Form I-693 & Preparing for the Medical Exam for Immigration

Key Takeaways

• Form I-693 is required for all applicants seeking permanent residency in the U.S. and records the results of the medical exam for immigration.
• The green card medical exam cost varies widely, ranging from $100 to $500, with some sources listing an average range of $250 to $650 depending on the location and specific medical tests required​.
• The immigration medical exam includes a physical examination, tuberculosis screening, vaccinations, and mental health evaluation.
• Additional medical costs may include lab work, vaccinations, and X-rays, which could increase the overall cost​.
• Insurance coverage for the exam varies, and most applicants pay out of pocket​.
• Some clinics offer bundled pricing, which may include multiple tests at a lower overall rate​.
• Processing time for Form I-693 varies, but applicants should allow at least 1–2 weeks to receive their completed form from the physician.
• Proper preparation for the exam includes gathering medical records, vaccination proof, and government-issued identification.
• The validity of Form I-693 is generally two years from the date of signature by the civil surgeon.
• UpCounsel can help connect applicants with qualified immigration attorneys for assistance in navigating the process.

Anyone applying for permanent residency in the US must undertake a medical exam for immigration. This exam ascertains that the green card applicants are in good health to live permanently in the US. The results of the medical exam for green card are reported in form I-693. This form is then submitted to the US Citizen Immigration Service(USCIS) for review and approval. 

The medical exam results noted on form I-693 are confidential and should only be accessed by USCIS. However, the government-approved doctor who administered the exam and USCIS might share your immigration medical exam results with other parties if required by law. These other parties can include your attorney, immigration officers, or BIA-accredited representatives. 

What is Form I-693?

Form I-693 is a document that reports the immigrant medical exam of people applying for permanent residency in the US. The official name is 'Report of Medical Examination and Vaccination Record. This report helps the USCIS determine whether you're inadmissible on medical grounds. 

For instance, if you have any of the following conditions per your medical exam, your application might be inadmissible on health grounds. This means your application for permanent residency might be denied. 

• Gonorrhea
• Infectious-stage syphilis
• Hansen's disease
• Active tuberculosis
• Drug abuse
• Severe mental disorders
• Communicable diseases which can cause a public health emergency
• Mental and physical disorders that can lead to harmful behavior

In addition, failing to show proof of certain vaccines can also make your application inadmissible. 

Who needs to submit form I-693?

Everyone applying to be a permanent US resident must submit form I-693. Whether you're applying for a green card through marriage or a green card through work, you will most likely have to undergo a medical exam for immigration. Failing to submit the medical exam results through form I-693 can result in your application being rejected. Sometimes, USCIS asks you to submit the entire form, while in other cases, you submit certain parts of form I-693.

Form I-693 Instructions

For form I-693 to be legitimate, a civil surgeon(if applying from the US) or panel physician(if applying outside the US) must sign, approve and annotate your medical exam results. Here are other guidelines and form I-693 instructions;

• The civil surgeon should sign form I-693 60 days or less before you file form I-485
• The civil surgeon should follow the instructions of the US Department of Health and Human Services(HHS) when administering the exam
• Have a vaccine or a waiver from USCIS for class A medical condition(e.g., Communicable disease)

When you attend the medical exam, the civil surgeon might ask you to present proof of identity. A government-issued passport or driving license is a valid document to present in this situation. Green card applicants under 14 years should bring their birth certificates with the applicant's full names, age, date of birth, and parents' names. If the documents are in a language other than English, the applicant should provide a translation. 

The civil surgeon's office can provide form I-693, but it's best to download it directly from the USCIS website as it will be the latest version.

Typically, form I-693 is split into 11 sections that you and your civil surgeon need to fill as per instructions. You can fill out the applicant's section before your visit but do not sign the form. Your civil surgeon should be present when you sign your section on form I-693. Parents or legal guardians may sign on behalf of applicants under 14 years. 

