Health Insurance

As a benefit of your BSMP scholarship you will be provided health insurance that meets or exceeds J-1 visa regulations (see below).  IIE, on behalf of CAPES/CNPq, will pay for the coverage upon receipt of an invoice from your host institution. It is your responsibility, however, to ensure you are enrolled in an appropriate plan that meets these requirements for the duration of your authorized program. If you find the health insurance provided by your host institution does not meet the requirements stated below, or it cannot provide any coverage at all or for the entire duration of your authorized program, you must inform IIE immediately by contacting your Student Relations Officer. In these two cases, IIE will enroll you in its private health plan for the duration of your authorized program.

J-1 Visa Health Insurance Coverage Requirements:

  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
  4. A deductible not to exceed $500 per accident or illness.
  5. An insurance policy secured to fulfill the requirements of this section:
    a. May require a waiting period for pre-existing conditions which is reasonable as determined by current industry standards
    b. May include provision for co-insurance under the terms of which the exchange visitor may be required to pay up to 25 percent  of the covered benefits per accident or illness.
  6. Policy must be underwritten by an insurance corporation having an A.M. Best rating of “A-” or have;an Insurance Solvency International, Ltd. (ISI) rating of “A-” or above; or a Weiss Research, Inc. rating of B+ or above.

Introduction to the U.S. Healthcare System

Understanding Your Health Insurance Plan

Glossary

Cultural Insurance Services International (CISI)

Important Notes (CISI)


Introduction to the U.S. Healthcare System

The below video explains the complexities of the U.S. healthcare system.  We highly suggest that you watch it to better understand your health insurance plan and to be prepared for emergency situations.

US Healthcare System Overview

Play Video

A major difference between the U.S. and many other countries is how the health care system works. In the U.S., healthcare is privatized. In other words, there is no universal national health care plan. This makes it very expensive to receive treatment and medicine without health insurance. Additionally, there are specific laws that govern which medications require a doctor’s prescription, and which do not. International students and scholars are also not eligible for financial assistance from the U.S. government or from their host institution to pay medical bills. A few additional facts to know about the U.S. health care system are: 

  • Payment is the responsibility of the individual patient, with or without health insurance, and patients are fully responsible for seeing that bills are submitted and that claim forms are properly completed.
  • Some doctors providing services at a hospital may bill patients separately.
  • Co-pays or pre-certification authorizations are usually expected at the time the care is given.
  • The reimbursement process of an insurance provider takes time, and incomplete or incorrect forms can cause further delays.
  • Not all health insurance plans cover pre-existing conditions and the costs associated with treatment; others have very low coverage limits or waiting periods.
  • All patients’ privacy must be respected and be kept confidential by law. With a few exceptions, licensed physicians, nurses or other medical care staff (including psychologists and other mental health professionals), are not permitted to discuss a patient’s medical symptoms, conditions, illness or treatment without written consent. These few exceptions include a life-threatening condition*, an unconscious state leaving someone unable to make a decision, or abuse. 

Understanding Your Health Insurance Plan

In order to better understand your insurance policy and be better prepared should you need to seek medical care, you should know the answers to the following questions:

  • What does my insurance plan cover? 
  • What is not covered?
  • Is there a co-pay*, co-insurance* or a deductible*?
  • Does my insurance cover pre-existing conditions*?
  • Where can I seek medical care and what are the hours of service?
  • Where is the nearest emergency room* to where I live?
  • Who are the doctors that provide services in the network?
  • What is a claim form? When do I need it? Where do I find it and where do I submit it?
  • Is there a dental or vision plan? Do I need dental or vision coverage?
  • When do I need a prescription?
  • Is there a co-pay for prescriptions?
  • Where is the nearest pharmacy?

