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All colleges and universities in the United States require that all students, including international students, have health insurance. You must have insurance in order to qualify for your student visa. Your I-20 will not if you will have the required insurance through your institution. Many campuses give you the option of purchasing health insurance through a college or university policy, or purchasing your own policy as long as it meets the college or university's requirements. In most cases, colleges and universities require that each student carry a minimum amount of insurance to cover accidents, illness, medical evacuation, or return of remains in case of death. In this section, you will find information on how to obtain medical assistance while in the United States. As insurance is critical in obtaining medical assistance while in the United States, we will then review different types of insurance that are available.

1. Medical Care

• Reviewing Your Medical History and Needs Before Going Abroad:It is a good idea to have a checkup to know your current medical condition. Your doctor or nurse can also advise you on what special precautions to take based on your medical history and what region of the United States in which you will be studying.
• Special Needs: If you have any special needs, check with your university's administrators to determine how they can best help you. Most regulations for accessibility in the United States are better than in other countries. However, they vary by regions and by institutions. Check to determine if accommodations like wheelchair ramps are provided in all modes of transportation, and to determine if the housing facilities are equipped to serve people with special needs.
• Availability of Medical Care: You should ask your college/university administrator whether they might help provide advice on available medical care and support while in the United States. Most medical facilities are very well equipped. But, again, facilities will vary depending on where in the United States you are studying.

2. Insurance

• What Insurance Covers: Know exactly what is and is not covered by your insurance plan. For example, high–risk sports injuries, dental care, and optical care are sometimes not covered by basic medical insurance. Also, if certain pre–existing conditions are excluded, check on the exact definition of "pre–existing."
• Insurance Provided By Program Sponsor: Most institutions include insurance as part of their fee and have pre-planned insurance arrangements for their international students. Purchasing their insurance may make it easier for staff to assist you. However, you should still look closely at the limitations in its coverage. If a university does not offer insurance, and/or you think a university's insurance is not sufficient, you should consider purchasing additional travel/international insurance.
• Other Aspects to Consider: Other aspects to consider include the financial limits of coverage, whether your insurance applies during independent travel or vacation, what countries it includes, whether evacuation and repatriation is included, the policy's start and end dates, and whether you will have to pay first for treatment and be reimbursed later by your insurance company. Another thing to look out for is "deductibles." A deductible is the amount you pay with your own money to the doctor or hospital. It is the part that is not covered by the insurance, and your insurance company pays the remainder of the bill.

3. Types of Insurance

• Major Medical: This type of insurance assures that all or part of your medical expenses for illness and injury will be paid. As costs vary from country to country, it is important to have sufficient coverage for any healthcare needs you may have while in the United States.
• Emergency Evacuation: This type of insurance provides support for transportation from the scene of an accident to the closest appropriate medical care facility. This could be by ambulance, helicopter, air rescue, or other form of special transportation. The insurance provider, in conjunction with an emergency assistance company should work with a local doctor in deciding where the appropriate medical care can be provided. It may not cover your return to the United States if the company does not believe it is necessary.
• Legal Assistance/Liability Insurance: If you encounter legal difficulties in the United States, you may need the assistance of a local attorney. If you are found responsible for damages, liability insurance may cover those costs. The U.S. Department of State may assist you in finding an attorney, but it can neither pay attorney costs nor damages.
• Lost Baggage/Property Insurance: Insurance can be purchased to cover lost baggage and loss or theft of your baggage during travel or in the United States.
• Motor Vehicle Coverage: Whether you rent a car, motorcycle, moped, or accompany someone in a personal vehicle, you should insure that you, the vehicle, and any passengers would be covered in case of accident or injury. You may need to pay for damage to someone else's vehicle or the injury of others if you are found responsible in the case of an accident.
• Kidnapping and Terrorism Insurance: Insurance is available to provide for response to kidnapping or terrorism.
• Repatriation of Remains: In the event of your death, this type of insurance will provide means for the return of your remains to the United States.
• Accidental Death and Dismemberment/Life Insurance: In the case of loss of limbs or death, this coverage provides funding to compensate you or your beneficiary. Students with a spouse or dependents may want to consider purchasing a comprehensive life insurance policy.

