J-1 Health Insurance
All J-1 Students must have health insurance prior to entering the United States and are responsible for satisfying health insurance requirements mandated by the U.S. Department of State (DoS). Georgetown requires all J-1 Students to purchase the University Premier Plan. This coverage is greater than that required by Federal Regulations for J-1 Students. J-2 dependents may be added to the University plan, or they can purchase other health insurance, provided it meets the DoS requirements.
All J-1 Student Interns must have health insurance prior to entering the United States and are responsible for satisfying health insurance requirements mandated by the DoS. J-1 Student Interns are not eligible to enroll in the University Premier Plan. Review Health Insurance Options for J-1 Student Interns (PDF).
If you will be in a full-time paid position, you may be eligible to participate in one of the insurance plans offered by the University for its employees. If you wish to sign up for one of these insurance plans, you must do so within 60 days of beginning work. Benefits begin on the 1st of the month. If you are not starting on the 1st, you will need to purchase temporary insurance until you can be covered under Georgetown insurance. The Georgetown University insurance plans offered to paid employees meet the requirements outlined above, except for the Kaiser HDHP 3 Signature and CareFirst CDHP. You will need copies of your family members’ passports and J-2 Visas to add them to your health insurance. Review Health Insurance Options for J-1 Scholars (PDF).
Detailed J-1 Health Insurance Requirements
U.S. laws governing J-1 status require Exchange Visitors to obtain health insurance for themselves and all J-2 dependents for the entire period of J-1 status in the United States.
U.S. Federal Regulations require the following:
- That the J-1 Exchange Visitor and any dependents in J-2 status have health insurance for the entire period of J-1 status;
- The minimum requirement for health insurance coverage is $100,000 per accident or illness;
- Insurance coverage for medical evacuation is required at a minimum of $50,000. This is used in the unlikely event that you or your family member must be evacuated to your home country for medical treatment;
- Insurance coverage for repatriation of remains is required at a $25,000 minimum. This is used in the unlikely event that you or a family member should die in the United States and the remains must be returned to your home country; and
- The maximum deductible on the health insurance may not exceed $500 per accident or illness.
Insurance policies secured to fulfill the requirements of this section may require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards; May include provisions for co-insurance under the terms of which the exchange visitor may be required to pay up to 25% of the covered benefits per accident or illness; and must not unreasonably exclude coverage for perils inherent to the activities of the exchange program in which the exchange visitor participates. Any policy, plan, or contract secured to fill the above requirements must, at a 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 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 Affordable Care Act mandates that all individuals who are considered U.S. residents for tax purposes (as defined by the IRS (new window)) carry adequate health insurance coverage. Most J-1 Exchange Visitors are considered nonresidents and are not subject to the mandate. In general, J-1 Exchange Visitors are considered nonresidents if they have been in the United States for less than 2 calendar years. It is the responsibility of the Exchange Visitors to determine whether or not they are subject to the mandate.
In addition to the federal regulations, Georgetown University also mandates that all international students enroll in the Student Health Insurance Premier Plan. The Student Health Insurance Premier Plan is required for J-1 Students but is not an option for J-1 Scholars (those in the Research Scholar, Professor, Short-Term Scholar, Specialist or Student Intern categories).
Federal regulations require Georgetown to terminate your J-1 program if:
- You willfully fail to obtain or maintain health insurance as set forth under insurance requirements;
- You misrepresent your insurance coverage; and/or
- You fail to maintain coverage for your J-2 dependents.
Therefore, Georgetown must refuse to issue any DS-2019(s) for J-1 or J-2 visa holders who do not comply with the health insurance requirements. Whenever you require an extension, you must confirm that you have and continue to maintain the required health insurance.
Your health insurance may not cover the full cost of your doctor’s visit, hospitalization or medication. Please review the rules related to the plan you choose to understand fully what is covered. Here are some of the terms defined:
- The amount you pay to your insurance company for your insurance policy. This is paid on a monthly or a yearly basis, depending upon your insurance plan.
- The co-pay, or co-payment, is the amount you are expected to pay directly to the health care provider at the time you receive medical treatment. This is usually a small amount and varies depending on your insurance plan.
The deductible is a part of the medical bill that you are expected to pay in addition to the co-pay. Insurance plans usually specify the amount of a medical bill they cover and the amount you must pay. The deductible is usually described as a flat amount or as a percentage, depending upon the policy. Generally, higher premiums have lower deductibles while lower premiums have higher deductibles.
In many cases, the doctor’s office or hospital where you seek treatment may not bill your insurance directly. They may require you to pay them directly and be reimbursed by your health insurance company.
Note: Students may only add dependents to the Georgetown University Premier Plan during the open enrollment season each fall semester.