Required Health Insurance
The U.S. Department of State (DOS) sets a standard minimum level of health insurance coverage required by law for J-1 scholars to participate in an exchange visitor program in the United States. Therefore, you are required to purchase a health insurance coverage that meets or exceeds that standard for yourself and your J-2 dependents throughout your entire stay in the U.S. Failure to do so would violate your non-immigrant status and you would no longer be eligible to participate on The Ohio State University’s J-1 program. Thus, you will be required to purchase a health insurance plan that meets or exceeds these requirements by selecting one of the options below:
- The Gallagher Accident and Sickness Plan (Gallagher A&S) - Meets the DOS requirements. All scholars are eligible to purchase this plan.
- An Ohio State health plan (several choices) or Nationwide Children's Hospital's health plan which meet ACA requirements. Eligibility for these plans is dependent on being paid by Ohio State or Nationwide Children's and the terms of your appointment/employment.
- An ACA/DOS compliant health plan via an application process. Read more below regarding this option and read the sections entitled: Alternative ACA Comprehensive Insurance Information & Compliance Application and Government- Sponsored J-1 Scholars Insurance Information.
For many scholars, having a health insurance plan that meets only DOS requirements is sufficient for their needs and budget. For this reason, Ohio State provides all scholars the option to purchase the Gallagher Accident and Sickness plan (Gallagher A&S), which meets the DOS requirements.
If you will be employed by Ohio State or Nationwide Children’s Hospital, you will be eligible to purchase one of the employment-based insurance plans through these employers. In most cases, getting one of the plans offered through the employer is recommended rather than purchasing the Gallagher A&S plan. The employer-based plans are compliant with the Affordable Care Act (ACA) rules and provide more comprehensive coverage than the Gallagher A&S plan. Also, in most cases, the cost is reasonable but it depends on your specific terms of appointment/employment. Check with your host department regarding the types of benefits that will be offered to you.
For those not eligible for the one of the employment-based insurance ACA compliant plans but wanting more coverage than Gallagher A&S plan, you may to opt out of the Gallagher A&S plan via an application process to purchase an ACA compliant plan available in the government Health Insurance Marketplace. Depending on your own or your family’s health care needs an ACA plan may be advisable because these plans provide much more coverage including coverage for pre-existing conditions and wellness care. For scholars who have been in the U.S. in the past or who may be staying for a long period, you may even be required to purchase an ACA complaint insurance plan and if you don’t be fined. For more information see the section below entitled: Alternative ACA Comprehensive Insurance Information & Compliance Application. You will find links in that section about the “physical presence test” to assist you to determine if you would be required to purchase an ACA plan for this reason.
The Gallagher Accident & Sickness Plan
Gallagher A&S is available to all J-1 scholars and their J-2 dependents regardless of whether you are employed in the U.S. Ohio State offers this accident and sickness plan because ACA compliant plans are typically very costly for individuals to purchase unless it is through U.S. employment. Thus, if you are not receiving any health insurance benefits from a U.S employer, this plan is cost effective and meets the DOS requirements. Your cost for the plan is $126 per month for yourself and same rate applies for each J-2 dependent.
Because your costs are lower, it provides health care coverage only when you are sick or need medical care due to an accident. More specifically, the plan provides 100% coverage with no deductible for expenses related to any accident or sickness and 100% coverage for medical evacuation and repatriation. Gallagher also offers a method to pay for medical services directly eliminating the need to file a claim to be reimbursed for costs you would pay for medical services when you seek medical care for accidents or sickness. We recommend that you enroll in this plan prior to arrival in the United States. Click here to enroll in the plan and for more information about the plan including exclusions and limitations on coverage.
Ohio State Health Plans and Nationwide Children's Hospital's Health Plan
If you are eligible for an Ohio State health plan or the Nationwide Children's health plan, selecting one of these plans will likely be the best option for you. These plans are ACA compliant providing comprehensive insurance coverage at a reasonable cost to you because it is a group plan. However, these plans do not include the medical evacuation and repatriation (M&R) coverage required for J-1 and J-2 non-immigrants because these plans are designed for U.S. citizens. Therefore, if you purchase an Ohio State or Nationwide Children's health plan, you will be required to purchase a supplemental plan for M&R coverage for yourself and J-2 dependents. We suggest you purchase the medical evacuation and repatriation plan offered also by Arthur J. Gallaher and Co. to meet this requirement. The Gallagher M&R Plan costs $45 per year per person. Be aware if you select a different M&R plan, that the minimum requirements for coverage are $50,000 for medical evacuation and $25,000 for repatriation. Additionally, you must complete an M&R Compliance Form and submit it to the Office of International Affairs (OIA).
