Health Care & Insurance

Health care system in the U.S.

 Health care in the United States is provided by private hospitals and clinics. Although in many countries the government bears the expense of health care for its citizens, in the U.S., individuals and families—including students—are responsible for these costs themselves. Living in the U.S. without adequate health insurance is unwise and potentially extremely expensive.

International students on a J-1 or F-1 visa as well as visiting scholars on J-1 visa are required by the University Texas System to have medical insurance during the duration of their studies/research.  J-2 visa holders who live in the U.S. are also required to have medical coverage. F-2 and F-3 visa holders are not required to have insurance but they are highly encouraged to purchase a policy. All exchange visitors and any accompanying dependents also may be subject to the terms of the Affordable Care Act.

Health care for Intl students and scholars

Registered J-1 and non-Mexican F-1 students will be charged the UTEP student health insurance premium on each semester’s tuition/fee statement. These students may qualify for a waiver of the health insurance premium if their insurance covers at least the following amounts as established by the UT System Board of Regents and the United States Department of State:

  • May include provisions for co-insurance under the terms of which the employee may be required to pay up to 25 percent of the covered benefits per accident and the covered benefits per illness.
  • Shall not unreasonably exclude coverage for perils inherent to the activities of the exchange programs in which the student participates.
  • Must be underwritten by an insurance corporation having an A.M. Best Rating of “A-“ or above, or a Standard and Poor’s Claims-paying Ability of “A” or above, and Insurance solvency International LTD (ISI) rating of “A” or above or Weiss Research Inc. rating of “B” or above.

If students/scholars have their own policy from their home country or another policy in the U.S. that meets the required health insurance amounts, they need to provide proof.  Registered students can apply for a waiver of the mandatory health insurance fee.

  1. a.       Students need to complete the “UT System International Student Insurance Waiver” form and submit it to the office of Human Resources no later than census day of each semester. If you are an employee of UTEP, you must be employed at 50% time (20 hours) or more per week and the appointment must be for 4½ months or more to qualify for UTEP health insurance.  
  2. b.      Scholars and J-1 student interns need to complete the “Confirmation of Insurance Coverage” form and submit it to the Office of International Programs.

The process for both forms is as follows:  1) complete the form; 2) attach proof of the other health insurance plan that includes the dates of coverage, insurance amounts, and coverage descriptions.

Both forms are located under the forms tab at the Office of International Programs website: http://sa.utep.edu/oip .

 Exemptions

 Considering that there is still no federal regulation for F-3 visa holders and based on the information available, it appears that F-3 visa holders are exempt from the insurance requirement.

To file as residents for tax purposes, individuals must live in the U.S. Since F-3 visa holders are required to live in Mexico and commute during their studies, the ACA will most likely not apply to this visa type.

  Affordable Care Act – ACA

 The ACA was enacted with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the costs of healthcare for individuals and the government. Beginning January 1, 2014, individuals who do not “maintain minimum essential healthcare coverage” must make an additional payment to the Internal Revenue Service (IRS) when they pay their taxes for the tax year 2014 and beyond. Individual tax status determines whether or not a person is subject to the tax penalty for not having health insurance. All exchange visitors and any accompanying dependents also may be subject to the terms of the Affordable Care Act.

If you file your taxes as a “resident,” and you do not have health insurance, you will be subject to the ACA tax penalty.

Example: If a student on F-1/F-3 visa is residing in the U.S. for five years or less, they can file as a “non-resident” for tax purposes. Starting their sixth year living in the U.S., they would become eligible to file as a “resident” for tax purposes and would need to abide by the ACA requirements. However, they may still be eligible to file as a “non-resident.”

If you file your taxes as a “non-resident” and you do not have health insurance, you will not be subject to the ACA tax penalty.

 Example: If students are Mexican nationals on an F-1/F-3 visa and commute to the US every day, they may always file their taxes as “non-resident” and will be exempt from the ACA requirements.

 If someone doesn’t have a health plan that qualifies as minimum essential coverage, he or she may have to pay a fee that increases every year:

  • from 1% of income (or $95 per adult, whichever is higher) in 2014 to
  • 2.5% of income (or $695 per adult) in 2016.

The fee for children is half the adult amount. The fee is paid on the 2014 federal income tax form, which is completed in 2015. People with very low incomes and others may be eligible for waivers. (www.healthcare.gov/glossary/fee )

 Resources

The staff at the Office of International Programs at UTEP is not trained in tax matters or the new health care reform (ACA). We do, however, host a tax assistance event every February where international students and scholars can complete their tax forms and speak to tax IRS representatives on-site.  If you have further questions, please visit the following websites:

Internal Revenue Service

Health Care.Gov

Family Resources

Academic Health Plans
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