The US health-exam requirements for green card applications — Form I-693 with a USCIS civil surgeon.
Overview
The US has substantial pre-arrival and pre-green-card health requirements — significantly more rigorous than European systems. Form I-693 (Medical Examination of Aliens Seeking Adjustment of Status) is required for almost all green card applicants. The examination is conducted by a USCIS-designated civil surgeon (for adjustment of status within the US) OR a US embassy/consulate-designated panel physician (for consular processing abroad). The examination covers: tuberculosis screening (chest X-ray + IGRA blood test or TST skin test depending on age), HIV testing (was required pre-2010 but no longer mandatory for most applicants), syphilis testing, mental health assessment, drug use assessment, and vaccination requirements (multiple required vaccines). The CDC publishes the Technical Instructions for civil surgeons. The exam expires 60 days from completion, so timing matters. This guide details the requirements, verified against uscis.gov, cdc.gov, and travel.state.gov.
Pre-Arrival Health Requirements by Visa
| Visa Category | Medical Required? | Details | When |
|---|---|---|---|
| H-1B / L-1 / O-1 (Nonimmigrant Work) | Generally no | — | — |
| F-1 (Student) | Generally no for visa | Some universities require post-arrival immunization records | — |
| B-1/B-2 (Visitor) | No | — | — |
| Immigrant Visa (Green Card) | Yes — DS-2054 (overseas) / I-693 (US) | TB screening + vaccinations + history | Before visa issuance |
| Adjustment of Status (I-485) | Yes — Form I-693 | Same exam standards | Submitted with or after I-485 |
| Refugee/Asylum | Yes — separate procedure | Tuberculosis + general health | Pre-arrival + post-arrival |
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See Paid Plans →Frequently Asked Questions
Do I need a medical exam for a US visa?
Depends. Most non-immigrant visas (H-1B, L-1, O-1, F-1, B-1/B-2) don't require pre-arrival medical examination. ALL immigrant visa (green card) applicants and almost all adjustment-of-status (I-485) applicants need Form I-693 — Medical Examination of Aliens Seeking Adjustment of Status. The exam is conducted by USCIS-designated civil surgeon. Refugee/asylum applicants have separate procedures.
How much does the USCIS Form I-693 medical exam cost?
USD 200-500 typically, depending on civil surgeon location and any additional tests required. Many large cities have specialised immigration clinics with set pricing. Vaccinations administered during the exam add additional cost — USD 50-200+ per vaccine for catch-up. Total realistic cost for I-693 + any required vaccinations: USD 300-800 per applicant.
Does the US require tuberculosis screening for green card applicants?
Yes — TB screening is mandatory for all green card applicants 2+ years old. Tests required: chest X-ray for 15+ years; IGRA blood test or TST skin test for younger ages depending on civil surgeon assessment. Active TB requires treatment before green card approval; latent TB requires assessment and may require treatment depending on circumstances. Children under 2 may have alternative screening based on parental TB history.
Is HIV testing still required for the US green card?
No — HIV testing requirement was removed in 2010. The US no longer requires HIV testing for visa applicants. HIV-positive applicants are not denied visas based on HIV status. HIV-related medical information may be requested if relevant to other inadmissibility grounds, but routine HIV testing is not part of I-693.
What vaccinations are required for a US green card?
Per CDC Technical Instructions: mumps, measles, rubella; polio; tetanus + diphtheria + pertussis (DTaP/Tdap); hepatitis B; varicella; pneumococcal; rotavirus (for infants); influenza (seasonal); meningococcal (adolescents); hepatitis A. Age-specific requirements apply. Civil surgeon can administer catch-up vaccinations at the exam. Medical or religious exemptions documented case-by-case.
What happens at the USCIS civil surgeon exam?
Medical history review (your home-country health records if available); physical examination; chest X-ray for tuberculosis screening; vaccination review and updates as needed; mental health assessment (questions about behavior and any psychiatric history); drug use questions; general health questionnaire. The exam takes 60-90 minutes typically. Civil surgeon signs Form I-693, which must be submitted within 60 days.
Can pre-existing medical conditions affect my US green card application?
Generally no for routine pre-existing conditions. The US doesn't have a general 'public charge' health-screening that excludes for diabetes, hypertension, etc. However, certain mental health conditions associated with 'harmful behavior' and active tuberculosis can be grounds for inadmissibility — potentially with waiver via Form I-601 in some cases. HIV-positive status is NOT grounds for inadmissibility.
What if I don't have my home-country vaccination records?
Civil surgeon can review your medical history and administer catch-up vaccinations at the exam. Some vaccinations (MMR, hepatitis B) can be verified via blood test (titer) — if you have sufficient antibodies, the vaccine is considered current. Other vaccines (varicella) might be assumed current if you have documented prior infection. Civil surgeons are familiar with international vaccination records and can assess what's needed.