To complete the medical examination for a US Green Card, you must be examined by a USCIS-approved Civil Surgeon and submit Form I-693. Based on recent federal updates, this form must be filed simultaneously with your Form I-485, and it remains valid only while your specific application is pending. The medical exam itself typically costs between $200 and $500, depending on your chosen physician.
Applying for a Green Card in the United States is a life-changing journey, but it requires passing a strict federal health screening. 📰 The U.S. government wants to ensure that prospective lawful permanent residents do not pose a public health risk. Navigating the USA immigration system is very different from dealing with a local civil lawsuit. There is no plaintiff suing a defendant to establish legal liability or secure a financial settlement, nor are you dealing with family court matters like child custody or alimony/spousal support. Instead, you must strictly follow administrative rules set by U.S. Citizenship and Immigration Services (USCIS). If the federal paperwork ever feels overwhelming, you can easily browse our directory to find an experienced immigration attorney to guide you safely through the process.
Step-by-Step Process in the USA
The medical examination is a federal requirement, meaning the exact same rules apply whether you are applying from Chicago, Miami (Miami-Dade County), or Los Angeles. 🏥 You cannot simply visit your family doctor; you must follow specific federal guidelines to ensure your Form I-693 is accepted.
Step 1: Finding a USCIS-Approved Civil Surgeon
To begin, you must locate a doctor who has been officially designated by USCIS as a “Civil Surgeon.” 🔍 You can find one by using the “Find a Civil Surgeon” tool on the official USCIS website. Just as you would trust the DMV for your driver’s license or the IRS for your tax transcripts, you must strictly use this federal registry. Going to an unapproved doctor will result in the immediate rejection of your medical paperwork.
Step 2: Gathering Your Medical Records
Before your appointment, gather all your previous health and vaccination records. 📁 You must prove you are immunized against diseases such as measles, mumps, rubella, polio, tetanus, and hepatitis B. As of a major policy update in January 2025, the COVID-19 vaccine is no longer federally required for this immigration exam. If you are missing any required vaccines, the Civil Surgeon can administer them during your visit.
Step 3: The Physical Examination and Lab Tests
During the actual exam, the doctor will review your medical history and conduct a standard physical evaluation. 🤖 They will also draw blood and take urine samples to test for infectious diseases like Syphilis and Gonorrhea, and conduct screening for Tuberculosis (TB). Unlike a civil legal claim that might eventually expire due to a statute of limitations, health inadmissibility is based on your present-day medical condition.
Step 4: Submitting the Sealed Envelope
Once the exam is complete, the Civil Surgeon will fill out Form I-693, sign it, and seal it in an envelope. 📩 Do not open this envelope under any circumstances. Under the newest federal regulations implemented in late 2024, you must submit this sealed envelope simultaneously with your Form I-485 (Adjustment of Status application). Filing the I-485 without the medical exam can lead to an outright rejection of your Green Card package.
How Much Does it Cost in the USA?
While there is no federal filing fee specifically for Form I-693 itself, you must pay the Civil Surgeon for their time and medical services. 💰 As of March 2026, you should prepare for the following estimated costs:
- Medical Examination Fee: Most USCIS-approved Civil Surgeons charge between $200 and $500 for the basic physical, lab work, and completing the paperwork. Prices vary significantly by state and clinic.
- Vaccination Costs: If you lack required immunizations and do not have health insurance that covers them, you may pay an additional $50 to $200 per vaccine.
- Legal Fees: If you hire an attorney from our directory to manage your entire Adjustment of Status (I-485) packet, their comprehensive fees generally range from $1,500 to $3,500.
How Long Does the Process Take?
Getting your medical exam completed is relatively quick, but timing your submission is crucial. ⏱ Scheduling the appointment and receiving the sealed envelope usually takes 1 to 3 weeks, depending on how quickly your lab test results come back.
As of June 2025, USCIS updated the validity rules for Form I-693. ⚠ The form is now valid only for the duration of the pending Form I-485 it was submitted with. If your Green Card application is denied or withdrawn, your medical exam immediately loses its validity, and you will need to pay for a brand-new exam if you reapply. Maintaining your legal status during this wait is critical; while federal agencies like the EEOC protect workers from workplace discrimination, you must still ensure your underlying immigration filings are solid.
| Medical Requirement | Details & Federal Policy | Estimated Cost |
|---|---|---|
| Basic Physical Exam | Conducted exclusively by a USCIS-approved Civil Surgeon. | Included in the $200-$500 base fee. |
| Lab Testing (Blood/Urine) | Checks for Tuberculosis, Syphilis, and Gonorrhea. | Usually included in the base fee. |
| Vaccinations | Measles, polio, tetanus, etc. (COVID-19 no longer required as of Jan 2025). | $50-$200 per shot (if uninsured). |
Frequently Asked Questions (FAQ)
Can my regular primary care doctor complete Form I-693?
No. You must use a doctor who has been specifically authorized by the federal government as a USCIS Civil Surgeon. Examinations performed by unapproved physicians will be rejected.
Is the COVID-19 vaccine still required for a US Green Card?
As of January 2025, USCIS officially removed the COVID-19 vaccination from the list of required immunizations for the immigration medical exam. You no longer need to show proof of it.
What happens if I accidentally open the sealed medical envelope?
If the envelope is opened or tampered with in any way, USCIS will immediately reject the form. You will have to return to the Civil Surgeon, pay a fee for a replacement envelope, or potentially undergo a new exam.
Do I have to submit Form I-693 at the same time as Form I-485?
Yes. Under federal rules enacted in late 2024, simultaneous filing is strictly required. You can no longer file Form I-485 first and wait to bring your medical exam to your interview or wait for a Request for Evidence (RFE).
What if I test positive for Tuberculosis (TB)?
A positive TB blood test does not automatically mean your Green Card will be denied. The Civil Surgeon will require a chest X-ray. If active TB is found, you must complete a medical treatment plan before your Form I-693 can be cleared and signed.
Can I reuse my Form I-693 if my Green Card application is denied?
No. Due to policy changes in June 2025, a Form I-693 is only valid for the specific application it was filed with. If your I-485 is denied or withdrawn, the medical exam loses its validity, and you must obtain a new one to reapply.
Does health insurance cover the cost of the immigration medical exam?
Most USA health insurance plans do not cover the administrative fee for the immigration medical exam itself. However, your insurance will very likely cover the cost of any necessary routine vaccinations or lab work if you go to an in-network provider for those specific services before seeing the Civil Surgeon.
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