Student Health

Health Information for International Students & Scholars

What rules apply to international students holding a J-1 or F-1 visa?


If you are enrolled in a program that requires payment of the health fee and you are an international student holding a J-1 or F-1 visa, participation in the Duke SMIP is mandatory - you will be automatically enrolled in and charged for the Duke SMIP, however, you will not receive your insurance card until the end of September. If you are going to enroll dependents, you do need to enroll yourself first at Blue Cross & Blue Shield of North Carolina (BCBS of NC).

Health Insurance – International Students
Health Care is very expensive in the USA and quite different from other countries. In many countries the government pays for health care for its citizens while in the United States individuals are responsible for these costs themselves. The USA has a pay-for-services system. Without insurance, an office visit to see a doctor for a minor illness costs between $200 - $400; a "normal" pregnancy and delivery care will cost at least $15,000; an appendectomy with two nights in the hospital could easily be $25,000. These potential fees are the reason why you must purchase health insurance!



Primary Care for Duke Students
Duke University requires that every enrolled international student have mandatory primary care through the Duke Student Health Center.  Thus you will see the Duke Student Health fee appear on your bursar's bill each semester. This mandatory Health Fee allows you to receive treatment at the Duke Student Health Center for free. It also entitles you to use CAPS (Counseling Services) at no additional cost.

Remember, if you have an emergency that is not CRITICAL when the Duke Student Health Center is NOT open, call (919) 681-9355 FIRST. A recorded message will tell you what to do for medical assistance.



Health Insurance - Scholars (all non-Duke students)
(The information below is applicable to all J-1 and J-2 Non-Student visa holders as well as H-1 and H-4 visa holders.)

The Need for Health Insurance
It is very unwise to be in the United States without adequate health insurance. Although in many countries the government bears the expense of health care for its citizens, individuals and families in the United States are responsible for these costs themselves. Since a single day of hospitalization and medical treatment can cost thousands of dollars, many hospitals and clinics refuse to treat uninsured patients except in life-threatening emergencies. A good medical insurance plan is the only protection against the enormous costs of health care in the USA.


The J-1 Visitor Exchange Program Medical Insurance Information
If you are a J-1 or J-2 visa holder, you MUST have a medical insurance policy that meets certain conditions the entire time you are in the United States. In addition to these requirements, Duke University has specific requirements for its J visa holders.  To view these Medical Requirements go to Duke University Visa Services webpage on J Visitor Exchange Program.

If you are a J-1 or H-1 visa holder AND are Employed by Duke
You should be getting a monthly paycheck and benefits from Duke.  If you are not sure, then please contact your sponsoring department immediately and ask them. Generally speaking, to qualify for the Duke Employee Health Insurance Plan, you must be employed 40 hours per week.  Ask your department. 

If you are eligible for the Duke Employee Medical Insurance, you will go to a Benefits Orientation a few weeks after you start working at Duke.  This is when you will sign up for the Duke Employee Medical Insurance.  Again, make sure to ask a representative from your department about registering for the Benefits Orientation. To learn more about the different options for the Duke Employee Medical Insurance, go to:  http://www.hr.duke.edu/benefits/medical/index.php

The Duke Employee Medical Insurance DOES NOT cover Medical Evacuation and Repatriation of Remains which is required for all J-visa holders.  International SOS is a supplemental policy that covers these two areas only.
The yearly costs are as follows:

• Individual: $68

• Individual & Spouse: $130
• 
Individual & a Child: $130
• 
Individual & Family: $200

For more information and to enroll go to  https://www.internationalsos.com/en/



NOTE : Clinical House Staff employees sponsored by the Educational Commission for Foreign Medical Graduates (ECFMG) do not need to purchase additional insurance for Medical Evacuation and Repatriation of Remains. This policy is already purchased for you by the ECFMG.

I am a J-1 Scholar Not Employed by Duke
You must purchase a policy from Garnett-Powers & Associates. An overview of their coverage is listed below. Detailed information can be found at:

 http://www.garnett-powers.com/duke/vs/ .

  • Plan maximum unlimited.
  • All service deductibles/copays, coinsurance and policy deductible will now apply toward the out of pocket maximum. 
  • There are no pre-existing condition limitations.
  • The plan includes pediatric dental and vision.
  • There is no maximum on durable medical equipment.
  • Out of pocket maximum is now $7,000 for family in network.
  • Out of pocket maximum is now $21,000 for family out of network.
  • Prescription coverage with regard to the types of drugs called tiers (1, 2 and 3) are $20/$40/$80.
  • Medical evacuation up to $10,000 or more.
  • Repatriation up to $7,500 or more.

