I-693 - Options around Vaccinations and payments

[Jonty Rhodes]

I have a question regarding immigration medicals.

1. Can we submit immigration medicals without RFE from USCIS?

2. Can we use medical records from India to prove that you have taken vaccinations?

3. Does anyone know a good civil surgeon in the Chicago area who does immigration medicals without much hassle?

Thanks in advance.

[idliman]

I have a question regarding immigration medicals.

1. Can we submit immigration medicals without RFE from USCIS?

2. Can we use medical records from India to prove that you have taken vaccinations?

3. Does anyone know a good civil surgeon in the Chicago area who does immigration medicals without much hassle?

Thanks in advance.

Jonty,

1. Please see the existing thread on "Dilemma or Conundrum of I693 Medical with 485 or after 485 filing" and this post for my take on it.
2. Yes. I produced a detailed vaccination history signed by a Surgeon in India on official letter pad. I also did the same for my wife. We produced it to the Surgeon here. He transferred it to the official vaccination card here in NC. That's it. I am sure you can comeup with a list with dates and ask your Doctor in India to validate it. Otherwise they will do a anti-body test and ask you to take required vaccines.
3. This is upto the folks from Chicago. Use USCIS - Find a Doctor website to search for approved Civil Surgeons. Then you shop around, make a few calls till you are satisfied. The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.,

[may2011]

Jonty,

1. Please see the existing thread on "Dilemma or Conundrum of I693 Medical with 485 or after 485 filing" and this post for my take on it.
2. Yes. I produced a detailed vaccination history signed by a Surgeon in India on official letter pad. I also did the same for my wife. We produced it to the Surgeon here. He transferred it to the official vaccination card here in NC. That's it. I am sure you can comeup with a list with dates and ask your Doctor in India to validate it. Otherwise they will do a anti-body test and ask you to take required vaccines.
3. This is upto the folks from Chicago. Use USCIS - Find a Doctor website to search for approved Civil Surgeons. Then you shop around, make a few calls till you are satisfied. The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.,

Thanks for the link to the post. I am wondering if anyone has used this method to send other documents like photographs.My company attorney didn't send our photographs with the I-485 application..Do you think we can send the photos proactively using this method.

[sling10]

Jonty,

1. Please see the existing thread on "Dilemma or Conundrum of I693 Medical with 485 or after 485 filing" and this post for my take on it.
2. Yes. I produced a detailed vaccination history signed by a Surgeon in India on official letter pad. I also did the same for my wife. We produced it to the Surgeon here. He transferred it to the official vaccination card here in NC. That's it. I am sure you can comeup with a list with dates and ask your Doctor in India to validate it. Otherwise they will do a anti-body test and ask you to take required vaccines.
3. This is upto the folks from Chicago. Use USCIS - Find a Doctor website to search for approved Civil Surgeons. Then you shop around, make a few calls till you are satisfied. The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.,

Hello idliman -

Can you please elaborate a little on your statement below ?

The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.

How do i take the vaccinations and ensure that they are covered by my insurance ?

[idliman]

Hello idliman -

Can you please elaborate a little on your statement below ?

The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.

How do i take the vaccinations and ensure that they are covered by my insurance ?

It has been 9+ years since I did the first medical evaluation and vaccination check. For the second I-693, all I had to show was the proof of last Flu vaccine.

What I understand is that many insurances (your coverage may vary based on plan and provider) will pay for protective vaccinations. So if your USCIS Surgeon says that you have to take Hepatitis vaccine for I-693, you have an option of doing it a) either with the I-693 examiner or b) from outside (your doctor or CVS or walgreens). Depending on how the billing code is entered, the CVS or Walgreens shot may be paid by insurance under protective vaccination (I am not from medical field, so don't know the exact terminology). The same shot if taken at the I-693 examiner's clinic, will require you to pay from your pocket. Something like this.

