• Insurance Requirements and Regulations
• Insurance Coverage for You and Your Dependents
• Health Care System in the United States
• Processing Insurance Claims
• Choosing an Insurance Policy
• Health Insurance Policy Options
  

INSURANCE REQUIREMENTS AND REGULATIONS

All J-1 exchange visitors and their dependents must be enrolled in an insurance plan that meets the following minimum levels of coverage:

• medical benefits of at least US$50,000 per accident or illness;
  
• repatriation of remains in case of death in the amount of US$7,500;
  
• medical evacuation of the exchange visitor to his or her home country in the amount of US$10,000;
  
• a deductible not to exceed US$500 per accident or illness; and
  
• co-payment not to exceed 25% of covered medical expenses.

An exchange visitor who willfully fails to maintain minimum insurance coverage will be subject to revocation of the exchange visitor status.

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INSURANCE COVERAGE FOR YOU AND YOUR DEPENDENTS

Your contract with COLCIENCIAS includes some funding to assist you with the costs of your health insurance. As an exchange visitor in the United States, you must purchase insurance for yourself and your family. Any insurance plan you choose must meet the U.S. government regulations described above. You must send LASPAU proof that you and your dependents have adequate coverage that will take effect as soon as you arrive in the United States and last for at least three months. The cost of medical treatment is very high in the United States so it is critical you arrange coverage for you and your family as soon as you can.

Often the best option for COLCIENCIAS grantees is to purchase the insurance offered by the host university. If adequate coverage is not available through your host institution, ask the international student office for guidance as to how you can ensure that you have access to health care. For other options, please refer to the sections on Choosing an Insurance Policy and Health Insurance Policy Options.

We recommend that you and any dependents travelling with you visit your optometrist and dentist before leaving Colombia, as these types of checkups can be expensive in the United States and are generally not covered by insurance. If you are interested in purchasing a separate dental coverage policy, the international student office at your host institution may be able to recommend a reputable insurance company. Your university's health plan (if you choose to use it) may also include access to an on-campus dental clinic.

Prescription Medication

If you or your dependents are taking a prescription medication, we recommend that you bring a sufficient amount with you to the United States, as well as copies of the prescriptions. Many pharmacies will not honor a prescription written in another country, and you may need to obtain a new prescription from a physician in the United States. The visit required to obtain the prescription might not be covered by your U.S. insurance policy.

Mental Health

It is important that you read and understand how this aspect of your insurance coverage works. Keep in mind that your emotional well-being is as important as your physical well-being. As you and your family adjust to your new surroundings, you may feel depressed, confused, or unhappy for a time. If you or your dependents are not feeling well emotionally, we recommend that you see a professional, just as you would for a physical problem. Most universities have mental health professionals who can help you. Please contact your LASPAU program advisor if you need assistance.

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The health care system in the United States is different from that in many countries. While elsewhere the government bears the expense of health coverage for its citizens (and sometimes even for visitors), individuals in the United States are responsible for these costs themselves. Since a single day of hospitalization and medical treatment can cost several thousand dollars, hospitals and doctors have been known to refuse to treat uninsured patients except in life-threatening emergencies. Most U.S. citizens rely on insurance, and the United States Department of State, which oversees the Exchange Visitor Program, requires that exchange visitors do the same. Insurance gives you access to better and more timely health care and provides the only protection against its enormous costs.

How Medical Insurance Works

When health coverage is purchased, the fee paid (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. Coverage remains valid only as long as your insurance premium is paid.

After your insurance is purchased, the company will provide you with an insurance identification card to use as proof of your coverage. Doctors, hospitals, and universities often ask to see this card, so you should carry it with you at all times. The company will also provide written instructions for reporting and documenting medical expenses (called "filing a claim"). The company will evaluate any claim that you file and make the appropriate payment for your particular policy. In some cases, the company pays the hospital or doctor directly; in others, the company reimburses the policyholder after he or she has paid the bills. Not all policies cover the same expenses, so it is important to read all literature sent to you regarding your policy.

