Health Insurance is mandatory while holding J status. You must prove that you are in compliance with the Department of State insurance regulation before we can validate your J program. DO NOT LISTEN to well intentioned individuals in the U.S. who might tell you that you can wait to purchase it or that you don’t need it at all. You must purchase health insurance that meets the Department of State’s criteria and you must bring proof of that with you when you check in.
Consistent with United States federal regulations, individuals in Exchange Visitor (J-1) status must purchase health insurance that includes minimum coverage as set by the United States Department of State, including coverage for medical evacuation and repatriation. To ensure that exchange visitors at Temple University purchase at least the minimum coverage, Temple University will accept proof of insurance only from firms whose coverage has been verified as meeting the Department of State minima. You may find a list of insurance companies with policies that meet Department of State standards at www.eseries.nafsa.org/scriptcontent/YP_auto/c12.cfm for; in addition, PSI (www.psiservice.com) provides acceptable coverage plans.
Moreover, an exchange visitor should purchase insurance from an approved vendor prior to entering the United States to ensure sufficient coverage from the date of entry to the US, consistent with federal regulations. That is, insurance coverage dates must match the program start and end dates on the exchange visitor’s DS-2019. Documentation of the insurance coverage must be provided to Sharon Loughran (Immigration Services Specialist) when the exchange visitor meets with her for the required immigration orientation session. Individuals who do not schedule an appointment for orientation with Ms. Loughran and who do not provide this documentation within five (5) days of arrival in the United States will be considered in violation of their J-1 status; and the SEVIS records of these individuals will be terminated. The insurance requirement applies also to any dependents in Exchange Visitor Dependent (J-2) status. If dependents will arrive after the exchange visitor, insurance may be purchased for them closer to their arrival in the US; however, proof of that insurance must be submitted to Ms. Loughran no later than five (5) days after the dependents’ arrival in the U.S.
Individuals who purchase health insurance under the Temple University employee plans will also need to purchase additional coverage for medical evacuation and repatriation. The suggested vendor for this additional coverage is MEDEX, whose web address is www.medexassist.com/Individuals/Products/MEDEXPlusScholastic.aspx.
You must obtain and maintain health insurance that meets the criteria below for yourself and any J2 dependents in the US in order to maintain your J-1 Exchange Visitor Status. It is your responsibility to ensure that you comply with this regulation. Willful failure to do so will require Temple University to terminate you from our sponsorship and render you out of status.
The Requirements
Program participants and their dependents are required to have medical insurance coverage FOR THE DURATION OF THEIR PROGRAM with the following minimum benefits [22 CFR 62.14].
- Medical benefits of at least $50,000 per accident or illness
- Repatriation of remains in the amount of $7,500
- Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $10,000
- A deductible not to exceed $500 per accident or illness.
An insurance policy secured to meet the benefits requirements must be underwritten by an insurance corporation with an A.M. Best rating of "A-" or above, an Insurance Solvency International, Ltd. (ISI) rating of "A-I" or above, a Standard and Poor's Claims Paying Ability rating of "A-" or above, or a Weiss Research, Inc. rating of B+ or above. Alternatively, your government may submit a statement verifying that they fully support your insurance policy.
The
reason for the requirement; and the need for health
insurance
It
is dangerous to be in the United States without adequate
health insurance. Although in many countries the government
bears the expense of health care for its citizens,
and sometimes even for visitors, individuals and families
in the United States are responsible for these costs
themselves. Since a single day of hospitalization
and medical treatment can cost thousands of dollars,
many hospitals and doctors refuse to treat uninsured
patients except in life-threatening emergencies. Most
Americans rely on insurance, and you should do the
same. Insurance gives you access to better and more
timely health care, and provides the only protection
against the enormous costs of health care in this
country.
