Full Coverage Requirements
J-1 Insurance Coverage Requirements
If you do not purchase a pre-approved health insurance plan, the plan you choose must meet the following requirements:
- Medical benefits of at least $100,000 per accident or illness;
- Mental/Nervous Conditions Expense Benefit and Alcohol & Drug Abuse Expense Benefit:
- Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis.
- Benefits are for both inpatient mental health treatment in a hospital or approved facility and for outpatient mental health treatment.
- Benefits are provided for inpatient and outpatient services including diagnosis, detoxification, counseling, and other medical treatment rendered in a physician's office or by an outpatient treatment department of a hospital, community mental health facility, or alcoholism treatment facility.
- So long as the facility is approved by the Joint Commission on the Accreditation of Hospitals or certified by the U.S. Department of Health.
- Inpatient Expense: Up to a minimum of 40 days.
- OUT-OF-NETWORK PROVIDER: Inpatient expense up to a minimum of 40 days.
- 80% coverage for in-network and 70% coverage for out-of-network.
- Outpatient Expense: Up to a minimum of 40 visits.
- OUT-OF-NETWORK PROVIDER: Outpatient expense up to a minimum of 40 days.
- 80% coverage for in-network and 70% coverage for out-of-network.
- Repatriation of remains in the amount of $25,000;
- Medical evacuation in the amount of $50,000;
- A deductible not to exceed $500
(also may include a 6-month waiting period for pre-existing conditions and 25% co-payment);
- Policy shall not unreasonably exclude coverage for perils inherent to the activities of the exchange program in which the exchange visitor participates;
- Any insurance policy secured to fulfill these requirements must meet minimum insurance solvency rating:
- Underwritten by an insurance corporation having an A.M. Best rating of "A-" or above, an Insurance Solvency International, Ltd. (ISI) rating of "A" or above, a Weiss Research, Inc. rating of B+ or above;
- 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 (HMO) or eligible Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration of the U.S. Department of Health and Human Services;
- Must be acceptable in all medical facilities.
- Reimbursement insurance policies will not be accepted.