Quick answer: Rules depend on your visa. J-1 sponsors must require insurance with federal minimum amounts. F-1 requirements usually come from the school. H-1B holders often use an employer plan. E-2 holders usually buy their own. Green card holders can use the Marketplace and remain eligible for federal subsidies from 2027, unlike most visa holders.
Health insurance for immigrants and visa holders is not one rule but several. Here is how each status works.
What health insurance does a J-1 exchange visitor need?
A J-1 sponsor must require insurance covering sickness and accidents for the whole program, and spouses and dependents (J-2) must be covered too, according to the State Department rule at 22 CFR 62.14. Minimum coverage is:
- medical benefits of at least $100,000 per accident or illness;
- repatriation of remains of $25,000;
- medical evacuation of $50,000;
- a deductible of no more than $500 per accident or illness.
Coinsurance may be up to 25% of covered benefits, and the insurer must meet rating standards. Sponsors must also tell exchange visitors they may be subject to the Affordable Care Act. A visitor who willfully fails to maintain coverage can be terminated from the program. A plan that meets these numbers satisfies a program rule, which is not the same thing as an ACA Marketplace plan.
What about F-1 students?
For F-1 students, insurance is normally set by the university, which is why you should read the school's requirements before buying anything. One French-language guide we reviewed says the F-1 visa itself imposes no insurance requirement; we did not verify that against a federal source, so treat it as unconfirmed. Ask your school in writing what it accepts and whether a waiver exists, and see our 2027 visa guide for what to compare next.
What about H-1B and other employer-sponsored visas (L-1, O-1)?
HealthCare.gov lists workers' visas such as H-1B among statuses that may qualify for Marketplace coverage, and the usual first stop is the employer plan. Compare that offer first, including dependents' cost and when coverage starts. Spouses and children (for example H-4) may have their own eligibility, so confirm their status on the application. If you lose the job, HealthCare.gov lists loss of job-based coverage as a Special Enrollment Period trigger, and immigration consequences are a legal matter for an attorney.
What about E-2 investors and entrepreneurs?
E-2 holders are often owners or self-employed, so they usually buy individually. The Maryland state marketplace page names E-2 (treaty investor) among statuses eligible to enroll in a private plan, and HealthCare.gov lists "other visas" for non-immigrants. From 2027 the premium tax credit is limited by law to permanent residents and a few other groups, so plan on full price. See our entrepreneur page and 2027 visa guide for the plan comparison.
What about green card holders and other immigrants?
For health insurance for green card holders, the key point is that lawful permanent residents (LPRs) are on HealthCare.gov's list and are among the groups that keep premium tax credit eligibility from 2027 under Public Law 119-21 section 71301. Many green card holders also face a five-year Medicaid waiting period, per the CMS deck of August 2024 (before the 2027 changes), and new federal Medicaid alien-eligibility rules start on October 1, 2026 under section 71109. Check current state rules.
Visa-by-visa comparison
| Status | Who usually sets or shapes the requirement | Marketplace purchase possible? | Federal premium tax credit from 2027 |
|---|---|---|---|
| J-1 / J-2 | Program sponsor, using 22 CFR 62.14 minimums | HealthCare.gov lists non-immigrant statuses; check your case | Not for most visa holders (Public Law 119-21) |
| F-1 / F-2 | School (verify with the school) | Student visas listed by HealthCare.gov | Not for most visa holders |
| H-1B / H-4, L-1, O-1 | Employer plan usually first | Workers' visas listed by HealthCare.gov | Not for most visa holders |
| E-2 | Usually yourself | Yes, named by Maryland's marketplace | Not for most visa holders |
| Green card (LPR) | Employer or yourself | Yes | Yes, LPRs remain eligible |
What changes for these visas in 2027?
Public Law 119-21 section 71301 limits premium tax credit eligibility to lawful permanent residents, Cuban and Haitian entrants and Compact of Free Association migrants for taxable years beginning after December 31, 2026. Visa holders can still buy Marketplace plans according to HealthCare.gov, without that credit. The primary source is the enacted text, and healthinsurance.org gives the practical reading. Full enrollment details are in our ACA and visa guide.
Does the picture change if I get a green card later?
