Health insurance for an international student in the US isn't a formality — it's a condition for maintaining status. Without a policy that meets the university's requirements, your student account is blocked: you cannot register for courses, and therefore cannot continue your studies. Understanding the rules in advance is easier than scrambling to fix things in the first weeks of the semester, when only days remain until the deadline.
Why Insurance Is Mandatory
For J-1 visa holders, insurance is a federal legal requirement. The State Department sets a minimum set of coverage: at least $100,000 per accident or illness, a deductible no higher than $500, repatriation of remains coverage of $25,000, and medical evacuation coverage of $50,000. Failure to comply with these requirements leads to termination of J-1 status.
For students with an F-1 visa, there is no federal mandate — the rules are set by the university itself. But almost all institutions require a policy as a condition of enrolment. Without it, the student account is blocked, and course registration becomes impossible. Even in the absence of a formal requirement, declining insurance is risky: a single visit to the emergency room starts at $1,500, and hospitalisation for a fracture or appendicitis can run into tens of thousands.
State Department Minimum Requirements
For J-1, four requirements are mandatory. Medical benefits — at least $100,000 per accident or illness. Deductible — no more than $500 per accident per year. Repatriation of remains — at least $25,000. Medical evacuation — at least $50,000. Additionally, the insurer must have a rating of at least A- on the A.M. Best scale or an equivalent from another recognised agency.
Universities often set their own thresholds for F-1, which may be higher than federal ones. In the UNC system, for example, since January 2026 all international students are required to participate in the SHIP plan, and the minimum coverage is $100,000 per accident, deductible no higher than $500, evacuation — $50,000, repatriation — $25,000. A waiver is possible only under strictly defined conditions.
What the University Plan Covers
The university policy is automatically included in the tuition bill. Cost varies: at Radford University, the plan for 2026–2027 costs $1,876.68 per year; at Oklahoma State — $3,157; at Drexel — $3,178. The average range nationwide is from $1,200 to $4,000 per year. The plan usually covers doctor visits, hospitalisation, emergency care, psychiatric services, and prescription medications. The deductible may be zero or low, and the provider network may be broad.
The downside is the price. University plans are calculated for a mixed group of students, including Americans, and are therefore more expensive than policies aimed exclusively at international students. For a student who rarely sees a doctor, the overpayment can be significant.
When It Makes Sense to File a Waiver
A waiver means opting out of the university plan in favour of an outside policy that meets the school's requirements. If the outside insurance is cheaper and covers everything necessary, the student saves from $1,000 to $3,000 per year. For example, at the University of South Carolina, the university plan for winter and spring costs $2,184, while an alternative policy from Student Medicover starts at $721. At Harvard, the savings when switching to Student Medicover reach $1,463.
Student Medicover is one of the popular providers working with F-1 and J-1 students. Plans are issued through UnitedHealthcare Student Resources, which gives access to the largest provider network in the US. There are several levels of coverage: Prime 100 with a $100 deductible and 80% coverage, Elite with a zero deductible and 90% coverage, Supreme with the maximum set of options. Prices start from $2.27 per day.
Waivers come with strict deadlines. At the University of Texas at Dallas, the application window for the autumn semester is open from 22 July to 9 September 2026. Missing the deadline means automatic enrolment in the university plan — and the charge that comes with it. The application process usually takes a few business days; after approval, the school refunds the previously charged amount.
How to Choose a Policy
First, check with your DSO about the specific university's requirements. They vary: some accept only plans registered and approved in the US, others require a minimum insurer rating, and still others set their own thresholds for deductible and coinsurance. Without this step, you may buy a policy that will not be accepted for a waiver.
Second, compare not just the price but the coverage structure. A low deductible is more important than a low premium if the student plans to see a doctor. The provider network determines which specialists you can see without a referral and at what rates. The out-of-pocket maximum limits the maximum amount the student pays per year — this is a key parameter for serious illness or injury.
Third, check the dates. The policy must be effective from the first day of the semester, without gaps. If the student arrives earlier, it is worth taking out separate travel insurance for the period before the main policy takes effect.