H1 and H4 Visa Medical Insurance

What is H1 visa and what is H4 visa?

An H1 visa holder is eligible to stay and work in the U.S. for a limited time. Their dependents (spouse and minor children) can get the H4 visa to accompany them but do not get a social security number and are not eligible to work. Work exception for H4 Visa EAD.

Please refer to Immihelp H visa section for complete information.

Who is considered U.S. resident? I am on the H1 visa which is a temporary worker. How can I be a U.S. resident?

In general, whoever lives in the U.S. is a U.S. resident. There is no precise or universal definition of U.S. residency. Different U.S. government agencies take the position that is suitable to them.

E.g., IRS (tax department) indicates that any person who stays in the U.S. 6 months or more of the year is a U.S. resident. However, Department of Homeland Security (immigration department) says that only persons with a green card are permanent residents, while the H1 visa holder is a temporary worker and their spouse is a temporary resident as well.

However, for health insurance purposes, most companies do not consider the possession (or lack) of a green card as the criteria for being a U.S. resident. Each company has their own rules and within each company, it may vary by states. (Remember, the United States is not united for insurance purposes.)

Therefore, if you have been living in the U.S., you are U.S. resident. Most states would consider you a U.S. resident after you have already lived in the U.S. for 6 months. Please note that, even for filing tax returns, you file Form 1040, and not Form 1040-NR which is for non-U.S. residents.

In short, green card and residency are two separate things.

What is visitors insurance?

Visitors insurance is the international travel medical insurance for persons temporarily visiting the U.S. The insurance products listed in the visitors insurance category themselves are not limited to visitors visa holders only. However, the visitors insurance category is used for such plans because visitors are most likely to qualify for them. However, some of the same plans could be used for international students on OPT who recently graduated, and that would be called OPT insurance. Similarly, some of those plans could be used for new immigrants to the U.S. and therefore called new immigrants insurance. Of course, everyone is not eligible for all the plans. Simply for the ease of referring to such plans, we will use the term visitors insurance for rest of this web page, even though some of the products are strictly not for visitors only.

Who is eligible for visitors insurance?

Anyone who is not eligible to get the domestic health insurance in the U.S. due to age, citizenship or residency is eligible to purchase visitors insurance.

My employer provides health insurance to employees, but it is very expensive. Can I buy visitors insurance?

No, you must buy the insurance through your employer.

I can't afford the premiums for the health insurance provided through my employer. Can I buy visitors insurance?

Affordability is not the criteria for eligibility to purchase visitors insurance.

My employer covers myself but they don't pay for my dependents and it is very expensive. Can I buy visitors insurance?

No.

My employer does not offer group health insurance. Can I buy visitors insurance?

It depends. If you are able to get individual health insurance, you need to buy that.

Individual health insurance plans are too expensive. Can I buy visitors insurance?

No. As long as you are eligible to enroll into domestic health insurance plans, you need to buy them.

But why can't I buy visitors insurance if I am eligible to purchase domestic health insurance?

You cannot buy visitors insurance if you are eligible for domestic health insurance because that is how the insurance companies offering visitors insurance are set up and what they are licensed to offer.

I am on the H1 visa and my wife will be joining me soon. However, my employer has a waiting period before I can enroll her into their group health insurance. Can I buy visitors insurance?

Possibly. If she is not yet in the U.S., you can purchase for a short duration. If she is already in the U.S., again, it depends upon whether she is eligible for any other domestic health insurance.

I have seen several web sites where they clearly mention that I can purchase XYZ visitors insurance plan while on H1 and H4. I am really tempted to purchase XYZ insurance plan, because it is really low cost and I believe it would fit my requirements. However, according to your FAQ here, it seems that I would not be eligible to purchase. Who is right?

We, as a broker, work in your best interest. Our first priority is to offer you the insurance plans that you are eligible to purchase and in turn, the insurance plans that will pay the eligible claims when you are sick or injured.

Most likely, we also offer the same XYZ insurance plan. However, we do not just want to sell you something when you are not eligible for coverage. It is in no one's best interest. Please note that the insurance is simply a piece of paper until you really need to use it. At the time of claim, if they determine that you were not eligible to buy the insurance, they would simply cancel your policy and return your premium, instead of providing you the coverage. You would be left without any coverage when you really need it.

By telling you that you are not eligible to purchase something that we also sell, we are simply turning away the business. However, that is in your best interest and shows our commitment to you.

I saw several plans in your expatriate health insurance section and I would like to purchase one of them. I also talked to one of the agents (not your office) and that agent indicated that I could purchase those plans if I am on H1. Am I eligible to buy it?

Almost all those plans are only meant for those who are non-U.S. residents, that is those who spent more than 6 months outside the U.S. They are not meant for U.S. residents. Just because you are H1 or H4 does not automatically make you a non-U.S. resident, as explained above. Those who advise you otherwise simply are not aware of complexities of the U.S. immigration system or just want to sell you something that you are not eligible for.

