F-1 students MUST have health insurance that meets the following requirements:
• A maximum deductible of $500 USD per accident or illness
• Payment of at least 75% of covered expenses
• Medical benefits of at least $100,000 USD per accident or illness
• Repatriation benefits of at least $25,000 USD
• Medical evacuation benefits of at least $50,000 USD
Which program are you in?
Current STREET ADDRESS in the U.S.
Current APARTMENT # (if applicable)
Current CITY and STATE in the U.S.
Current POSTAL CODE in the U.S.
Students have the opportunity to purchase other health insurance policies. Ask the representative if your policy covers the minimum requirements at the top of this page.
Health Insurance Confirmation Form:
Please attach your insurance confirmation
Name of Insurance Company
Policy Start Date (MM/DD/YYYY)
Policy Expiration Date (MM/DD/YYYY)
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