Who Needs an Immigration Medical Exam?
All applicants filing Form I-485 adjustment of status to become permanent residents must complete the immigration medical examination. This includes employment-based, family-based, and diversity visa green card applicants.
Certain applicants may be exempt or have modified requirements. Applicants who completed overseas medical exams within specified timeframes may not need new exams. Children adopted abroad with certain visas have modified procedures.
K-1 fiancé visa holders who completed medical exams abroad within one year may use those exams, though civil surgeon review may still be required for vaccination updates.
Who Can Perform the Medical Exam?
Only physicians designated as civil surgeons by USCIS can perform immigration medical examinations for adjustment of status applicants. Regular physicians, even specialists, cannot complete Form I-693.
Find designated civil surgeons using the USCIS Civil Surgeon Locator tool. Enter your zip code to find authorized physicians in your area.
Civil surgeons complete specialized training on immigration medical requirements and maintain current designation with USCIS. They are authorized to complete and sign Form I-693.
What Happens During the Medical Exam?
The examination includes several components designed to identify health-related grounds of inadmissibility.
Physical Examination: The civil surgeon conducts a general physical exam, checking vital signs, heart, lungs, abdomen, skin, and other systems. The exam identifies physical abnormalities or conditions requiring further evaluation.
Mental Health Evaluation: The physician assesses mental health status through interview and observation. History of mental disorders associated with harmful behavior triggers additional evaluation.
Vaccination Review: The civil surgeon reviews your vaccination records against CDC requirements. Missing vaccinations must be administered or documented exemptions provided.
Disease Testing: Testing for tuberculosis and syphilis is standard. Additional testing may be required based on symptoms or exposure history.
What Vaccinations Are Required?
Vaccination requirements follow the CDC Advisory Committee on Immunization Practices (ACIP) recommendations. Required vaccines for most adults include:
Measles, mumps, rubella (MMR), varicella (chickenpox), tetanus and diphtheria (Td or Tdap), hepatitis B, polio, influenza (seasonal requirement), and COVID-19.
Age-based requirements vary. Children require additional vaccinations including hepatitis A, rotavirus, Haemophilus influenzae type b, and pneumococcal vaccines per childhood immunization schedules.
Medical contraindications or religious/moral objections to vaccinations require documentation. Waivers may be available but must be properly documented on Form I-693.
How Do You Prepare for the Medical Exam?
Gather your vaccination records before the appointment. Records from childhood, school requirements, military service, or previous medical care help document prior immunizations.
Bring government-issued photo identification (passport, driver's license, or state ID). The civil surgeon must verify your identity.
Bring the Form I-693 instructions so you and the civil surgeon can reference current requirements. Requirements occasionally change, and having current instructions ensures compliance.
What Documents Should You Bring?
Vaccination records from any source: childhood immunization cards, school records, military records, foreign vaccination certificates, or medical records from prior physicians.
Previous medical exam forms if you completed an overseas panel physician exam within the validity period. The civil surgeon may be able to use or supplement this documentation.
Any medications you take and information about ongoing medical conditions. This helps the physician complete accurate medical history documentation.
How Much Does the Immigration Medical Exam Cost?
Civil surgeon exam fees typically range from $200 to $500 for the examination itself, not including vaccinations. Fees vary by location, physician, and local market rates.
Vaccinations can add substantial cost. If you need multiple vaccines, expect to pay $50 to $200 per vaccine depending on type and whether insurance covers immunizations.
Some civil surgeons offer package pricing including common vaccinations. Compare costs among civil surgeons in your area, as fees vary significantly.
Does Insurance Cover the Immigration Medical Exam?
Most health insurance plans do not cover the civil surgeon examination fee because it is considered an immigration-related administrative service rather than medically necessary care.
Vaccinations may be covered by insurance even if the exam itself is not. Check with your insurance provider about immunization coverage under preventive care benefits.
HSA and FSA accounts may cover immigration medical exam costs in some circumstances. Consult your plan administrator about eligible expenses.
What Conditions Cause Medical Inadmissibility?
Certain health conditions can make you inadmissible to the United States on health-related grounds under INA Section 212(a)(1).
Communicable Diseases of Public Health Significance: Active tuberculosis, syphilis, gonorrhea, and other designated communicable diseases can cause inadmissibility. Treatment typically resolves the inadmissibility.
Failure to Show Vaccination: Lacking required vaccinations without proper waiver documentation results in inadmissibility. Getting vaccinated or obtaining waivers resolves this ground.
Physical or Mental Disorders: Conditions associated with harmful behavior may cause inadmissibility. Evaluation and treatment can address these concerns.
Drug Abuse or Addiction: Current drug abuse or addiction is a ground of inadmissibility. Rehabilitation and documentation of recovery may address this ground.
Are Waivers Available for Medical Inadmissibility?
Waivers exist for some health-related grounds of inadmissibility. Form I-601 Application for Waiver of Grounds of Inadmissibility addresses certain medical conditions.
Vaccination waivers are available for medical contraindications (when vaccination would harm your health) and religious or moral objections. Documentation requirements vary by waiver type.
Communicable disease inadmissibility may be waived for immediate relatives of U.S. citizens and certain other categories upon showing the condition is under treatment.
How Long Is Form I-693 Valid?
Form I-693 is valid for two years from the date of the civil surgeon's signature. The form must be submitted to USCIS within this validity period.
Time your examination strategically. If your I-485 will be pending for extended periods, an exam completed too early may expire before your case is adjudicated.
If your Form I-693 expires during processing, USCIS will request a new medical examination. This adds cost and time to your case.
When Should You Complete the Medical Exam?
For cases expected to process quickly (under one year), complete the exam before or shortly after filing I-485.
For cases with long expected processing times or visa bulletin waits, consider waiting until closer to expected adjudication. Monitor your case status and priority date movement.
Some applicants complete exams at filing and accept the risk of needing a second exam if processing extends beyond two years. Others wait for interview scheduling before completing the exam.
What Happens After the Exam?
The civil surgeon completes Form I-693 and seals it in an envelope. Do not open the sealed envelope; submit it sealed to USCIS.
Submit Form I-693 with your I-485 application or bring it to your adjustment interview. USCIS officers review the form as part of your case adjudication.
If the civil surgeon identifies issues requiring follow-up, additional appointments or specialist referrals may be necessary before the form can be completed.
What If You Disagree with the Civil Surgeon's Findings?
If you believe the civil surgeon made errors, discuss concerns directly with the physician before the form is finalized.
You may seek a second examination from a different civil surgeon. USCIS will consider the most recent Form I-693 submitted.
For disputes about inadmissibility determinations, immigration attorneys can advise on challenging findings or pursuing waivers.
