highest deductible allowed by federal law for the J program is $500.
Claim procedures - Be sure that you understand what is required in order to file a claim. Will the healthcare provider present a bill to the insurer? Are you responsible for the entire bill in the beginning and must apply for reimbursement at a later date? What is the standard time for reimbursement? When must bills be submitted? Many plans require that bills be submitted within 30 days of the injury or illness, but many doctors and healthcare providers do not provide a bill that quickly. In that case, you will have to make calls to get the bill more quickly, or the claim will likely not be paid.
Healthcare in the U.S. will be different than what you would expect at home. The process can seem confusing, disjointed, and ineffective. The Thagard Student Health Center and the Center for Global Engagement will do their best to provide you assistance along the way. Please feel free to ask questions and seek advice.
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