When to Submit Form I-693 

You can submit form I-693 when filing form I-485. Submitting the two together can help with speedy approval by the USCIS. You can also submit form I-693 during your in-person interview. However, the USCIS does not always require interviews from all applicants. If USCIS doesn't ask you for an interview and you hadn't submitted form I-693 when filing form 1-485, the USCIS may be forced to issue you an RFE requesting you to submit the medical exam form. This can cause delays in your application.

After the medical exam for green card, your doctor will avail a sealed envelope with your medical results and form I-693. This form should remain unopened and within the sealed envelope for submission; otherwise, the USCIS might reject an unsealed form. However, if you're outside the US, your doctor might send your form to your country's U.S embassy or consulate, although this will depend on your country's requirements. 

Sample I-693 form

Here's a sample section of form I-693. 

Form I-693 Fee

The USCIS does not have a filing fee for form I-693. However, you should be aware and prepared to pay the physician rate and medical exam costs, which will vary by region and facility. 

Factors Affecting the Cost of the Green Card Medical Exam

The green card medical exam cost can vary widely due to several factors, including:

• Location of the Exam – Costs are often higher in large metropolitan areas compared to rural locations.
• Clinic vs. Private Doctor – Some clinics offer competitive pricing, while private doctors may charge higher fees.
• Additional Tests Required – Depending on your medical history, additional tests such as chest X-rays for tuberculosis or extra blood work can increase costs​.
• Vaccination Costs – If an applicant needs required vaccinations, this can significantly add to the overall expense​.
• Insurance Coverage – While some insurance plans may cover certain tests, most applicants pay out of pocket​.

How Long Does it Take to Get Form I-693?

The medical exam reported on form I-693 takes the same time as a regular doctor's visit. However, you might wait 1 week to 2 weeks to receive your form I-693 from the civil surgeon unless your surgeon recommends further testing. You can collect the form from the physician once the medical examination results are out or have them send the form to your lawyer's office. 

I-693 Medical Exam Cost

The USCIS medical exam costs between $100—$500, depending on your state, region, and civil surgeon. The USCIS does not have any regulations about how much a medical exam for immigration should cost since it's at the discretion of your physician. You, as the applicant, are responsible for covering all medical costs. Your insurance may cover some or all of your costs, but in most cases, you will pay out of pocket.

How to Find Affordable Immigration Medical Exams

Since the cost of the green card medical exam varies significantly, consider the following tips to find a more affordable option:

• Compare Prices – Call multiple USCIS-approved civil surgeons in your area and compare rates.
• Look for Discounted Packages – Some clinics offer bundled pricing that includes lab tests and vaccinations at a lower cost.
• Ask About Payment Plans – Some doctors allow installment payments if the total cost is high.
• Utilize Community Health Clinics – Certain nonprofit health clinics may offer medical exams at reduced rates or provide financial assistance.
• Check for Employer or Insurance Assistance – Some employers provide reimbursement for the medical exam, and some insurance policies may partially cover certain aspects​.

What Does the Immigration Medical Exam Include?

The immigration medical exams consist of a medical review, blood tests, physical exams, drug and alcohol screening, and checking for vaccines. The medical exam is administered by a physician approved by the USCIS. The USCIS mandates this exam to ensure applicants do not have a psychiatric or medical problem that may cause harm to US citizens.

Generally, these are the items to bring with you when taking your medical exams for immigration. 

• Government-issued ID/ passport or driver's license
• Vaccine records
• Insurance card or payment to cover your medical expenses
• Form 1I693 when applying from within the United states
• Green card interview if you're applying outside the US
• Medical history, forms, and X-rays(e.g. a chest X-ray), if they're accessible to you

Let's break down what a medical exam for immigration includes:

Green Card Vaccine Requirements

Any applicant applying for permanent residency in the US must have been vaccinated against these diseases:

• Covid-19
• Polio
• Hepatitis B
• Hepatitis A
• Meningococcal
• Rubella
• Mumps
• Measles
• Pertussis
• Pneumococcal pneumonia
• Tetanus and Diphtheria Toxoids
• Haemophilus Influenzae type B

The list can change from time to time, so make sure to check the USCIS website for changes. You only need to provide proof of vaccination if you have received these vaccinations. These records should be official, and the applicant must provide a translation when in a language other than English. 

