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ACA Requirements and Exemptions - International Students

ACA Requirements and Exemptions - International Students


ACA stands for Affordable Care Act. The full name of this law is PPACA or Patient Protection and Affordable Care Act. However, many people commonly refer to it by its nickname, Obamacare.

ACA mandates that all US citizens, permanent residents and certain other US residents maintain minimum adequate coverage throughout the year.


There are several exemptions to the ACA mandate. One very important exemption is how it relates to International Students on F and J visas as well as other J visa holders.

The mandate applies to people who are considered US residents by the IRS (tax authority in USA).

If you are an international student or a dependent of an international student on either F visa or J visa, you don't have to purchase ACA compliant health insurance for the first 5 years of your US stay.

If you are non-student on a J visa such as Au Pair, Work and Travel, Trainees, Interns, Teachers and Counselors, you don't have to purchase ACA compliant health insurance for the first 2 years in the U.S.

After 5 years (or 2 years in case of non-student J visa holders), you must purchase ACA compliant health insurance if you meet the Substantial Presence Test by IRS, which is:

  • Physically present in the US for at least 31 days in the current calendar year, and
  • The total number of days present in the US exceeds 183 days by adding the following days:
    • All days present in the current calendar year, plus
    • 1/3 of the days present in the previous calendar year, plus
    • 1/6 of the days present in the calendar year two years ago.

That means that vast majority of the F and J visa holders would be exempt from having to purchase ACA compliant medical insurance.

F Visa

The US government has not specified any insurance requirements for F visa holders.

Even though not required, many schools and universities in the US mandate that all international students enroll into ACA compliant group insurance provided by the school. In that case, students have no other choice than to do so.

Some schools may offer their own insurance, but allow students to purchase an insurance plan provided by private companies as long as it meets the schools minimum requirements, which are not the same requirements that make a plan ACA compliant. International student insurance plans are more affordable for international students; as long as the plan purchased from a private company meets the schools requirements that is suitable to the school. There are many such international student medical insurance plans available for instant purchase online. After purchasing such insurance, we can assist with getting the waiver form completed.

J Visa

US Department of State has specified the minimum requirements for J visa insurance.

Some sponsoring organizations let the participants purchase any compliant J visa insurance.

Some schools and universities provide their ACA compliant group health insurance that everyone has to enroll in; however, in order to satisfy the J visa insurance requirements, they would be required to purchase supplemental coverage, emergency medical evacuation and repatriation insurance.

The following chart will help you understand the ACA requirements and exemptions easily.

F and J Visa PPACA Eligibility

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