4. Insurance Policy Components

• Pre–Existing Conditions: Some insurance will specifically limit coverage for medical conditions existing prior to the beginning of coverage.
• High Risk Activities: Some insurance will specifically exclude coverage for high–risk activities like contact sports, skiing, mountain climbing, etc.
• Continuing Coverage in the United States: Many international insurance plans do not cover continued care in the United States, or if they do, the amount of coverage is limited. You may want to continue your Major Medical coverage in the United States while in the United States in case you need to come home for medical care.
• Special Areas: Some insurance will limit coverage for accidents involving alcohol and drug related activities.
• Advance Payment vs. Reimbursement: It is important to know whether your insurance company will pay when services are provided. Many travel insurance policies require you to obtain approval before treatment, pay in advance and then submit a claim for later reimbursement of medical expenses.
• 24–hour Emergency Assistance/Help Line: This type of service can be limited to a simple phone response system, or provide you with comprehensive emergency assistance for evacuation, legal aid, translation services, and other support around the world.
• Family Emergencies: Some policies may offer coverage for family emergencies, illness or death. The costs of emergency bereavement flights back home may be covered, as well as a refund in the event you cannot complete your program.
• Airline/Program Bankruptcy: Find out if your policy covers the possibility of airline or program bankruptcy, and if you are entitled to a refund if such an event occurs.

5. Relevant Questions

• Does the program you are considering include insurance as part of its program fee? If so, what kind of insurance does it provide you?
  • Are sports accidents covered?
  • What does the plan consider to be "high risk activities"?
  • Is dental and/or optical care included?
  • Are pre–existing conditions excluded or covered?
  • Are sexually transmitted diseases (including AIDS) covered?
  • Is emergency evacuation for medical and psychological problems covered?
• Should you consider purchasing your own insurance? If you do, will you not have to pay for the "package deal" insurance provided by the program?
• What are the insurance policy's start and end dates? How long after the program ends are you covered?
• What are the financial limits of coverage?
• Does your insurance policy provider have a 24–hour assistance phone number/hotline?
• Will you have to pay for medical care as you receive it, and then be reimbursed by your insurance company?
• If your illness requires long–term care, for how long will you be covered?
• In case of death, will the insurance company pay for repatriation– the return of your body to the United States?
• If you have to return to the United States because of evacuation or medical emergency, will you be refunded for the program fee?

6. Checklist

• I am familiar with the health care system of the U.S., including the quality of facilities and the cost of services.
• I know the location of the nearest hospital to my U.S. residence.
• I know what my insurance policy does and does not cover.
• I will be provided with a translator if needed during a doctor visit or hospital stay.
• I have an emergency contact in the U.S.
• I have a first aid kit.
• I know how to refill needed prescriptions in the U.S.

7. Resources

• AllAbroad.us – Insurance: Mentors answer the question about seeking additional health insurance when abroad.
• GlobalScholar.us: Go to Course 1, Module 9, Task 2, Action 3 – "Get Insurance" to learn about why you need travel insurance when studying abroad.
• CDC Information for Travelers with Disabilities Ways for students with special needs to have as much access as possible while abroad.
• Diseases, Food and Water Borne This SAFETI Adaptation of a Peace Corps Predeparture Handbook tells how to avoid contaminated food and water that could make you sick.
• National Mental Health Association College Student and Depression Fact Sheets This site provides a brief background on issues related to college student mental health issues.
• Regional Health Advisories A list by destination of the epidemics, diseases, and common infections.
• STDs Official government website of the Center for Disease Control, contains links to information on AIDS and other sexually transmitted diseases.
• U.S. Centers for Disease control and Prevention Information SAFETI Online Newsletter article offering travel health resources for students studying abroad.
• US Department of Health and Human Services Disaster Mental Health This site provides information about US Government resources to support mental health for those who have been affected by a disaster.

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