Monthly Premiums for Garnett-Powers and Associates Medical Insurance
Scholar:  $242.00 per month
Scholar and Spouse:  $863.00 per month
Scholar, Spouse and one Child:  $1203.00 per month

The specific text regarding the insurance requirement information appears in the Exchange Visitor Regulations, Title 22 of the Code of Federal Regulations, on the Department of State web site. Scroll down to Section 62.14 for the full text. While these regulations provide the minimum insurance guidelines, it has been determined by the Duke University Administration that the minimum standards do not reflect the relatively high cost of medical services in North Carolina. Duke University requires the following insurance coverage:

  • $500,000 or above per person per event or accident.
  • Annual Deductible $250 or less.
  • Coinsurance that does not exceed 20%.
  • Medical evacuation up to $10,000 or more.
  • Repatriation up to $7,500 or more.
  • Maternity included in the coverage (pregnancy).

For more details, visit the Duke University Visa Services website at http://www.visaservices.duke.edu/J_Health_Insurance.html

If you want to purchase a Medical Insurance Plan from your home country, take the J-1 Medical Insurance Requirements to your local insurance office or travel office. Ask the insurance agent to determine if their company has a Medical Insurance Plan that meets all the requirements of the J-1 Medical Insurance. If they do, you will purchase the medical insurance for the length of time you are in the United States. International House and Duke Visa Services cannot legally verify if your home medical insurance plan meets all of the J-1 health insurance requirements. You must verify this yourself or have an insurance agent from home to do so.



If you do NOT purchase a medical insurance plan from your home country, then International House has applications for four different Medical Insurance Plans that meet all the J-1 visa requirements: to see what the six requirements are. cover you while in the United States, then you can either purchase a medical insurance policy that will OR you can purchase a Medical Insurance policy after you arrive to Duke, see chart below:

Please note that none of these Medical Insurance Plans cover a Pre-Existing Condition (i.e. a medical condition you have had prior to signing up for the plan. If you are already pregnant prior to signing up for the plan then pregnancy expenses will not be covered.)  Compass, The Plan and the NY Service Center Plan for Chinese Scholars do cover pregnancy if one conceives after enrolling in the plan.  If interested, we can assisted you in registering for one of these plans during a Scholar Orientation.

Medical Insurance for Travel to United States and First Month at Duke

We recommend that everyone purchase a traveler's medical insurance for his or her first month at Duke. WHY? If you are an employee and eligible for the Duke Employee Health Insurance Plan, the Plan does not begin until one month after your start date at Duke.  If you are NOT an employee and plan to purchase a Medical Insurance Plan from International House, it may take several weeks to do so, or to finalize your decision.



Therefore we strongly recommend that all J-1 scholars and dependents arrive in the United States with a one-month traveler's insurance. The only exception would be if you have purchased a Medical Insurance Plan from home for your entire stay at Duke and therefore you are covered from the start.  Or, now with credit cards, you can purchase one of the US plans we recommend prior to your departure to Duke. 



The Need for Health Insurance 

It is very unwise to be in the United States without adequate health insurance. Although in many countries the government bears the expense of health care for its citizens, individuals and families in the United States are responsible for these costs themselves. Since a single day of hospitalization and medical treatment can cost thousands of dollars, many hospitals and clinics refuse to treat uninsured patients except in life-threatening emergencies.  A good medical insurance plan is the only protection against the enormous costs of health care in the USA.



How Medical Insurance Works 

When you purchase a medical insurance plan, the money you pay (the monthly premium) is combined with the premiums of other subscribers to form a pool of money. This money is then used to pay the medical bills of subscribers who need medical insurance. Your medical coverage remains valid only as long as you pay your medical insurance premiums.

Once you purchase medical insurance, your insurance company will provide you with an identification card.  Show this card when you have to go to the hospital or clinic. The insurance company will evaluate any doctor's bill (also called a claim) that you file and make the appropriate payment either your doctor's office or to you, based on your particular medical policy. In some cases the insurance company pays the hospital or doctor directly. In other cases the company reimburses you directly.