There are more qualified people here who know current info on this topic. They might be able to explain this better. HTH.

Additional Info: You may read this post. Maybe we need to create a Medical Evaluation (I-693) best practices thread.

[sling10]

It has been 9+ years since I did the first medical evaluation and vaccination check. For the second I-693, all I had to show was the proof of last Flu vaccine.

What I understand is that many insurances (your coverage may vary based on plan and provider) will pay for protective vaccinations. So if your USCIS Surgeon says that you have to take Hepatitis vaccine for I-693, you have an option of doing it a) either with the I-693 examiner or b) from outside (your doctor or CVS or walgreens). Depending on how the billing code is entered, the CVS or Walgreens shot may be paid by insurance under protective vaccination (I am not from medical field, so don't know the exact terminology). The same shot if taken at the I-693 examiner's clinic, will require you to pay from your pocket. Something like this.

There are more qualified people here who know current info on this topic. They might be able to explain this better. HTH.

Additional Info: You may read this post. Maybe we need to create a Medical Evaluation (I-693) best practices thread.

Thanks idliman !

Can someone who has done the medicals recently explain the process of how to make sure that the vaccinations are covered by the insurance ? It is already a very expensive process, so trying to save some $$s, if possible.

[rsnake]

Thanks idliman !

Can someone who has done the medicals recently explain the process of how to make sure that the vaccinations are covered by the insurance ? It is already a very expensive process, so trying to save some $$s, if possible.

This is a complicated topic. First, you have to read your health insurance policy coverage document and find the section on vaccinations. Each type of policy may have different coverage. You can also call them to find out. Then you have to read I-693 and the vaccinations guide, and find the vaccinations required for your(and your dependents) age group. Then you have to make sure that you either have proof of having taken that vaccination in the past, for example the MMR vaccination as a child, or actually take that vaccination now and show proof of it to the civil surgeon.

Some health insurance providers only cover vaccines(and lab tests etc.) only at certain places like say CVS and Costco, which are usually searchable on their website related to your policy. If the policy does not cover vaccines, you can find the prices at various places on websites(e.g. CVS https://www.cvs.com/minuteclinic/services/price-lists) or by calling them.

In my case, I had taken the MMR vaccine as a child, but I lost the document proving it. So when I told that to the medical assistant, she ordered an antibody test that proved that I had taken the vaccine. You can also get this antibody test at various places like CVS etc on your own. I had to take only the Tdap(tetanus) vaccine as a booster and the flu vaccine because it was flu season.

[qesehmk]

Thanks idliman !

Can someone who has done the medicals recently explain the process of how to make sure that the vaccinations are covered by the insurance ? It is already a very expensive process, so trying to save some $$s, if possible.

I am curious about this. My understanding is that insurance always covers vaccines without copay. The reason is intuitive - vaccination saves them money.

Has anybody actually paid for vaccination in US?

[srimurthy]

This thread is to discuss the options for covering Vaccinations through Insurance and other paths

[andhraguy]

My recent experience with medicals.

Since the medicals are done by non-Primary care physicians it is not covered by health insurance. If you change your primary care to USCIC approved doctors and possibilities is that will be covered by insurance if you have not claimed any annual physical exams within last 12 months. Doctors typical charge $200-250 for physical exams depending on credit card/cash option.

Tdap vaccine is mandatory, get it with your local pharmacy (csv,wallgreen,wallmart) they are much cheaper than the USCIC approved doctor which is normally $85.

Get bloodwork done for MMR and Varicella antibody test. insurance covers 100% bloodwork. If you have already got these vaccine earlier or in your childhood it will show up in the bloodwork report. in my case it did so no need to take additional vaccine.

Most cases doctor will find TB positive and ask you for chest X-ray. Get it done with your network insurance provider. it should be 100% covered or may be little co-pay.

I end up paying $220 (physicals) + $45 Tdap at walmart + free bloodwork and chest x-ray.

