Health Insurance

UH Policy for International Students

The University of Hawai'i (UH) requires F-1 and J-1 international students to have adequate health insurance coverage throughout their programs of study. F-1 and J-1 students must either enroll in a UH endorsed student health insurance plan or furnish proof of enrollment in a health insurance plan that provides the required minimum coverage set by the President or the President's designee.

Because of federal regulations, there are differences between requirements for J-1 and F-1 students. The FAQs below will guide you for your visa type.

F-1 Health Insurance Requirements FAQ

Do I need to have health insurance?
Yes. The University of Hawaiʻi (UH) requires F-1 students to carry adequate health insurance. We recommend that both F-1 students and any F-2 dependents have health insurance for the entire period of their stay in the U.S.
Why is having health insurance important in the U.S.?

Medical treatment can be very confusing and expensive in the U.S. And because it is the responsibility of each person (not the U.S. government’s) to pay for his/her own health care, health insurance is required.

Does my health insurance need to provide a minimum level of coverage?

Yes. The University of Hawaii requires that your health insurance plan offers the following minimum levels of coverage (indicated in USD):

  • Comprehensive medical coverage = at least $100,000 per accident or illness;
  • Inpatient/Outpatient medical (including mental health) coverage at no less than 75% usual/customary charge (UCC);
  • Repatriation of remains coverage = at least $25,000;
  • Medical evacuation coverage to home country = at least $25,000
  • A deductible not to exceed $500 per accident or illness;
  • Waiting period for pre-existing conditions no longer than 6 months.
Are there important terms I should know before selecting a health insurance plan?
Yes. Here is a list of terms to help you understand health insurance plans:
  • Premium - an amount to be paid for a health insurance policy.
  • Deductible - a specified amount of money that the insured (the student) must pay before an insurance company will pay a claim. Some plans offer deductibles that are applied for each accident or illness, while others offer a deductible for each policy period.
  • Coinsurance refers to money that the insured (the student) is required to pay for services, after a deductible has been paid. Coinsurance is often specified by a percentage. For example, the insured pays 25% toward the charges for a service and the employer or insurance company pays 75%.
  • Co-payment - A co-pay is commonly confused with co-insurance. The two are similar, but there is one key difference. With a co-pay, the dollar amount that an individual will pay for health care services is fixed. There are absolutely no percentage participation rates with a co-pay.
  • Covered expense - an expense that qualifies for reimbursement or coverage under a health insurance plan.
  • In network provider - doctors or hospitals that are part of a health plan'snetwork of providers with which it has negotiated a discount.
  • Pre-existing condition - anycondition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan.
How do I decide which health insurance plan to purchase?

It is advisable that you contact a few different insurance providers for premium quotes and to compare coverage. You should feel free to ask the insurance representative any questions and take the time to learn about each plan before making a decision. If you are uncertain or confused, you should not purchase any plan until you fully understand the coverage.

What is health insurance clearance?

F-1 students must submit documentation of having health insurance that meets required health insurance coverage to the UH Student Health Insurance Office (SHIO), located in the QLCSS Building, Room 313D, in order to receive clearance to register for classes.

How do F-1 students receive health insurance clearance from Student Health Insurance Office (SHIO)?

Visit SHIO’s website on health insurance clearance. Go to Forms and Memos for additional information on purchasing other health insurance plans or requesting a waiver of clearance, if enrolled but conducting research outside of the U.S.

Whenever an F-1 student purchases or extends health insurance coverage, he/she must submit evidence of coverage to SHIO, QLCSS Building, Room 313D. If there are any questions, contact the SHIO Coordinator, at shio@hawaii.edu .

There are three options to purchase health insurance plans for F-1 students:

  • The University of Hawaii Student Health Insurance Plan (SHIP) - University of Hawaii has a student health insurance plan provided by HMSA, the BlueCross/BlueShield provider in Hawaii. The plan is available for purchase by the semester to all students, who meet eligibility requirements. There are four options offered to students. However, if international students choose to purchase the SHIP, they MUST buy Option 2 or 4 because they both offer medical evacuation and repatriation coverage.
  • The University of Hawaii “Employee Union Trust Fund” (EUTF) – for graduate assistants only – Employees of the University of Hawaii are eligible to purchase EUTF plans. NOTE: Because EUTF plans do not provide required minimum coverage for repatriation and medical evacuation (RME), you will need to purchase RME insurance in addition to any EUTF plan. Although University of Hawaii does not endorse health insurance plans outside of the student health insurance plan, this option for an RME plan has been accepted.
  • Other health insurance plans of your choosing – The University of Hawaii health insurance policy allows international students to purchase other health insurance plans, as long as those plans offer at least the minimum level of coverage required by the University of Hawaii. To do so, a representative of your health insurance plan must complete the F-1 Student Health Insurance Provider Certification Form certifying that your choice of plan meets the University of Hawaii required minimum level of coverage.
How does health insurance work in the U.S.?
  1. Purchase a health insurance plan that will enable you to receive clearance from SHIO (Student Health Insurance Office).
  2. The insurance company will provide you with an insurance identification card for use as proof of your coverage when you are seeking health care from a hospital or doctor.
  3. Continue to make payments (premiums) to continue your health insurance coverage each semester of enrollment.
  4. When you visit a doctor or hospital, the doctor or hospital may:
    1. file a medical claim to your health insurance plan on your behalf and wait for payment of services, or
    2. require you to submit your medical claim to your health insurance plan and wait for any reimbursement and pay for the cost of services at the time of your doctor/hospital visit.
  5. The insurance company will evaluate any claim that is filed, and make the appropriate payment for coverage under your particular policy. In some cases, the insurance company pays the hospital or doctor directly; in other cases, the company reimburses the policy holder (insured F-1 student or F-2 dependent) after he or she has paid the bill.
What is ACA compliant health insurance and am I required to purchase such a health insurance plan?