These employment-based health insurance plans through Ohio State and Nationwide Children's Hospital are managed by human resource offices at each institution and enrollment is offered after you arrive in Columbus. Individuals employed through Nationwide Children's should seek information regarding the details of the insurance plan directly from the hospital. Click on the following links for more information about the Ohio State employment-based health insurance plans:
Alternative ACA Comprehensive Insurance Information & Compliance Application
As mentioned above, depending on your situation, you may prefer, or be required to purchase an ACA compliant health insurance plan. However, you may not be eligible for the ACA employment-based plans offered by Ohio State or Nationwide Children’s Hospital. If this is the case, you may email OIA Office Associate Latasha Carruthers at firstname.lastname@example.org requesting information about other ACA plans that are available to J-1 visiting scholars and their families. You are responsible, however, for determining the quality of the insurance coverage and for determining if the insurance you select meets the all the ACA and DOS rules. Also be aware you must agree to the risks associated with selecting your own plan and agree to continue to verify your insurance coverage to OIA throughout your stay. To do this, email Ms. Carruthers to request the OIA ACA/DOS Alternate Health Insurance Compliance Application form. Complete the application form and return it to her. She will notify you if you have received approval to use an ACA alternate health insurance plan which also meets DOS requirements. To find out more information about the DOS and ACA rules and to determine if you are subject to ACA requirements review the following resources.
DOS and ACA Rules and Resources
DOS Minimum Insurance Requirements
ACA Healthcare - Rights and Laws
Requirements of Marketplace Health Insurance Plans
U.S. Internal Revenue Service links regarding the “Substantial Presence Test” to determine if you are subject to the ACA rules. If you are subject, you need to purchase an ACA compliant heath plan or you will be fined a penalty fee.
IRS International Taxpayers Substantial Presence Test
IRS Exempt International Taxpayers
Government Sponsored J-1 Scholars Insurance Information
If your home government is paying for your visit as a J-1 scholar and has purchased a health insurance plan on your behalf, OIA must receive proof regarding this plan. The plan must be a U.S. based plan that meets DOS and/or ACA requirements. To provide proof you are in compliance with the regulations, you must complete the ACA/DOS Alternate Health Insurance Compliance Application form. Email OIA Office Associate Latasha Carruthers at email@example.com to request the form.
Important Advice Regarding Dependents and Pregnancy
Depending on your situation and the health plan you choose, health insurance coverage for J-2 dependents can be very expensive. If this is the case for you, we suggest you do not bring your family on the J-2 status. However, family members can visit you on the B-2 tourist status and they will not be subject to the same insurance requirements and costs. For more information, click here.
If you become pregnant during your stay, having a health insurance policy that covers costs related to pregnancy and childbirth is strongly recommended. Not all insurance policies cover these costs so we recommend you look at the policies and chose one that does. Additionally, if conception occurred before arrival in the United States, it will be considered a “pre-existing” condition and some insurance policies do not cover pre-existing conditions which would result in you having to pay all costs. Estimates for costs vary, for more information read about the costs of having a baby in the United States.
Enrollling in the Health Insurance Plan(s)
Enroll in the health insurance plan before you arrive in the United States or immediately after arrival. If you select the Gallagher A&S Plan, enrolll online. If you select one of Ohio State's or Nationwide Children's Hospital's plans due to your employment, you will receive enrollment information after you arrive in Columbus.
Dental and Vision Coverage Options:
- Ohio State Health plans: Coverage is included but there is an additional cost for this coverage for J-2 dependents.
- Nationwide Children's Hospital plan: Coverage is optional and can be included for an additional cost.
- Gallagher A&S plan: Coverage is not included for J-1 scholars or J-2 dependent spouses but dental coverage can be added at an extra cost by purchasing Gallagher Voluntary Dental Insurance. There is no option for vision coverage.