Most people talked about spending $500 to $750 for 485 medicals. I didn't experience this may be i was lucky

[sling10]

My recent experience with medicals.

Since the medicals are done by non-Primary care physicians it is not covered by health insurance. If you change your primary care to USCIC approved doctors and possibilities is that will be covered by insurance if you have not claimed any annual physical exams within last 12 months. Doctors typical charge $200-250 for physical exams depending on credit card/cash option.

Tdap vaccine is mandatory, get it with your local pharmacy (csv,wallgreen,wallmart) they are much cheaper than the USCIC approved doctor which is normally $85.

Get bloodwork done for MMR and Varicella antibody test. insurance covers 100% bloodwork. If you have already got these vaccine earlier or in your childhood it will show up in the bloodwork report. in my case it did so no need to take additional vaccine.

Most cases doctor will find TB positive and ask you for chest X-ray. Get it done with your network insurance provider. it should be 100% covered or may be little co-pay.

I end up paying $220 (physicals) + $45 Tdap at walmart + free bloodwork and chest x-ray.

Most people talked about spending $500 to $750 for 485 medicals. I didn't experience this may be i was lucky

Thanks for the info !

Did you get the Tdap vaccine, bloodwork for MMR and Varicella antibody test, chest X-rays done with your primary physician / network insurance provider in advance of visiting the civil surgeon ?

[smuggymba]

PD March 2010

I did the medicals in 2012 and at that time I had to go to my PCP to get some vaccines and some titer test and even did a chest X-ray - so I had records of those.

I went for my medicals again this Friday and showed them the paperwork form 2012 and they said they will use that info to fill out I-693 so NO new vaccines/tests needed. We're awaiting the blood TB test (no longer a skin patch test) and might have to go for a new X-ray if needed.

Paid 290 per person in Houston and maybe another 50-100 for the Xray if needed...should know my tomorrow.

[Jonty Rhodes]

Jonty,

1. Please see the existing thread on "Dilemma or Conundrum of I693 Medical with 485 or after 485 filing" and this post for my take on it.
2. Yes. I produced a detailed vaccination history signed by a Surgeon in India on official letter pad. I also did the same for my wife. We produced it to the Surgeon here. He transferred it to the official vaccination card here in NC. That's it. I am sure you can comeup with a list with dates and ask your Doctor in India to validate it. Otherwise they will do a anti-body test and ask you to take required vaccines.
3. This is upto the folks from Chicago. Use USCIS - Find a Doctor website to search for approved Civil Surgeons. Then you shop around, make a few calls till you are satisfied. The insurance will not pay for USCIS medical. But they will pay for vaccinations, if it is not for USCIS purposes. So you may have to take vaccinations from your personal Dr or CVS, Walgreens, etc.,

Thanks. I really appreciate it. I guess once I am done with my medicals, I will ask my attorney and see what he says. But looks like, it's worth taking a chance sending it to USCIS.

Thank you again for your insight.

[andhraguy]

Thanks for the info !

Did you get the Tdap vaccine, bloodwork for MMR and Varicella antibody test, chest X-rays done with your primary physician / network insurance provider in advance of visiting the civil surgeon ?

No, First I visited the civil surgeon, got the prescription for tdap vaccine and bloodwork order. Then did my tdap vaccine from walmart (dont know why, my friend suggested to get it from Walmart so i did) and bloodwork from primary care physician office. After seeing my bloodwork report the civil surgeon sent me for chest x-ray which i did again with primary care physician's office. The entire process took me about 10 days and 2 visit (2nd one to collect the final sealed envelop) and few phone calls and emails. Doctor clearly mentioned that they don't accept any insurance.

Hope this helps.

[abcx13]

Does anyone have recommendations for a civil surgeon in San Francisco? (I know how to look up the USCIS list but just asking in case anyone has first hand experience and has a recommendation.)