The Patient Protection and Affordable Care Act (PPACA), often referred to as the “Affordable Care Act” (ACA), is a U.S. federal law intended to provide individuals with increased access to higher quality and lower cost health insurance through subsidies, exchanges, and the establishment of minimum coverage standards. It includes the Individual Shared Responsibility Provision, which requires each person who is subject to the ACA to comply with one of the following: (1) have qualifying health coverage (minimum essential coverage); (2) qualify for a health coverage exemption; or (3) make a shared responsibility payment when filing his/her federal income tax return.

For more information on the ACA, see the U.S. Department of Health and Human Services’ Health Care website.

J-1 Health Insurance Requirements FAQ

Do I need to have health insurance?
Yes. The University of Hawaiʻi (UH) and the U.S. Department of State Exchange Visitor Program require J-1 students and their J-2 dependents to carry adequate health insurance. J-1 students and their J-2 dependents must have health insurance coverage for the entire program duration.
Why is having health insurance important in the U.S.?

Medical treatment can be very confusing and expensive in the U.S. And because it is the responsibility of each person (not the U.S. government’s) to pay for his/her own health care, health insurance is required. Any time you seek medical advice or attention by visiting a doctor or hospital, you will be asked to show health insurance coverage. Furthermore, having adequate health insurance coverage is a requirement to maintain valid J-1 or J-2 visa status.

Does my health insurance need to provide specific levels of coverage?

Yes. The U.S Department of State Exchange Visitor Program requires that your health insurance plan offers the following specific levels of coverage:

Kind of CoverageSpecific Level of Coverage
Medical BenefitAt least USD 100,000 per accident or illness
Repatriation of RemainsAt least USD 25,000
Medical EvacuationAt least USD 50,000
Deductible per accident or illnessAt most USD 500

  • May require a waiting period for pre-existing conditions which is reasonable under current industry standards;
  • May include a provision for co-insurance, but, if included, must pay at least 75% of covered medical expenses.
Are there important terms I should know before selecting a health insurance plan?
Yes. Here is a list of terms to help you understand health insurance plans:
  • Premium - an amount to be paid for a health insurance policy.
  • Deductible -  a specified amount of money that the insured (the student) must pay before an insurance company will pay a claim. Some plans offer deductibles that are applied for each accident or illness, while others offer a deductible for each policy period.
  • Coinsurance refers to money that the insured (the student) is required to pay for services, after a deductible has been paid. Coinsurance is often specified by a percentage. For example, the insured pays 25% toward the charges for a service and the employer or insurance company pays 75%.
  • Co-payment - A co-pay is commonly confused with co-insurance. The two are similar, but there is one key difference. With a co-pay, the dollar amount that an individual will pay for health care services is fixed. There are absolutely no percentage participation rates with a co-pay.
  • Covered expense - an expense that qualifies for reimbursement or coverage under a health insurance plan.
  • In network provider - doctors or hospitals that are part of a health plan's network of providers with which it has negotiated a discount.
  • Pre-existing condition - any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan.
How do I decide which health insurance plan to purchase?

It is advisable that you contact a few different insurance providers for premium quotes and to compare coverage. You should feel free to ask the insurance representative any questions and take the time to learn about each plan before making a decision. If you are uncertain or confused, you should not purchase any plan until you fully understand the coverage.

What is health insurance clearance?

J-1 students must bring documentation of health insurance that meets minimum requirements of coverage (for the J-1 student and any J-2 dependents) in order to receive clearance to register for classes from the International Student Services Office (ISS), located in the QLCSS Building, Room 206.

How do J-1 students receive health insurance clearance from the ISS?

Whenever a J-1 student/J-2 dependent purchases or extends health insurance coverage, they must submit evidence of coverage to ISS, QLCSS Building, Room 206.

There are four options to purchase health insurance plans, listed in the table below.

