Proof of Insurance Coverage

When filling out the form below please make sure you include an insurance card or confirmation of enrolled dates.  The insurance must meet the minimum requirements laid out below.  The minimum requirements must be clearly stated in the insurance policy that you provide.  If the insurance policy does not clearly state the categories below and the amounts covered then the insurance company can issue a letter on letterhead stating the requirements below are met by the policy.

Minimum Alternate Insurance Requirements:
$500,000+ per injury or illness
$50,000+ medical evacuation
$25,000+ repatriation
Alternate insurance must have a United States based contact. (Effective January 1, 2022)

If you are a J visa holder you can learn more about your alternate insurance requirements here.