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The Immigration Medical Exam, Explained

The green card medical examination is an important step of the immigration process and is required for all spouses seeking a marriage-based green card. The exam, to be completed by a government-authorized doctor, consists of several parts:

A review of your medical history and immunization records
A physical and mental evaluation
Drug and alcohol screening
Tests for various diseases and illnesses

The purpose of the green card medical exam is to ensure that the spouse seeking a green card has no health condition that could make them “inadmissible” to the United States — meaning they’re ineligible to receive a green card.

Many green card applicants get nervous about this step of the process, and that’s normal. But there’s no need to worry! Adequate preparation can make the entire exam less stressful and also help you avoid any issues that could delay or cause denial of your green card application. Plus, it’s rare to fail the medical exam. And even if you do have a condition that might complicate your green card application, you can often request a waiver.

To help you prepare, this guide will cover everything you can expect in every stage of the medical exam process: before, during, and after.

Before the Exam

1Who’s the doctor?

There are only two types of doctors who can perform the medical exam, and the right one for your situation depends on where you’re applying from: 1. If you’re applying from within the United States, you will see a civil surgeon designated by U.S. Citizenship and Immigration Services (USCIS). 2. If you’re applying from abroad, you will see a panel physician authorized by the U.S. Department of State. When choosing a doctor, make sure to ask about fees, the doctor’s availability, and whether they accept your health insurance.

2How much will the exam cost?

The cost of the medical exam varies significantly by location and provider. Boundless customers have reported paying between $100 and $500, but $200 is typical. (See our detailed guide on the costs of a marriage green card.)

3When and how do I schedule the exam?

The process for scheduling the medical exam and the validity period of the results depend on where the spouse seeking a green card is applying from. Regardless, the exam must be completed prior to your green card interview, so it’s important to be mindful of the marriage green card timeline for your particular situation.

If you’re applying from within the united states

When to schedule: You have two options — each with pros and cons — as far as when to schedule your appointment (also see this important policy change from USCIS regarding when the results must be certified by a doctor and how long they will be valid): 1. Schedule it before you begin the green card application process. In this case, you would submit your medical exam results with your application package (including all government forms and supporting documents). This process is known as “concurrent filing.” You are not required to do it this way. With this option, however, you risk needing to repeat the medical exam (and pay the doctor’s fees again) if USCIS does not schedule your green card interview before your initial exam results expire. (See below about an important policy change from USCIS regarding when the results must be certified by a doctor and how long they will be valid.) 2. Schedule it after filing your green card application package. In this case, you can either send your medical exam results to USCIS soon after submitting your green card application (Form I-485) or bring the results with you to your green card interview. Some people choose this option to avoid needing to take the medical exam a second time — as long as USCIS schedules their interview within two years (the exam results expire after that, as of November 1, 2018). But if they wait too long — and it’s hard to predict when USCIS will schedule the interview — then they also risk not completing the medical exam in time. (See below about an important policy change from USCIS regarding when the results must be certified by a doctor and how long they will be valid.) How to schedule: Use the USCIS “find a doctor” tool, or call the USCIS Contact Center at 1-800-375-5283 (TTY: 1-800-767-1833) to locate a nearby civil surgeon authorized to perform immigration medical exams. Let the doctor’s office know that you are contacting them to set up a medical exam appointment for immigration purposes.

4What should I bring to my exam?

Having all of your documents ready before your appointment can help the medical exam go smoothly. Here’s what you’ll need to bring with you:

Your immunization or vaccination records

A copy of your medical history

Copies of any previous chest X-rays, if any

A letter from your regular doctor outlining the treatment plan for any health problems you have

A government-issued photo ID, such as your passport, state ID, driver’s license, travel permit, or work permit

Payment for the medical exam fee (check with the doctor’s office before your appointment for acceptable payment options) Your health insurance card, if any (check with the doctor’s office before your appointment if they accept your insurance)

You must also bring an additional document, depending on where you’re applying from.

During the Exam

The green card medical exam is not like a routine physical you’d receive from your family doctor. Nor will the doctor give you a “pass” or “fail” grade based on your overall health. (See below for important medical exam information for women.) During the medical exam, the doctor will review your immunization and medical history with you. They will ask both general and specific questions about your health. You’ll also get a basic checkup (or “physical”).

In addition, the doctor will look for specific conditions that fall into the following categories (see below for information about how the presence of such conditions can affect your green card application):

Communicable diseases (including tuberculosis, syphilis, and gonorrhea)
Drug abuse or addiction
Physical or mental disorders associated with harmful behavior
Conditions that make it impossible for you to support yourself

To check for the above conditions, the doctor will conduct several types of tests.

Tuberculosis test

Civil surgeons in the United States and panel physicians abroad follow different tuberculosis testing guidelines from the Centers for Disease Control and Prevention (CDC):

The civil surgeon will follow the CDC’s Tuberculosis Technical Instructions for Civil Surgeons, which currently require them to conduct a test called the “interferon gamma release assay” (IGRA) on all green card applicants aged 2 and older. Generally, you will not be required to return to the doctor’s office to obtain the IGRA results.

If, however, the IGRA results reveal signs or symptoms of tuberculosis, you’ll be required to return to the clinic in order to get a chest X-ray and undergo other further testing.

Drug and alcohol screening

The doctor will ask questions about any prescription drugs you take, as well as your past and present drug and alcohol use. To learn more about specific screening procedures for green card applicants, check out the CDC’s guidance for civil surgeons (if you’re applying from within the United States) or its guidance for panel physicians (if you’re applying from abroad).

Boundless helps you prepare for every milestone of the marriage-based green card process, including the medical exam. Find out more about what you get with Boundless, or let’s begin!

Blood and urine tests

Doctors are required to perform a blood test for syphilis and a urine test for gonorrhea on all green card applicants aged 15 and older — whether applying from within the United States or abroad.

Vaccination screening

The doctor is required to make sure that you’ve received all required vaccines. If you’re missing any, you’ll be required to obtain these before you attend your green card interview, but the doctor should be able to provide these vaccines during your medical exam.