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  • Raj Singh

HR Guide: Health Insurance for foreign-national Employees

Updated: Apr 7, 2023

Why are your foreign-national employees not thinking about their health coverage?

For those who were born or brought up in the US, thinking about health insurance and its implications comes as second nature. We understand the value of good health insurance for us and for our dependents and have had enough experience to make good health insurance decisions.

But foreign-national employees may need help understanding all the nuances of the US healthcare system because most of them, thankfully, have yet to have a chance to deal with a medical situation here or are from countries where healthcare infrastructure is set up differently.

Why a foreign-national employee may not utilize full health insurance benefits?

Most of the concerns or apprehensions stem from the following assumptions. So, let's try to address these:

Monthly premium: the hefty monthly premium can feel financially intimidating to a foreign-national employee because there are no apparent immediate benefits.

No history of medical issues: if they've never had to deal with medical issues, then getting insurance is low on the priority list.

Can always go back home: taking a flight back home to solve a medical complication may seem like a viable option.

How should foreign-nationals think about health insurance?

The best way to think about health insurance is like an

investment that one makes in future self

With that in mind, let's tackle each of the assumptions with two scenarios for Sean (a foreign-national employee), who came to the US as an international student on an F-1 visa and is now working for a company on OPT and has enrolled in the company's health insurance plan -

Best case scenario:

Sean has no medical emergencies. As a result of the health insurance, he registers with service providers and starts to go in for yearly health, dental, and vision checkup. These checkups are almost free, and will tell Sean if he should be concerned about anything in the future.

Worst case scenario:

Sean has severe abdominal pain and has to be rushed to an emergency room (ER) because flying to his home country isn't an option right now. The hospital finds the issue, and it's an easy fix. If Sean weren't insured, the medical bill for the ER visit would be thousands. Now, Sean just has to pay a few hundred dollars.

Can foreign-national employees cover their dependents on their health insurance?

Yes. A foreign-national employee can cover their eligible dependents on their health insurance plan.

Who are considered eligible dependents?

Spouse or legal partner and children under the age of 18 years and 26 years after ACA.

Do the dependents have to have a dependent status in the US?

The spouse and/or children don't need to be on a dependent visa of the foreign-national employee. For example, if the employee is on an H-1B or L-1A visa, their dependents can be on an F-1 visa and still be covered under their health insurance plan.

Does covering a dependent on F-1 status impact their immigration status in any way?

No. Covering the dependent under a health insurance plan has no implications on the dependent's immigration status.

What if the dependent already has health insurance through their school?

Health insurance for F-1 students is almost always the worst option with the least amount of coverage. So, the dependent should always be covered under the health insurance of the foreign-national employee.

Can foreign-national employees get medical insurance while working on CPT?

Since CPT is considering an internship, the foreign-national employee is still considered a full-time student and needs to keep their school's health insurance.

Can foreign-national employees get medical insurance while working on OPT?

On OPT, the foreign-national employee is considered a full-time employee and should move to the employer's insurance plan.

What aspects of health insurance should the foreign-national employees understand when making a decision?

Plan Selection

Selecting the plan that suits you best can be a lot of work. I say this from experience - Keep it simple. When it comes to health insurance, always go for the top-tier plan. Spending a little extra every month makes sense if it can provide higher coverage at the time of need.

In-Network vs Out of Network Providers

Simply put, in-network providers are the ones that will charge less for medical services than out-of-network providers. Insurance websites provide a list of in-network and out-of-network doctors and facilities. Understand if a facility or a doctor is in-network or out-of-network before scheduling appointments.

Registering with a Primary Physician

Registering with a physician can take multiple weeks. So, start looking for a primary physician (preferably in-network) as soon as you get the health plan. If you need prescription medication for any serious condition, you need to go through your physician.


The foreign-national employees could greatly benefit from employers' guidance. Providing some guide rails to these employees would not only result in a better experience for them but will also mean that they can take advantage of the benefits that you, as the employer, have worked so hard to provide them.

If you have more questions about health care benefits for your foreign-national employees, please email us at


When a student is on CPT, depending on the way the company's health plan and benefit policies are written, they may be eligible for the employer's health plan.
Most plans are written so that if the internship lasts longer than 6 months (as a lot of CPT does), interns must be offered company coverage. And as a general note, some insurance plans are written so that spouses and dependents cannot be covered if they are eligible for coverage from another employer or school.


Content in this publication is not intended as legal advice, nor should it be relied on as such. For additional information on the issues discussed, consult a WayLit-affiliated attorney or another qualified professional.



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