As we already offer those plans to those who are eligible, and we are indicating that you are not eligible to buy them. You can be certain that there is no other intention than to provide you with the correct information.

expatriate health insurance section and it asks for the home country address. I am from India, for example. Should I enter the U.S. address as my home country address or the India address?

Home country is the place where you live. Just because you are on an H1 visa that does not automatically mean you are not a U.S. resident. Again, green card (permanent resident card) is a separate matter from the U.S. residency. Just because you are a citizen of India or were born in India, it does not automatically mean your home country is India. Even after you get your green card, then become U.S. citizen, most people will still refer to you as Indian, but that does not automatically make your home country India. Even your U.S.-born children and their grandchildren may still be referred to as Indian even though they are only of Indian descent, but that does not mean that their home country as India.

If you are in the U.S. on the H1 visa, in most cases, your home country is the U.S. You live in the U.S., have a driver's license in the U.S., have a house, apartment or condominium in the U.S., you pay taxes and file U.S. resident tax returns in the U.S., and pretty much do most of the same activities just like any other U.S. resident.

If you put your home country as the U.S., you will not be accepted in most plans. Even if you are accepted initially in some plan, you will not be allowed to renew your insurance. In most cases, the insurance agent will have to sign an affidavit that he/she diligently tried to obtain the insurance for you from at least three domestic health insurance companies that are licensed to do business in your state, but declined to offer you the insurance. Only then, you would be able to have such insurance as this insurance is not meant to be purchased by those who are eligible to purchase domestic health insurance in the U.S. In some case, the insurance agent may ask you to sign the affidavit that you tried to obtain the insurance from at least three companies but couldn't. Do not sign such an affidavit unless it is really true.

Do not put your home country as India simply to attempt to get insurance coverage.

If you don't do everything correctly and truthfully, at the time of claim the insurance company would simply reject your claim and instead state that you misrepresented the facts on your application and cancel your insurance and not pay any of the claims. Believe us, it has happened in the past.

My wife is joining me soon on an H4. However, she is pregnant. What health insurance can I buy for her?

Check with your employer to find out whether she would be eligible to enroll in their group health insurance and whether there would be any waiting period before the maternity expenses would be covered. Even if that plan is expensive, that is your only choice. You will not find individual health insurance anywhere in the U.S. market that would cover pregnancy related expenses for someone who is already pregnant, as it is clearly a loss to the insurance company.

If that is not an option, you would have to be ready to pay all the expenses out of your pocket. If that is not an option, it would be the best if she delivers the baby in her home country before traveling to the U.S. However, if you want to deliver the baby in the U.S. so that he/she is a U.S. citizen, you will have to pay the expenses yourself. Someone else is not going to pay so that you can get the perceived benefits of baby being a U.S. citizen.

My wife is currently not pregnant. However, we are planning on expanding our family. Do you have family health insurance that would cover maternity?

Check with your employer to see if they provide group health insurance that would include maternity. That is pretty much your only option.

Even without maternity coverage, it is already difficult to get individual health insurance for H4 visa holders in most U.S. states because they don't have a social security number.

My employer's group health insurance is quite expensive. Even the individual health insurance is quite expensive. Do you have any affordable alternatives?

Healthcare expenses are very high in the U.S. and therefore, health insurance is very expensive. Therefore, you will just have to get used to paying high premiums. There is no other alternative. You can only purchase what is available in the market, provided you are eligible to purchase it.

Consider working for an employer who is wiling to pay a major portion of your health insurance premiums.

I am on the H1 visa. I was covered by my employer's group health insurance. I have switched to a new employer and there is a waiting period before I can be covered under their group health insurance plan. Can I buy visitors insurance?

No. Consider purchasing domestic short term medical insurance instead. If you are in a state where domestic health insurance is not offered (such as New York, New Jersey, etc.), you are out of luck.

I am still not convinced. I have seen several websites where they have a specific H1 visa health insurance and they have specifically listed the products that you claim that I am not eligible to purchase. How is that possible?

Please read all of the above discussion again and show it to that agent and educate him. Either they don't know what they are doing or are hoping that you will not find out. Please note that we are among the largest brokerage firms in the U.S. for visitors insurance plans, and we have nothing against those plans. We, as a broker, are here to sell you insurance, but only if you are eligible to purchase.

If you are still not convinced, please buy the insurance from somewhere else, not from our website if you are not eligible for it. Please remember that you are just getting a really expensive piece of paper, not insurance coverage for when you need it. And we wish you a lots of good luck.

I am not on the H visa but on the L visa. What are the options in that case?

All the discussion and FAQ above applies to the H visa as well the L visa and even the R visa.