Dental
and Vision Information for International
Scholars
Please
keep in mind that many health insurance plans offered
in the United States do not include Dental and Vision
Insurance. Please consult your insurance provider
to ascertain whether or not your plan will cover dental
and vision. If not, you may wish to contact
the following companies for more information:
Associated Insurance Plans
www.associatedinsuranceplans.com
1 800-452-5772
Golden West Dental and Vision
www.goldenwestdental.com/
1 800 655 3225
How medical
insurance works:
When
you purchase health insurance coverage, the money
you pay (your premium) is combined with the premiums
of others to form a pool of money. That money is then
used to pay the medical bills of those participants
who need health care. Your coverage remains valid
only as long as you continue to pay your insurance
premiums.
Once
you purchase insurance, the company will provide you
with an insurance identification card for use as proof
of your coverage when you are seeking health care
from a hospital or doctor. The company will also provide
written instructions for reporting and documenting
medical expenses (filing a claim). The company will
evaluate any claim that you file, and make the appropriate
payment for coverage under your particular policy.
In some cases the company pays the hospital or doctor
directly; in others the company reimburses the policy
holder after he or she has paid the bills.
Choosing
an insurance policy
Your
J-1 sponsor may include coverage as part of sponsorship,
without further charge to you. Alternatively, your
J-1 sponsor may have selected and approved a specific
policy for all its Exchange Visitors, and may require
you to buy that insurance as soon as you arrive in
the United States. In many cases, however, you will
be required to select and purchase your own insurance
coverage. In choosing an insurance policy, you should
consider many factors, not simply the minimum stipulated
by USIA:
1. The reliability of the company. Does it treat people
fairly? Does it pay claims promptly? Does it have
staff to answer your question and resolve your problems?
2. Deductible amounts. Most insurance policies require
you to cover part of your health expenses yourself
(your part is called the deductible), before the company
pays anything. Under some policies the deductible
is annual, and you pay only once each year if you
use the insurance. Under others, you pay the deductible
each time you have an illness or injury. The J regulations
limit the deductible to $500 per accident or illness,
but many policies offer a lower, more advantageous
one. In choosing insurance, you should think carefully
about how much you can afford to pay out of your own
pocket each time you are sick or injured, and weigh
the deductible against the premium before you decide.
3. Co-insurance. Usually, even after you have paid the
deductible, an insurance policy pays only a percentage
of your medical expenses. The policy might pay 80%,
for example, and the remaining 20%, which you would
have to pay, is called the co-insurance. Thus, if
you were injured and incurred $3,000 in medical expenses,
a policy with a $400 deductible and 20% co-insurance
would cover $2,080 (80% of $2,600). The J regulations
require the insurance company to pay at least 75 %
of covered medical expenses.
4. Specific limits. Some policies state specific dollar
limits on what they will pay for particular services.
Other policies pay "usual" or "reasonable
and customary" charges, which means they pay
what is usually charged in the local area.
Be
very careful in evaluating policies with specific
dollar limits; for serious illnesses, the limit might
be far too low and you might have large medical bills
not covered by your insurance.
5. Lifetime/per-occurrence maximums. Many insurance policies
limit the amount they will pay for any single individual's
medical bills or for any specific illness or injury.
Exchange Visitors must have insurance with a maximum
no lower than $50,000 for each specific illness or
injury, which may be enough for most conditions. Major
illnesses, however, can cost several times that amount.
6. Benefit period. Some insurance policies limit the
amount of time they will go on paying for each illness
or injury. In that case, after the benefit period
for a condition has expired, you must pay the full
cost of continuing treatment of the illness, even
if you are still insured by the company. A policy
with a long benefit period provides the best coverage.
7. Exclusions. Most insurance policies exclude coverage
for certain conditions. The J regulations require
that if a particular activity is a part of your ExchangeVisitor program, your insurance must cover injuries
resulting from your participation in that activity.
Read the list of exclusions carefully so that you
understand exactly what is not covered by the policy.
Insurance
Agents
An
agent is an individual who represents one or several
insurance companies and sells insurance to individuals
and groups. When working with an agent you should
feel free to ask questions and take the time to learn
about and understand several choices before you make
a decision. If you are uncertain or confused, don't
sign anything. Contact Temple University's Benefits office with any questions you have at 215-204-1321.