If the applicant hasn't received these vaccinations yet are age and medical appropriate, they have a Class A condition and are inadmissible. If the applicant is not age or medical appropriate, the physician should record this on form I-693, so the USIS can waive the vaccines. 

Immigration Psychological Evaluation

During your medical exam for immigration, your doctor will also assess your mental health by checking for psychiatric or mental illness. This assessment will include a review of your behavior, judgment, and comprehension. The civil surgeon will pay particular attention to any medical or physical disorders that might cause harmful or violent behavior. They might also review a past mental disorder which is likely to reoccur. 

Immigration Physical Exam

Your doctor will most likely perform a complete physical examination on the following areas:

• Ear, nose, and throat
• Heart
• Lungs
• Abdomen
• Skin
• Lymph Nodes
• External genitalia
• Hands and Feet

You will also undergo a blood test to check for syphilis, although applicants under 15 years don't take the test. However, if they have symptoms or past history of syphilis, they might be required to take the test. In addition, you might undergo a chest X-ray.

Drug & Alcohol Screening

The physician will gauge your past and present drug or alcohol use. They might ask if you're taking any prescription medication and whether you have previously received drug abuse treatment.

If you're currently abusing substances or drugs, you might be inadmissible as it can cause you to engage in harmful behavior. However, if you have the records to prove that you have completed a drug treatment program and recovered from drug and substance abuse, you are still eligible for permanent residency applications. 

Medical History Review

Finally, the civil surgeon will review your medical history for past and current medical conditions. They will look for any significant events in your health history, such as prolonged hospital stays. 

USCIS does not always ask all applicants for interviews. The best way to go about it is to submit both form I-693 together with form I-485 to reduce the back and forth. 

What Happens After the Medical Exam?

Once the immigration medical exam is completed, the civil surgeon will provide the results in a sealed envelope. It is crucial not to open this envelope, as USCIS will reject an unsealed form.

If any medical conditions require additional tests or treatment, the physician may provide further instructions before completing Form I-693. Some key points to keep in mind:

• If further tests are needed, the processing time may extend beyond 2 weeks.
• If vaccinations are missing, you may need follow-up visits before receiving a completed Form I-693.
• The medical exam results must be submitted to USCIS within two years of the civil surgeon’s signature date​.

Frequently Asked Questions

1. How much does the green card medical exam cost?
   The green card medical exam cost typically ranges from $100 to $650, depending on location, additional tests required, and the physician’s fees​.
2. Can I use my health insurance to cover the exam costs?
   Most applicants pay out of pocket, though some health insurance plans may cover specific tests or vaccinations required for the green card medical exam​.
3. How can I find the lowest-cost civil surgeon for my exam?
   To find affordable options, compare prices from USCIS-approved doctors, look for community health clinics, and inquire about discounted packages or payment plans​.
4. How long does it take to get my medical exam results?
   It usually takes 1 to 2 weeks to receive the sealed Form I-693. However, delays may occur if further tests or vaccinations are needed​.
5. What happens if I don’t submit Form I-693 with my green card application?
   If Form I-693 is not submitted with Form I-485, USCIS may request it later through a Request for Evidence (RFE), causing potential delays in processing​.

Having a lawyer through the green card application process simplifies matters and ensures you're doing everything right. It can be an arduous process, so having someone walk you through the numerous applications, forms, and requirements can make it less stressful. Simply post a job on UpCounsel explaining your legal needs, and we will match you to a qualified lawyer for your immigration process.