*  See Glossary below

Glossary

  • Co-pay: A co-payment- or “co-pay”- is a specified amount you must pay every time you visit a doctor or pay for a prescription. If you plan on visiting a doctor, it may cost you 25$-50$ per visit depending on your insurance plan (in addition to co-insurance). You should inquire about this fee while scheduling your appointment so that you are prepared for the charges, or contact your insurance provider ahead of time. (IIE does not cover co-pays).
  • Co-insurance: A certain percentage of the total covered costs to be paid upon completion of medical services provided by a doctor, laboratory, or hospital. Depending on your health insurance plan, your insurance provider will cover a certain percentage while you cover the remainder. For example, if your health insurance plan covers 80% for a medical treatment, you will be required to pay the remaining 20% out of your own personal funds. If possible, you should inquire about the co-insurance prior to scheduling an appointment to get an overall sense of the costs that you will owe to the healthcare provider, laboratory, or hospital. (IIE does not cover co-insurance).
  • Deductible: The amount you pay for covered services before your health plan begins to pay. (IIE does not cover deductibles).
  • Pre-existing conditions: A pre-existing condition is any condition which (i) originated prior to the start date of your health insurance coverage or (ii) you received consultation/treatment/medication from a physician prior to the start date of your health insurance coverage. It is important to note that not all health insurance plans cover pre-existing conditions and the costs associated with treatment. If there is a medication you take for a pre-existing condition, it is recommended that you secure enough in your home country for the time you will be in the U.S. Otherwise, it may become very expensive.
  • Emergency Rooms: Emergency rooms (ER), emergency department (ED), accident & emergency (A&E) or casualty department are medical treatment facilities that you can go to without an appointment to treat a medical emergency. In the U.S., the average wait time to be treated by health care professional at an emergency room is three to four hours due to the high number of patients. Please note that depending on your medical health plan, emergency room co-pay’s can be very expensive.
  • Life-threatening situation: Life-threating situations are defined as conditions that require immediate attention at an emergency room. For example, uncontrolled bleeding, high fever, broken bones, seizures or unconsciousness.
  • In-Network/Out-of-Network provider: an in-network provider is one that has an understanding with your health insurance company. In-network providers usually offer reduced costs/charges to patients. Out-of-Network providers are ones that will generally accept your health insurance, but at which your costs for treatment will be considerably higher.


Cultural Insurance Services International (CISI)

BSMP students must be enrolled in an adequate health insurance plan that meets J-1 visa regulations at all times during their authorized program. There will be certain cases where a host institution will not be able to provide health coverage to BSMP students. In such cases BSMP students will be enrolled in IIE’s private health insurance plan - CISI. If you have CISI insurance, it means that your university does not provide health insurance, does not have insurance that meets the J-1 regulations, or you need insurance for a specific gap period during your program when you are not covered by an eligible insurance provider. To find out more about how to obtain CISI insurance for a gap period during your program, please see the IIE Insurance Request Form in the “Materials” section.

If you are enrolled in CISI, or are seeking enrollment, you will be given the World Class Coverage Plan designed for the Institute of International Education. Please review the CISI Brochure (downloadable in the "Materials" section) for a summary of the benefits and limitations of coverage that you would receive under the CISI World Class Coverage Plan.

To file a medical claim with CISI, please complete the CISI Medical Claim Form (downloadable in the "Materials" section).  
To inquire about the status of a claim, explanation of benefits and eligibility, please call: (203) 399-5130
 
The website for CISI is http://www.culturalinsurance.com 
To speak to a CISI representative, please call (800) 303-8120 toll-free within the United States.
The Customer Service Email is: cisiwebadmin@culturalinsurance.com
Please contact your Student Relations Officer for any issues that you are experiencing with your health insurance plan.

Important Notes

Always be ready to explain your symptoms and conditions from the onset to a physician or nurse. When doing so try not to feel intimidated and always tell the truth. Be prepared to tell them what medications or treatments you have taken or are currently taking. Always feel free to ask them as many questions about your condition, treatment, medical procedure or cost as you’d like, even if you have already left the office. 

Check with your host institution’s health center to see if you need to complete a medical form and/or submit immunization documentation. If you are required to have immunizations (tuberculosis, measles/mumps/rubella, hepatitis, influenza, meningitis), you may be able to receive them in your home country or upon arrival. In some instances, host institutions require certain immunizations or tests be administered in the U.S. IIE does not cover the costs of immunizations. 

