American Medical Visa Process, Requirements and Service
“Medical tourism,” traveling abroad for medical treatment, is a vibrant and growing industry. According to a 2014 article on the news website Caixin citing a survey conducted by the Stanford Research Institute, the worldwide medical tourism market doubled between 2006 and 2013 to an estimated value of US $438.6 billion. This represents 14 percent of worldwide tourism with further growth expected as large economies continue to grow and develop. This growth is also responsible for an increase in the number of patients who apply for the American medical visa each year.
Medical tourism serves an important function. According to a recent staff research report from the U.S.-China Economic and Security Review Commission on medical and birth tourism, many Chinese seek to access the American healthcare system due to 1) a relative shortage of doctors in mainland China which has led to the Chinese medical system being overburdened; 2) widespread distrust of doctors and the medical system as a whole that sometimes manifests itself in acts of violence against doctors and hospital staff; 3) the ability of American doctors and hospitals to provide services and medications that may not be available through mainland medical providers. This situation has led to innovations such as the establishment of the Citizen Health Platform of Shenzhen, an app run by the Shenzhen city government that allows mainland patients to submit their medical records for review and diagnosis by leading hospitals in the U.S., usually within two weeks of submission. Beginning in 2014, the Chinese government began to permit wholly owned and invested foreign hospitals to operate in seven Chinese cities and provinces.
American Medical Visa Process
Those who wish to travel to the U.S. for medical treatment must obtain the B-2 visa for tourism which is regularly issued in combination with the B-1 business visa. This is the same visa combination that is required for those who wish to travel to the U.S. for business and travel. For a thorough explanation of the application process, please see my post entitled American Travel Visa Requirements and Process. In short, an applicant must 1) submit Form DS-160 to the proper U.S. embassy or consular post; 2) appear for an interview; 3) demonstrate to the satisfaction of the assigned Consular Officer that they do not have the intent to immigrate to the U.S.; 4) that they can afford to make the trip and will not be dependent upon the government for support prior to return to the home country and 5) are not otherwise inadmissible.
The requirement of proof of non-immigrant intent is common to most non-immigrant visa types. Section 214(b) of the United States Immigration and Nationality Act requires that Consular Officers must assume that every visa applicant intends to leave his or her home country and immigrate to the United States. The applicant must show during the interview that this presumption of immigrant intent is incorrect.. The Consular Officer must be convinced that the applicant:
- Has a home outside the United States that they will not abandon;
- Is visiting the United States temporarily and will leave when the stated purpose of travel is complete;
- Is able to pay for the trip; and
- Meets the requirements of the visa type for which they are applying, and/or that planned activities in the U.S. are allowed by that category.
American medical visa applicants must meet additional requirements as follows :
- Home Country Medical Diagnosis: The application must include a diagnosis from a doctor, typically from their country of residence, describing their condition and why the applicant wishes or needs to go abroad for treatment.
- Treatment Plan: The application must include a detailed treatment plan from a qualified American doctor that will take place at a hospital or clinic in the U.S. The treatment plan should include a detailed explanation of the course of treatment, its length and an itemized and specific explanation of associated costs. A patient will not need to travel abroad for an examination in order to obtain a treatment plan. My office may refer you to one or more U.S. medical institutions that will receive and examine your medical records and provide you with a properly formed and formatted treatment plan. An additional examination by a specially designated physician in the applicant’s home country may also be required.
- Ability to Pay for Medical Treatment: An applicant seeking a visa to the U.S. for medical treatment must demonstrate the ability to not only make the trip without U.S. government assistance but also to pay for the course of treatment. The applicant may do so by presenting bank records, tax returns and/or insurance policies that will cover costs of treatment. If someone else will pay for all or part of the trip, the applicant should include an affidavit of support from the responsible party. The applicant may also demonstrate ability to pay by arranging to prepay, in part or in full, for the course of treatment.
Note: The B-1/B-2 visa combination is also the proper vehicle for relatives to accompany a medical tourist visa holder to the U.S.
U.S. Public Policy Considerations
America welcomes medical tourists. Applicants for American medical visas will be treated with respect and compassion by consular staff and should not be intimidated by the visa application process. However, the American medical visa application process is defined by important public policy considerations. While the American government not only permits but promotes medical tourism for both economic and humanitarian reasons, the nature of the American medical system and the reality of scarce resources demands that Consular Officers exercise special care when considering American medical visa applications. This caution is well tempered with concern and consideration for the needs of the American medical visa applicant.
The American medical system operates with a mix of for-profit and not-for-profit motives and institutions. The Patient Protection and Affordable Care Act (PPACA), also referred to as the Affordable Care Act (ACA) or “Obamacare,” is a United States federal statute that went into effect on March 23, 2010. The purpose of the ACA is to extend medical insurance to those who might not be able to otherwise afford it through subsidies and a requirement that all persons enroll or purchase comparable coverage if not already receiving qualifying coverage through an employer or other entity. The ACA is widely considered to be a tentative step towards the single payer systems common to most developed countries. The future structure of the American medical system is a matter of intense political debate.
Upon entrance to the medical profession, Western doctors must, in most cases, accept and swear to adhere to an ancient doctrine known as the Hippocratic Oath. The Hippocratic Oath requires that a physician render aid to any person in need without consideration for their ability to pay. The belief that the provision of emergency medical treatment is a human right is also codified as law by a number of American states and territories and by the national government in the form of The Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA imposes upon hospitals the duty to perform an examination upon any patient presenting at an emergency department in order to determine if an emergency medical condition exists. If so, the hospital must treat the patient until the condition is stabilized, which may include follow up treatment. Finally, a hospital providing specialty care that has capacity at the time of the request must accept a transfer of a patient in spite of their ability to pay. Hospitals that fail to live up to the standards set by EMTALA and equivalent state laws are subject to inspection, investigation, civil fines and penalties which may, in extreme cases, include the loss of their license to accept payments from the government that comprise a large portion of U.S. healthcare spending.
In 2001, the American Secretary of State directed a diplomatic cable to all Consular Officers advising them to exercise caution and to be judicious in their review of medical treatment visa applications. See DOS Cable #199998, Nonimmigrant Visas for Medical Treatment (Nov. 19, 2001). The State Department head noted that a number of hospitals had contacted his department and reported instances in which American medical visa holders had presented at the emergency department or at a specialty hospital, sometimes on the referral of an American doctor. The patient, though not an American citizen, was treated as required under EMTALA. Some patients were also the beneficiaries of funds raised by charitable organizations for the support of the indigent. The cable advises Consular Officers to strictly enforce the requirement that American medical visa applicants present a clear treatment plan that includes all follow up treatments and demonstrates the ability to pay while acting in a way that is sensitive to and respectful of the health condition of the American medical visa applicant.
The Immigration Law Office of L. Ford Banister, II is pleased to provide American medical visa application and interview preparation and review as well as ancillary legal support and due diligence services for American medical visa applicants and their family members. Contact us today for a free consultation.