[abcx13]

No, First I visited the civil surgeon, got the prescription for tdap vaccine and bloodwork order. Then did my tdap vaccine from walmart (dont know why, my friend suggested to get it from Walmart so i did) and bloodwork from primary care physician office. After seeing my bloodwork report the civil surgeon sent me for chest x-ray which i did again with primary care physician's office. The entire process took me about 10 days and 2 visit (2nd one to collect the final sealed envelop) and few phone calls and emails. Doctor clearly mentioned that they don't accept any insurance.

Hope this helps.

Does the bloodwork have to be prescribed by a doctor or can you go to a Labcorp/Quest and get it done and have insurance cover it?

[andhraguy]

Does the bloodwork have to be prescribed by a doctor or can you go to a Labcorp/Quest and get it done and have insurance cover it?

Not sure about you question. For simplicity get the blood work order from civil surgeon. Otherwise he might ask you to redo for other things he need to see.

[sling10]

Not sure about you question. For simplicity get the blood work order from civil surgeon. Otherwise he might ask you to redo for other things he need to see.

If we visit the primary care physician directly and ask for the bloodwork for MMR and Varicella antibody test, will they NOT do it ? Does it have to be prescribed by the civil surgeon ?

[andhraguy]

If we visit the primary care physician directly and ask for the bloodwork for MMR and Varicella antibody test, will they NOT do it ? Does it have to be prescribed by the civil surgeon ?

Certainly you can try that.

[may2011]

If we visit the primary care physician directly and ask for the bloodwork for MMR and Varicella antibody test, will they NOT do it ? Does it have to be prescribed by the civil surgeon ?

they might do your blood work.Any doctor can order it.Insurance coverage depends on your plan.

[may2011]

Does the bloodwork have to be prescribed by a doctor or can you go to a Labcorp/Quest and get it done and have insurance cover it?

many civil surgeons do the blood work in advance and then sign the form.Better get it from the civil surgeons as they will test for the vaccines required by USCIS.

[gammaray]

My recent experience with medicals.

Since the medicals are done by non-Primary care physicians it is not covered by health insurance. If you change your primary care to USCIC approved doctors and possibilities is that will be covered by insurance if you have not claimed any annual physical exams within last 12 months. Doctors typical charge $200-250 for physical exams depending on credit card/cash option.

Tdap vaccine is mandatory, get it with your local pharmacy (csv,wallgreen,wallmart) they are much cheaper than the USCIC approved doctor which is normally $85.

Get bloodwork done for MMR and Varicella antibody test. insurance covers 100% bloodwork. If you have already got these vaccine earlier or in your childhood it will show up in the bloodwork report. in my case it did so no need to take additional vaccine.

Most cases doctor will find TB positive and ask you for chest X-ray. Get it done with your network insurance provider. it should be 100% covered or may be little co-pay.

I end up paying $220 (physicals) + $45 Tdap at walmart + free bloodwork and chest x-ray.

Most people talked about spending $500 to $750 for 485 medicals. I didn't experience this may be i was lucky

Just a minor correction -- medicals are not covered because they are done by a non-primary care physician, is not entirely accurate. It really depends on the medical plan on what's covered and what's not. My plan doesn't require a designated primary care and allows me to go to specialist or any other doctor directly without requiring a primary care first. There is however in-network (completely free) and out of network (partially paid) doctors that's are in the plan. My suggestion would be to call up the insurance company and clearly understand what will be covered.

[andhraguy]

Just a minor correction -- medicals are not covered because they are done by a non-primary care physician, is not entirely accurate. It really depends on the medical plan on what's covered and what's not. My plan doesn't require a designated primary care and allows me to go to specialist or any other doctor directly without requiring a primary care first. There is however in-network (completely free) and out of network (partially paid) doctors that's are in the plan. My suggestion would be to call up the insurance company and clearly understand what will be covered.

Agreed. IMO don't get bloodwork done without getting order from civil surgeon who is going to sign your form.