No matter what the possible cost, your health and well-being must always come first, so it is of the utmost importance that you see a doctor if you are injured or ill. Please use your best judgment to assess which medical care facility is appropriate for your current condition. 

It is your responsibility to keep yourself up-to-date on any changes to your health insurance plan and coverage dates. If you are going to be traveling internationally during your program, or if you plan on staying in the U.S. before or after completing your program, you are responsible for providing your own international health insurance coverage for these periods.  Should you need to purchase additional coverage for temporary periods such as these, below is a list of companies in the United States that offer health insurance plans to exchange visitors. Please note that this list is for informational purposes only, it does not represent any endorsement by IIE.

All Aboard Benefits
Tel: 1-800-462-2322 
www.allaboardbenefits.com

CMI Insurance Specialists
Tel: 1-410-583-2595
Fax: 1-410-583-8244 
http://www.cmi-insurance.com

CareMed International Travel Insurance
Tel: 1-855-547-6499
http://caremed-travel.net/

ISO Student Health Insurance 
Tel: 1-800-244-1180
www.isoa.org

Travel Insurance Services
Tel: 1-800-937-1387
www.travelinsure.com

United Healthcare Student Resources
Tel: 1-800-767-0700
https://www.uhcsr.com



Do I need to have immunizations before arriving in the United States? What other treatments should I schedule before departing for the US?

When should I go to the Emergency Room (ER)?

Where do I find the details about what my health insurance plan includes?

How much medication can I bring into the United States?

Why am I receiving bills from my health insurance company?

I have a medical issue that requires special medications or treatments. Will IIE help me cover the costs of treatment and medication, or provide me more comprehensive health insurance coverage?


Q: Do I need to have immunizations before arriving in the United States? What other treatments should I schedule before departing for the US?

A: IIE does not require immunizations; however, your host institution may require immunizations.  Please contact your international student advisor for the specific requirements of your host institution.  We highly suggest that you receive immunizations before you leave Brazil.  Immunizations can be very expensive in the United States, and your health insurance provider may not pay for the immunization cost. In addition to immunizations, we suggest that you receive any necessary dental and vision care prior to arriving in the U.S., as this is not generally included in a J-1 adequate insurance policy.

back to top


Q: When should I go to the Emergency Room (ER)?

A: You should only go to the emergency room if you have a life threatening emergency. Otherwise, we suggest that you make an appointment with your doctor, visit a clinic, or urgent care. For example, if you have an ear infection or a cold you should schedule an appointment with a doctor. If you are bleeding severely or break a bone, please go to the ER.

back to top


Q: Where do I find the details about what my health insurance plan includes?

A: Please ask for a copy of your health insurance plan document or brochure. This document outlines what your health insurance plan covers and does not cover. Should you have specific questions about your plan, the plan document likely includes the contact information of your health insurance provider.

back to top


Q: How much medication can I bring into the United States?

A: You may bring up to 3 months’ worth of your prescription into the United States. It is possible to have your medication sent to you but we highly suggest that you contact the FDA (Food and Drug Administration, a government agency) and ask them about the rules and regulations of sending medication to the United States. http://www.fda.gov/AboutFDA/ContactFDA/default.htm

back to top


Q: Why am I receiving bills from my health insurance company?

A: Although, you have health insurance, it does not cover your medical bills 100%. As explained in “U.S. Healthcare System,” co-pay, co-insurance, or doctor visits may not be covered by your health insurance. As stated in your TOA, you are responsible for these costs. IIE, on behalf of CAPES/CNPQ, does not pay for any medical bills beyond the health insurance policy premium. All students should be prepared to incur out-of-pocket medical expenses while in the United States.

back to top


Q: I have a medical issue that requires special medications or treatments. Will IIE help me cover the costs of treatment and medication, or provide me more comprehensive health insurance coverage?

A: IIE will cover only the cost of the basic health insurance plan provided by each university that meets J-1 regulations. IIE, on behalf of CAPES, is unable to provide additional financial assistance for medical treatment. In addition, students should note that many insurance plans will not cover treatment costs for anything that may be considered a “pre-existing condition” (see glossary).

back to top


© 2014 Institute of International Education, Inc. All rights reserved.