The Green Card medical exam experience can be daunting if you don’t know what to expect or what is required of you. It is an integral part of the application process for those hoping to obtain a Green Card through marriage.

Before beginning the Green Card application process myself back in late 2018, I had no idea that I needed to have a medical doctor fill out forms to be submitted with my application.

This guide documents everything you will need to bring to your United States Citizenship and Immigration Services USCIS medical exam, and gives you an idea of what to expect during the immigration medical. However, please keep in mind that this article is based on my own experience of the process and you may notice some differences.

I’d appreciate your comments below if you have anything to add, or have experienced something differently.

Purpose of the Green Card Medical exam

You might be wondering why you need to undergo a medical examination at all when applying for a Green Card, especially if you come from a western country that has all but eradicated some diseases.

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RELATED: Green Card through marriage processing time and procedure

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The immigration medical is in place to ensure that an applicant meets basic health standards that include having vaccinations. The USCIS medical exam can result in a Green Card application being denied on health grounds.

You could be denied a Green Card if you:

• Have a communicable disease of “public health significance”
• Fail to show proof that you’ve had the required vaccinations
• Have a physical or mental disorder that is associated with harmful behaviour
• Are abusing drugs or have a drug addiction

It is rare to fail a medical exam, even if you meet one of the above criteria. Those with chronic but managed diseases such as diabetes or heart disease don’t need to worry, as these kinds of diseases are rarely, if ever, used as a reason to deny a Green Card application.

The same is true for those who are HIV-positive, or who have previously had communicable diseases such as gonorrhea, leprosy, syphilis or tuberculosis, but are now cured. It’s important to bring copies of medical records to the Green Card medical exam to show that you received treatment for the aforementioned communicable diseases, as well as a letter from your treating doctor advising that the disease is being managed or has been cured.

Find a doctor to complete the Green Card medical exam

If you are living in the United States when you are preparing your Green Card application, you will need to be seen by either a Military doctor, or a doctor approved by the USCIS, known as a civil surgeon.

Not every doctor in the USA will be a USCIS civil surgeon, and it’s likely that your personal doctor will not be one. To find an appropriate doctor, use the USCIS’ Find a Doctor website to pinpoint a civil surgeon near you. The search results will give you addresses, names and phone numbers of civil surgeons who you can make an appointment with.

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TIP: Shop around before committing to a civil surgeon. Ask for pricing information upfront.

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However, those not living within the United States while applying for their Green Card, will need to be examined by a “panel physician”. These doctors are residents of countries and territories outside of the United States, and are usually appointed by the Department of State.

Panel physicians work out of US Embassies or Consulates abroad. The National Visa Center will provide overseas applicants with information on authorised panel physicians. Those applying from overseas can only schedule the medical exam after receiving a Green Card interview date from the National Visa Center. At that time, they will also get information on scheduling the medical exam.

How much does the USCIS medical exam cost?

The pricing for the Green Card medical exam can very depending on the doctor you choose to go with.

For that reason, I suggest using the Find a Doctor website to create a list of the the civil surgeons closest to you, and then start making phone calls.

Here are a couple of questions to ask:

• Is the doctor still performing immigration medical exams?
• When is the next available appointment for an exam?
• How much does it cost, including any blood work and extra immunisations?
• Find out if your health insurance is accepted

The typical Green Card medical exam experience, in terms of cost, sets applicants back around $200. However, it isn’t unheard of for providers to charge up to $500 for the service, and others can be as cheap as $100. There is no cost to file the Green Card medical exam with USCIS.

Keep in mind the time frame in which you need the exam, and whether it will be a complex process because of your medical history/illnesses, while making a decision.

When to get the immigration medical exam

If you are applying from inside the United States, there are a few rules that can make it tricky to work out exactly when you should get your medical exam signed-off.

• Concurrent filing: You can file your medical exam results at the same time as you submit your Green Card application forms and supporting documents.
  • Your USCIS medical exam needs to be signed by the USCIS civil surgeon less than 60 days before you file your Green Card application, otherwise it is invalid.
  • If, after you file, USCIS does not schedule your Green Card interview within two years of the medical exam, you will need to take the immigration medical exam again.
•  Exam after filing: You can file your Green Card application forms and support documents without your medical exam.
  • Usually, applicants do this because they want to make sure their exam is still valid when they are called in for the Green Card interview.
  • The downside is that it’s difficult to predict when USCIS will schedule your Green Card interview, and you may not have enough time to complete the medical exam before your interview.

As mentioned above, those applying for a Green Card while living overseas, can only schedule their medical exam after the National Visa Center sends them a letter with a Green Card interview date. These examinations are valid for just six months after they are signed by a panel physician.

What to bring to the Green Card medical exam

Be prepared for your immigration medical exam appointment by having the following information and documents ready:

• Bring Form I-693 with parts 1-4 already filled out (where applicable)
• Photo identification such as a valid passport or driver’s license
• Vaccination/immunisation records
• A copy of your medical history
• Letter from your doctor stating the details of treatment you are receiving for health issues
• Health insurance card
• Payment (check whether the doctor accepts cheques or requires credit or debit card payment)

If you are undertaking the immigration medical exam while abroad, you will also need to bring the National Visa Center letter advising you of your Green Card interview date.

Vaccines you need to have

If you’re wondering which vaccinations you need to have had to be eligible for a Green Card, here’s the list:

• DT, DTaP, DTP
• Td, Tdap
• OPV, IPV
• Measles, mumps-rubella
• Hib
• Hepatitis B
• Hepatitis A
• Varicella
• Pneumococcal
• Influenza
• Rotavirus
• Meningococcal

During my own Green Card medical exam experience, I didn’t realise that I needed to have had the flu shot before Form I-693 could be completed. So it stretched out the examination time, because I needed to go get the flu shot, and then return to the civil surgeon with proof of the vaccination.

No vaccination history available

There is a way around the hurdle of not having an official vaccination/immunisation record at your finger tips, however it will make the Green Card medical exam take a little longer.

You can have the USCIS civil surgeon request a blood test, called the Titer test, to check your immunity for certain diseases. The Titer test checks how your immune system responds to threats like bacteria and viruses, and thus your immunity against diseases.

If it detects that you are not producing proteins to kill off certain viruses, you will need to be immunised again. For example, I had the measles, mumps-rubella vaccine as a teenager, but my Titer test showed that I needed to be vaccinated against mumps again before I could be cleared for the medical exam.

During the USCIS medical exam

Visiting the USCIS civil surgeon for the appointment seems to be the easiest part of the process, albeit the most heart-thumping.

The doctor will run through Form I-693 with you, asking you about your medical history and performing a physical examination. They will look for symptoms of the communicable diseases mentioned above such as Tuberculosis, Gonorrhea, and Syphilis.

You’ll also be asked about your history of physical or mental disorders that are associated with harmful behaviour, and whether you are or have been a drug abuser or addict.

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IMPORTANT: Once the civil surgeon places Form I-693 into an envelope and seals it, you are not allowed to tamper or open the envelope. Doing so will render the medical exam invalid

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Ask your doctor for a copy of Form I-693 (Report of Medical Examination and Vaccination Record) before they place it in a sealed envelope.