Health Insurance Requirement

Both the U.S. Department of State (DoS) and Kentucky State University require J-1 Exchange Visitors and any dependents to have medical insurance coverage during their entire stay in the U.S. The Department of State has established guidelines for minimum coverage a J-1 and any dependents need to have. Their health insurance policy must meet the following minimum coverages:

  • $50,000 per sickness, accidents, or maternity (pregnancy, pre-natal, and birth)
  • $10,000 for medical evacuation
  • $7,500 for repatriation of remains to your home country in case of death
  • A deductible not to exceed $500 per accident/illness

If the exchange visitors qualify for employee benefits (including health insurance) please note that they must purchase supplemental insurance to cover medical evacuation and repatriation. If they are a self-funded J-1 scholar, exchange visitors must purchase health insurance on their own and provide proof to the Office of International Affairs (OIA).

If they are a self-funded J-1 scholar, the exchange visitor must purchase health insurance on their own and provide proof to International Affairs (OIA). For their convenience, the OIA website provides a list of US insurance carriers with insurance plans that meet the requirements for J-1 scholars and J-2 dependents: http://nafsa.org/ . OIA recommends ISO International Student Insurance (https://www.isoa.org/) that provides J-1 Exchange Plans meeting and exceeding J-1 Visa Insurance Requirements. The ISO insurance policy is enclosed. OIA staff and HR specialist will help the exchange visitors go over and select the best plan for them, if they choose to purchase their health insurance right after their arrival. However, it is highly recommended that all exchange visitors and their dependents purchase health insurance coverage before traveling to the United States and that their health insurance coverage is active prior to their travelling.

Exchange Visitors, who will be employed full-time and paid by the University, may enroll in the university medical insurance plan (copy of insurance policy is enclosed). Human Resources will go over these plans with them and help them select the best plan for them.

KSU’s Employee health insurance plans meet all federal requirements except payment for repatriation and medical evacuation. Therefore, all J-1 exchange visitors and J-2 dependents with KSU Employee health insurance must purchase a supplemental policy that will bring their full health coverage up to minimum federal requirements.

All dependents of exchange visitors must be insured throughout the entire program of the Exchange Visitor. If the program is longer than one semester, insurance must be purchased at least until the end of the academic semester and renewed prior to the expiration date.

If the J-1 is a paid university employee, the Exchange Visitor may pay to have the J-2 added to their employee insurance. If the J-1 is not a paid university employee, the exchange visitor is responsible for purchasing the J-2 health insurance.

NOTES:

  • It is recommended that all scholars and their dependents purchase health insurance coverage before traveling to the United States.
  • It is recommended that their health insurance coverage is active prior to their travelling.
  • Not all providers offer insurance coverage for pregnancy and maternity. For those that do, the pregnancy cannot be a pre-existing condition at the time of application.
  • In addition, not all plans cover dependents, and in some cases, the J-1 must be enrolled in the health insurance plan for the J-2 to be eligible.

Please note that failure to maintain adequate health insurance for the principal and dependents throughout the duration of your DS-2019 is considered a violation of the Exchange Visitor Program regulations, which will result in termination from the program.

When determining which insurance plan to purchase, here are a few important terms to understand:

  • HMO: A “Health Maintenance Organization” functions as one’s health care network. If your insurance is an HMO, you will need to go to a certain network of doctors, hospitals, pharmacies, specialists, etc. to have your expenses covered by your insurance (this is called “in-network”)-
  • In-network vs. Out of Network Providers: In- network care is significantly cheaper than out of network care. Insurance companies have negotiated prices with health care providers that are in their network. If you must use an out of network doctor or provider, note the different deductible, out of pocket maximums, and costs for services.
  • Deductible: A deductible is the amount you must pay for your health care before your insurance provider begins to pay.
  • Co-Pay(ment): Amount you are responsible for every time you get medical care. Note that this cost may vary depending on the type of doctor.
  • Primary Care Provider: Some insurance plans require you to select a primary care provider (doctor) that will be the main health care provider. PCP’s normally have a lower co-pay and will write referrals if you need care not provided in their practice.