Usually your options improve, but check the timing. Ask your broker whether to stay on your plan or change when the status changes, and whether a green card application affects coverage choices. The Maryland marketplace says financial help through Medicaid or a private plan can matter for public charge from September 18, 2026, while a private plan without help does not. Ask an immigration attorney.
What mistakes should visa holders avoid?
- Buying a plan before reading the school or sponsor requirement.
- Assuming a plan that satisfies J-1 rules also works as an ACA plan, or the reverse.
- Forgetting spouses and children, who may need coverage of their own.
- Counting on a subsidy in 2027 without checking your status against the law.
What should I ask before I choose a plan for my visa?
Ask your sponsor, school or employer for the requirement in writing. Ask the insurer whether the plan satisfies it and whether it covers dependents. Ask a broker to compare a plan at full price if you lose the subsidy in 2027.
Key facts
- J-1 minimums: $100,000 medical, $25,000 repatriation, $50,000 evacuation, deductible up to $500, coinsurance up to 25% (22 CFR 62.14).
- J-2 spouses and dependents must be covered too.
- F-1: check the school's rules; the visa requirement itself is unverified in our sources.
- Non-immigrant visas including H-1B and student visas may qualify for Marketplace purchase (HealthCare.gov).
- From taxable year 2027, the premium tax credit is limited to LPRs, Cuban and Haitian entrants and COFA migrants.
- DACA recipients are not eligible for the Marketplace.
Frequently asked questions
What are the insurance requirements for the J-1 visa?
The sponsor must require coverage with at least $100,000 medical, $25,000 repatriation, $50,000 evacuation and a deductible of no more than $500. Dependents must be covered too.
What does Exchange Visitor insurance cover for J-1 and J-2?
The rule sets minimum amounts for medical benefits, repatriation and evacuation, and allows a waiting period for pre-existing conditions that is reasonable by industry standards. Read your policy wording for the details.
Does Exchange Visitor insurance cover pre-existing conditions?
The rule permits a reasonable waiting period for pre-existing conditions, so the answer depends on the policy. Ask the insurer.
What insurance for an H-1B or O-1 visa?
Start with the employer plan, then compare a Marketplace or private plan for dependents. Check subsidy limits from 2027.
Is my university student insurance enough in the USA?
Only if it meets the school's own rules and covers what you need. Ask the school and read the plan's exclusions.
Can immigrants on a work visa buy health insurance in the US?
Yes, HealthCare.gov lists workers' visas among the statuses that may be eligible to buy a Marketplace plan.
How long do green card holders wait for Medicaid?
CMS says many green card holders face a five-year waiting period, and federal rules change on October 1, 2026. Check your state.
Does my insurance need to cover repatriation?
For J-1, yes: $25,000 for remains and $50,000 for medical evacuation. For other visas, it depends on the school, employer or your own risk tolerance.
Sources
- eCFR, 22 CFR 62.14 (exchange visitor insurance): https://www.ecfr.gov/current/title-22/chapter-I/subchapter-G/part-62/subpart-A/section-62.14
- HealthCare.gov, immigration statuses that may qualify: https://www.healthcare.gov/immigrants/immigration-status/
- HealthCare.gov, health coverage for immigrants: https://www.healthcare.gov/immigrants/
- HealthCare.gov, Special Enrollment Periods: https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
- CMS, immigrant eligibility for Marketplace, Medicaid and CHIP (Aug. 2024 deck, before the 2027 changes): https://www.cms.gov/marketplace/technical-assistance-resources/immigrant-eligibility-marketplace-medicaid-chip.pdf
- Maryland Health Connection, immigrant families (example of a state marketplace): https://www.marylandhealthconnection.gov/health-coverage/immigrant-families/
- Public Law 119-21 (H.R. 1), official text, GovInfo: https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm
- healthinsurance.org, One Big Beautiful Bill Act changes (secondary source, updated Aug. 27, 2026): https://www.healthinsurance.org/blog/one-big-beautiful-bill-act-brings-sweeping-changes-to-health-coverage/
Get a quote
Want help comparing your options in English or French? Request a quote or message Charlyne on WhatsApp. This article is general information, not personal advice; plans, prices and eligibility vary by state, insurer, immigration status and year.