Health Insurance in the United States
If you are not a full-time employee of Columbia University, you must obtain health insurance from an outside carrier. While it is your responsibility to select, obtain and maintain health insurance coverage for yourself and any of your dependents in the U.S. on J-2 status, Columbia University would like to provide you with some early guidance in the confusing and expensive world of health insurance. If you will not obtain acceptable health insurance before arriving in the U.S., the following information will be useful to you.
Most health insurance in the U.S. is private. This means that you must apply to a private company in order to obtain insurance, your application must be approved, and you must make timely payments of your monthly premiums in order to remain insured. Health coverage for individuals is significantly less expensive than coverage that includes family members. Some insurance policies are supplements to other policies.
The minimum coverage requirements specified by the EVP address a few, very general features that your health insurance policy must have. These include "(1) Medical benefits of at least $50,000 per accident or illness; (2) repatriation of remains in the amount of $7,500; (3) expenses associated with medical evacuation of the exchange visitor to his or her home country in the amount of $10,000; and (4) a deductible not to exceed $500." [22 CFR 62.14]. There are many other coverage conditions, coverage limitations and coverage exclusions - not regulated by the EVP - which will be part of the insurance policies you will encounter. You must understand these details in order to make an informed choice. Insurance companies often use words in their policies with very specific meanings, relevant to their business. It is extremely important that, before purchasing any insurance policy, you understand as much as possible about your policy and its conditions. You are purchasing a product from a health insurance company; do not hesitate to ask them as many questions as necessary, as often as necessary.
The following is a list of approximate definitions of terms and conditions often found in U.S. health insurance policies:
Policy (whole):A contract with a health insurance company providing for a broad range of medical treatments and/or payments in case of accidents or illness. Most whole policies usually provide a standard set of benefits, but the provisions, conditions and benefits of different policies can vary widely.
Supplement: A policy providing only very specific, limited benefits (i.e.: medical evacuation, repatriation of remains), and whose benefits can supplement benefits by another policy you already have.
Premium:The amount you must pay each month to purchase the insurance coverage. In some policies, the premium varies with the age of the insured(s).
Dependent coverage: Coverage for your spouse or children. Sometimes, dependents can be enrolled in a policy independent of you.
Deductible: The amount of money you must pay, in each case of accident or illness, before the insurance starts paying. Most policies have a deductible.
Application Deadline: Sometimes you and/or your dependents must be enrolled in the insurance within a certain period after arrival in the U.S.
Coverage Period: The units of time in which the insurance can be bought (i.e.: six months, one year). Most policies are renewable, but the premiums may increase at renewal.
Coverage: The percent of costs the insurance will pay and the maximum amount up to which the insurance will pay per accident or illness, or per coverage period. The coverage starts after you pay the deductible.
Hospitalization: Usually includes a semi-private room, doctor's fees, drugs, x-rays, laboratory tests, etc. Sometimes there is a limit on the number of days covered.
Maternity: It includes visits to your doctor, the delivery and related hospital charges. Sometimes policies limit or do not offer this coverage. Some policies do not cover abortions.
Prescription: Coverage for medications ordered by a doctor for use outside of the hospital.
Dental: Most policies cover injuries to teeth, not preventive or maintenance dental care.
Evacuation: The amount the insurance policy will pay if you need to be transported to your home country for medical treatment.
Repatriation: The amount the insurance company will pay to transport your remains to your country.
Accidental Death and Dismemberment: The amount the insurance will pay if you are killed or maimed accidentally
Exclusions: These are the injuries, illnesses or treatments for which the insurance will not pay. "Usual Exclusions" normally means pre-existing conditions, eye care, foot care, infertility and birth control, injuries while playing organized sports or piloting an airplane, injuries or death from war, terrorism, revolution or suicide, cosmetic surgery, experimental treatments, treatments administered by a member of your family, and expenses covered under other insurance policies you may have. This is not a complete list of exclusions. Different policies may have different exclusions.
While Columbia University cannot evaluate, recommend, or endorse any specific health insurance company or policy, see list of health insurance providers prepared by NAFSA.
Last Reviewed: 1 December 2011. Last modified: 1 December 2011