Policy Overview
Green card applicants must complete a medical examination by a USCIS-authorized civil surgeon before receiving their green card — here's exactly what the exam includes and costs.
Plan Details & Expat Advice
The USCIS immigration medical examination includes: (1) Complete physical examination (cardiovascular, neurological, skin examination). (2) Mental health screening. (3) Substance use disorder screening. (4) Vaccination review and required updates — CDC requires: measles/mumps/rubella (MMR), influenza (seasonal), varicella, Tdap, COVID-19, meningococcal, pneumococcal, and Hepatitis A and B vaccines (series varies by age). (5) Tuberculosis (TB) screening — all applicants age 2+ undergo IGRA blood test or TST; those over 15 with reactive results need chest X-ray. Results are recorded on Form I-693, sealed by the civil surgeon, and submitted directly with the I-485 or to USCIS. Never open the sealed envelope. The exam results are valid for 2 years — if your case takes longer than 2 years, you may need to repeat the exam at additional cost. Find USCIS-designated civil surgeons at the USCIS website (uscis.gov/civilsurgeons).
Coverage Limits & Conditions:
Medical exam (Form I-693) required for: all family-based and employment-based green card applicants. Exam performed only by USCIS-designated civil surgeons (not personal doctors). Results are sealed and valid for 2 years from exam date.
Average Costs & Premium Structure:
Civil surgeon examination: $200–$500 depending on physician and city. Additional costs: required vaccinations ($50–$300), TB test or IGRA blood test ($40–$80), chest X-ray if TB screen positive ($100–$200). Total typical cost: $300–$800.
🏥 Navigating the U.S. Healthcare System
For newly arrived expats and international visitors, the United States medical system operates via private insurers, employer-sponsored plans, and independent network provider groups. Understanding terms like deductibles, copayments, coinsurance, and out-of-pocket maximums under ACA rules (45 CFR 156.130) is essential.
❓ Frequently Asked Healthcare Questions
A copay is a fixed dollar fee for a service (e.g. $30 per doctor visit). Coinsurance is a percentage of the total medical bill paid after meeting your deductible (e.g. 20% of a surgery cost).
Yes. Urgent Care clinics treat non-life-threatening conditions much faster and cheaper than hospital Emergency Rooms.
• Healthcare.gov Official Marketplace: healthcare.gov
• Medicare.gov Official Portal: medicare.gov
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- 📋 In-Network: Confirm your doctor is inside the PPO Network before booking appointments.
- 🔍 Brochure: Always read the detailed certificate of insurance.
- 🚨 Emergencies: Understand differences between urgent care and emergency room costs.