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All insurance policies designed to cover accidents and illnesses will require you or your dependents to complete and submit a claim form with your medical bills when you ask for payment or reimbursement. Please keep the following guidelines in mind to avoid delays:

• Pay the deductible (that is, the amount you have to pay before your insurance will cover any of your bills). The deductible may vary from one company to another, so check your policy to find out how much you have to pay.
  
  
• Use the claim form issued by the insurance company, and follow the instructions printed on it.
  
  
• Fill out the form completely.
  
  
• Send all of your bills together, if possible.
  
  
• Sign the form and send it to the address for making claims, which may differ from the company’s main address.
  
  
• Keep a copy of everything you submit to the insurance company and record the date you sent it, in case you have to contact the insurance company again.
  
  
• In all correspondence to the insurance company, be sure to include an address and phone number where you can be reached as well as your insurance ID number.

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If you need to select a health insurance policy for your dependents, keep the following in mind:

• The reliability of the company: Does it treat people fairly? Does it pay claims promptly? Does it have staff to answer your questions and resolve your problems? Ask other students what their experiences have been with the insurance company or ask the international student office if they have any suggestions.
  
  
• Specific monetary limits: Some policies state specific dollar amounts that they will pay for particular services. Other policies pay "usual" or "customary" charges, which means that they pay what is usually charged in the local area. Be careful when evaluating policies with specific amounts; these amounts may not cover the full charges for serious illnesses, and you might find yourself responsible for large medical bills.
  
  
• Benefit period: Some insurance policies limit the amount of time they will cover any one accident or illness. Once this benefit period has elapsed, you will be responsible for all charges associated with treatment for this illness, even if you are still insured and the maximum coverage amount has not been reached.
  
  
• Exclusions: Most insurance policies exclude coverage for certain conditions. Read the list of exclusions carefully so that you understand exactly what is not covered by the policy. You would be responsible for paying any excluded charges yourself. If you are presently being treated for an accident, illness, or condition (including maternity), pay close attention to how the policy you are considering handles preexisting conditions.
  
  
• 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, consult a knowledgeable friend, the international office at your university, or LASPAU before you sign anything.
  
  
• Deductibles: Make sure you understand how the deductible is paid for any policy you are considering. Under some policies the deductible is annual, and you pay only once each year if you use the insurance. Under other policies, you pay the deductible each time you have an illness or accident. In choosing a policy, think carefully about how much you can afford to pay out of your pocket each time you are sick or injured, and weigh the cost of the deductible against the premium cost before you decide on a policy.
  
  
• If it seems too good to be true, it probably is. If you find a policy with a very low premium, it probably does not provide the level of protection you need.
  

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Following is information on several policies that meet U.S. government guidelines. Please contact the companies listed to request further information and/or a brochure. The policies differ in both price and type of coverage, so it is important that you review the information carefully in order to choose a policy that best meets your needs. Should you wish to use an alternative policy to the ones listed here, please send a copy of the brochure to LASPAU before purchasing the policy so that your program advisor can examine and approve the coverage.

The insurance policies below offer coverage for varying lengths of time, from 15 days to several years. Please review the policies to determine which is the best one for you and/or your dependents.

If your current health insurance policy meets all requirements except repatriation and medical evacuation coverage, you may continue to use it as long as you buy an additional policy, referred to as a "rider policy," which will provide you with sufficient repatriation and medical evacuation coverage. International SOS provides an acceptable repatriation and medical evacuation rider policy:

Some insurance companies will allow the J-2 dependents of J-1 grantees to apply separately for their own coverage. However, there are some policies that can only be used for dependents when purchased for the grantee as well. Please contact each company directly for more information.

Insurance Policies

This list is provided for the convenience of our grantees.  LASPAU is not endorsing nor recommending these policies.

*A grantee must be enrolled in the SOS plan in order for his or her dependents to be eligible for this policy.

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