Type of Insurance PlanDocumentation
UH Student Health Insurance Plan, Option 2 or 4 - University of Hawai'i has a student health insurance plan provided by HMSA, the BlueCross/BlueShield provider in Hawaii. The plan is available for purchase by the semester to all students, who meet eligibility requirements. International students MUST buy Option 2 or 4 because these options provide medical evacuation and repatriation coverage. No documentation needed. Student Health Insurance Office will confirm evidence of coverage to the ISS.
Pre-screened health insurance plans - Another option for J-1 students and J-2 dependents is to purchase a pre-screened health insurance plan. These plans appear to meet US Department of State Exchange Visitor Program (DOS/EVP) health insurance requirements. ISS does not endorse or recommend any specific plan. The J-1 student or J-2 dependent should carefully review each plan to select one that meets both his/her needs as well as the DOS/EVP requirements.

NOTE: Doctor offices or hospitals may or may not file claims on your behalf to your health insurance plan seeking payment for the cost of your medical visit. If the doctor/hospital files a claim for you, that means the doctor/hospital is willing to wait for payment of the cost of your doctor visit from your health insurance plan. If you must file your claim to your health insurance plan, that means that you will need to pay the total cost of the doctor visit at the time of your visit and you will need to wait for your health insurance plan to reimburse you the cost of your doctor visit, per the level of coverage in your health insurance plan.
Enrollment confirmation email or letter from the insurance company showing the following information:

  • Insurance company’s name

  • J-1’s name

  • Each J-2 dependent’s name (if applicable)

  • Plan type; and

  • Coverage start and end dates.

UH EUTF (Employee University Trust Fund) health insurance plans (graduate assistants only) - Employees of the University of Hawaii are eligible to purchase these plans. NOTE: Because these employee plans do not provide required minimum coverage for repatriation and medical evacuation (RME), you will also need to purchase RME insurance in addition to any EUTF plan. Because UH EUTF health insurance plans do not include required repatriation and medical evacuation coverage, you must provide proof of enrollment in a repatriation and medical evacuation (RME) plan. Betins is one pre-screened RME option. Documentation must show the following:

  • Insurance company’s name;

  • J-1’s name;

  • Each J-2 dependent’s name (if applicable);

  • Dollar amounts of coverage ($25,000 repatriation and $50,000 medical evacuation);

  • Coverage start and end dates.


Student will also need to submit copy of EC-1 form or letter from personnel officer showing the following information:

  • J-1 student’s name

  • Student UH ID#

  • Each J-2 dependent’s name (if applicable)

  • EUTF plan name

  • Coverage start and end dates.

Other health insurance plans - The University of Hawai'i health insurance policy allows international students to purchase other health insurance plans, as long as those plans offer at least the minimum level of coverage required by the U.S. Department of State Exchange Visitor Program. J-1 Student Health Insurance Provider Form signed by a representative of the health insurance company – OR – a signed letter from the health insurance company printed on company letterhead that includes the following:

  • Statement certifying the health insurance plan meets the DOS requirements;

  • J-1 student’s name;

  • Each J-2 dependent’s name, if applicable;

  • Plan type; and

  • Coverage start and end dates.

How does health insurance work in the U.S.?
  1. Purchase a health insurance plan that will enable you to receive clearance from the ISS office.
  2. The insurance company will provide you with an insurance identification card for use as proof of your coverage when you are seeking health care from a hospital or doctor.
  3. Continue to make payments to continue your health insurance coverage. These payments are called premiums.
  4. When you visit a doctor or hospital, the doctor or hospital may file a medical claim to your health insurance plan on your behalf and wait for payment of services, or may require you to submit your medical claim to your health insurance plan and pay for the cost of services at the time of your doctor/hospital visit.
  5. The insurance company will evaluate any claim that is filed, and make the appropriate payment for coverage under your particular policy. In some cases, the insurance company pays the hospital or doctor directly; in others, the company reimburses the policy holder (insured J-1 student or J-2 dependent) after he or she has paid the bill.
What is ACA compliant health insurance and am I required to purchase such a health insurance plan?
The Patient Protection and Affordable Care Act (PPACA), often referred to as the “Affordable Care Act” (ACA), is a U.S. federal law intended to provide individuals with increased access to higher quality and lower cost health insurance through subsidies, exchanges, and the establishment of minimum coverage standards. It includes the Individual Shared Responsibility Provision, which requires each person who is subject to the ACA to comply with one of the following: (1) have qualifying health coverage (minimum essential coverage); (2) qualify for a health coverage exemption; or (3) make a shared responsibility payment when filing his/her federal income tax return. J-1 students and their J-2 dependents who file tax returns as resident aliens (resident for tax purposes) may be subject to the ACA. If they do not qualify for one of the exemptions from the Individual Shared Responsibility Provision, they will need to either purchase an ACA-compliant insurance plan or make a Shared Responsibility Payment. J-1s and J-2s who determine they are nonresident aliens for tax purposes are not subject to the ACA. To determine whether they are resident or nonresident aliens for U.S. tax purposes, they should apply the Substantial Presence Test. For more information on the ACA, see the U.S. Department of Health and Human Services’ Health Care website.