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International Student and Scholar Services

J Exchange Visitor Health Insurance Information

J Exchange Visitor Health Insurance Requirement

As a J-visa holder, you are required to have health insurance during your entire stay in the U.S. in J-1 visa status for you and your J-2 dependents. The insurance plans must meet the following requirements:

  1. Medical benefits of at least $100,000 per accident or illness;
  2. Repatriation of remains in the amount of $25,000;
  3. Expenses associated with medical evacuation of the EV to the home country in the amount of $50,000; and
  4. A deductible not to exceed $500 per accident or illness.

Insurance policies secured to fulfill the requirements of this section:

  1. May require a waiting period for pre-existing conditions that is reasonable as determined by current industry standards;
  2. May include provisions for co-insurance under the terms of which the exchange visitor may be required to pay up to 25% of the covered benefits per accident or illness; and
  3. Must not unreasonably exclude coverage for perils inherent to the activities of the exchange program in which the exchange visitor participates.

Any policy, plan, or contract secured to fill the above requirements must, at a minimum, be:

  1. Underwritten by an insurance corporation having an A.M. Best rating of “A+” or above; a McGraw Hill Financial/Standard & Poor’s Claims-paying Ability rating of “A+” or above; a Weiss Research, Inc. rating of “B+” or above; a Fitch Ratings, Inc. rating of “A+” or above; a Moody’s Investor Services rating of “A3” or above; or such other rating as the Department of State may from time to time specify; or
  2. Backed by the full faith and credit of the government of the Exchange Visitor’s home country; or
  3. Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor; or
  4. Offered through or underwritten by a federally qualified Health Maintenance Organization or eligible Competitive Medical Plan as determined by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.

Any J-1 Exchange Visitor who fails to maintain minimum insurance coverage for themselves or their J-2 dependents may be subject to termination of their Exchange Visitor status, so it is important that you have adequate health insurance for your and your dependents for the duration of your stay while participating in your J program.

As of January 1, 2026, there are no Middlebury employee health insurance plans which meet the J Exchange Visitor regulatory requirements.  Middlebury Human Resources with the assistance of ISSS is in process of determining if any alternatives can be offered that do meet the requirements.  We will update this page accordingly. 

Any Middlebury non-student employee is welcome to sign up for one of the Middlebury employee health insurance plans.  However, if the employee is in J-1 status they will have to purchased an additional health plan on their own to meet the regulatory requirements. See the list of companies further down on this page that sell plans that meet the requirements.  To learn about the Middlebury employee health insurance go to: https://www.middlebury.edu/human-resources/self-service-resources (click on the location-based employee section that is relevant to you first, then the current year benefits link in that).

Students are generally eligible to purchase the Middlebury student health insurance at the College.  This includes those who are Teaching Assistants and Exchange Students.  This plan exceeds the J regulatory requirements. (NOTE: the student insurance does not cover vision or dental care.)

If one is not eligible for Middlebury’s student health insurance plan, a plan must be purchased that will meet this requirement either before or upon arrival to Middlebury.  You may be asked by ISSS to provide evidence that you have health insurance as is required by regulations during your check in or orientation.

All Summer Language School faculty/staff that are sponsored by Middlebury in J-1 Status: Middlebury provides health insurance that meets the requirement for this population.  The J-2 dependents are provided this insurance as well as it is required they have the same coverage by J regulations; but Middlebury deducts the J-2 dependents’ premium from the J-1’s salary.

Health Insurance Companies

Many U.S. companies provide health insurance for international Exchange Visitors. Some Exchange Visitors qualify for plans offered by Middlebury to its students and benefits-eligible scholars (professors, researchers, short-term scholars). For Exchange Visitors who do not qualify for a plan offered by Middlebury, we provide this resource list of companies that offer insurance plans for J-1 students and scholars.

NOTE: Middlebury does not endorse any of the companies on this list, nor is this list a complete list of available options. You are responsible to ensure that the plan you purchase meets/exceeds the J regulatory requirements as explained above.

If you are a J-1 Exchange Student at the Middlebury Institute, please visit the health insurance section on their website at: https://www.middlebury.edu/institute/student-life/health-wellness/insurance.

Affordable Care Act

All Exchange Visitors and any accompanying spouse and child dependent(s) may be subject to the requirements of the Affordable Care Act (ACA) [22 CFR 62.14(a)]. Per the NAFSA: Association of International Educators website:

The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or “ACA” for short, is the comprehensive health care reform law enacted in March 2010. This law requires individuals who do not maintain “minimum essential healthcare coverage” to make an additional payment to the Internal Revenue Service (IRS) when they pay their taxes, unless they are exempt. This is often called the “individual mandate.”

The individual mandate and nonimmigrant students and scholars: A nonimmigrant alien’s tax residency status under Internal Revenue Service (IRS) rules determines whether he or she is subject to the requirement to carry ACA-compliant insurance or to pay the tax penalty for not carrying it:

  • Nonresident aliens for tax purposes are not subject to the individual mandate
  • Resident aliens for tax purposes are subject to the individual mandate

Background: The ACA provides in general that aliens who are “lawfully present in the United States” will be subject to the individual mandate and the shared responsibility payment. IRS regulations at 26 CFR §1.5000A-1(a) provide that “For each month during the taxable year, a nonexempt individual must have minimum essential coverage or pay the shared responsibility payment.” The question then becomes whether nonimmigrants are “exempt” or “nonexempt.” If exempt, they do not need to carry minimum essential coverage or pay the shared responsibility payment under the ACA. Since the shared responsibility payment is connected to the tax process, the categories of individuals exempt from the individual mandate are listed in IRS regulations, at 26 CFR §1.5000A-3 [as amended by 78 Fed. Reg. 53646 (August 30, 2013)].

Applying the rules for determining tax status requires great attention to detail, and a nonimmigrant’s tax residency status (and therefore his or her liability under ACA) can change during the year.

For additional information on tax filing requirements for students and scholars and to learn more about the ACA, please consult a tax expert.


Updated 01/08/2026

International Student and Scholar Services

(802) 443-5858
isss@middlebury.edu