J-1 Health Insurance
J-1 Exchange Visitors are responsible for satisfying health insurance requirements mandated by the Department of State and Georgetown University. Additionally, J-1 Exchange Visitors may also be mandated to comply with regulations set forth in the Patient Protection and Affordable Care Act (Affordable Care Act – ACA).
Current J-1 students are required to purchase coverage through Georgetown’s Premier Plan. The Premier plan meets all of these requirements. J-1 student who stay in the U.S. after graduation to participate in academic training need to ensure that coverage purchased for the Academic Training period meets the requirements below. If current students have dependents in the U.S. who are not covered by the Premier Plan, they will need to purchase insurance for their dependents that meets the requirements below.
A. U.S. Federal Regulations
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.
22 CF 62.14 requires that J-1 health insurance plans have the following minimum coverage:
- Medical benefits of at least $100,000 per accident or illness;
- Repatriation of remains in the amount of $25,000
- Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000
- A deductible not to exceed $500 per accident or illness.
- An acceptable insurance policy may require a reasonable waiting period for pre-existing conditions. It may also include provisions for co-insurance payments of up to 25%. It may not unreasonably exclude coverage for perils inherent to the activities of the exchange program. Any insurance policy must be underwritten by an insurance corporation having an A.M. Best rating of “A-” or above, and Insurance Solvency International Ltd. rating of “A-I” or above, a Standard & Poor’s Claims-Paying Ability rating of “A-” or above, or a Weiss Research Inc. rating of “B+” or above. Insurance backed by the full faith and credit of the Exchange Visitor’s home government, insurance that is part of a group health benefits program offered to employees or enrolled students by the University, and insurance that is underwritten by a federally qualified HMO or CMP do not require a rating.
B. Georgetown University Requirements
Georgetown requires all J-1 students purchase Georgetown University’s Premier Insurance Plan. This coverage is greater than that required by 22 CFR 62.14. J-2 dependents may be added to the University plan.
C. Affordable Care Act Requirements
The Affordable Care Act mandates that all individuals who are considered U.S. residents for tax purposes (as defined by the IRS) carry adequate health insurance coverage. Most students in F-1 or J-1 status at Georgetown are considered nonresidents and are not subject to the mandate. In general, F-1 and J-1 students are considered nonresidents if they have been in the United States for less than 5 years. It is the responsibility of the student to determine whether or not they are subject to the mandate.
Georgetown University’s Premier Plan satisfies the Affordable Care Act minimum coverage requirements.
Federal regulations require Georgetown to terminate your J-1 program if:
• You willfully fail to obtain or maintain health insurance as set forth above;
• You misrepresent your insurance coverage; and/or
• You fail to maintain coverage for your J-2 dependents.
As a result, Georgetown will refuse to issue any DS-2019 Forms 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.
For information about Georgetown University’s mandatory coverage requirement, please visit the Student Health Insurance website.
Students who are subject to the Affordable Care Act mandate but fail to comply will be subject to a fine upon filing a tax return.