When you’re applying for a green card or some other immigration benefits in the United States, one important step is the USCIS Immigration Medical Exam. This is a health check that you must pass to make sure you meet the U.S. health requirements. It helps protect you and the people living in the U.S. Whether you’re applying from inside the country or from outside, knowing about this exam will help you avoid any surprises or delays.

Legal and Regulatory Framework

The immigration medical exam isn’t your regular doctor’s visit. It’s required by U.S. immigration law. The U.S. Citizenship and Immigration Services (USCIS) uses this exam to check for certain health problems that might stop someone from being allowed to live in the U.S. These include contagious diseases, missing required vaccines, drug abuse, or mental health issues that could be harmful.

The doctor who does this exam is called a civil surgeon if you’re in the U.S., or a panel physician if you’re outside the U.S. These doctors are specially approved by USCIS to do this exam. The exam focuses only on health issues related to immigration rules, not a full physical check-up.

When and Who Must Take the Exam

Now, who needs to take this medical exam? Most people applying for a green card have to take it. This includes people who are already in the U.S. and are changing their status, as well as those applying from outside the country. Some other groups, like asylees adjusting their status, also need to take it.

There are some exceptions. For example, children under 14 or people over 79 might have different rules. Children under 14 generally do not need chest X-rays or blood tests unless there’s a medical reason, making their exam less extensive. Similarly, applicants aged 79 and older are usually exempt from the tuberculosis (TB) test and blood tests, as the risk for certain conditions is lower or testing may not be appropriate. However, both age groups still require a basic physical exam and vaccination review to ensure public health safety.

Some temporary visa applicants might not need the exam unless asked. Also, sometimes USCIS officers can ask for the exam if they think it’s needed. It’s important to know if you need this exam because missing it can cause delays or even stop your immigration process.

Preparing for the Medical Exam

Getting ready for your immigration medical exam is easier when you know exactly what to expect and what to bring. First, you need to find a doctor who is authorized by USCIS to perform this exam. You can find a list of approved doctors on the USCIS website.

Before your appointment, gather important documents like your passport or government-issued photo ID, your vaccination records, and any medical history or treatment information you have. If you’re applying from inside the U.S., you should also bring Form I-693, the official “Report of Medical Examination and Vaccination Record.” It’s a good idea to download the latest version from the USCIS website and fill out your part before the visit, but don’t sign it until the doctor tells you to.

Make sure to ask the doctor’s office about the exam fee and payment methods, as you’ll need to pay for the exam, blood tests, and any vaccinations. Also, if you have health insurance, check if the doctor accepts it.

If you’re applying from outside the U.S., bring your green card interview appointment letter. The doctor won’t perform the exam without this.

Being prepared with these documents and information will help your medical exam go smoothly and avoid delays.

What Happens During the Medical Exam

The immigration medical exam is different from a regular check-up. It usually takes about 30 minutes to two hours. During the exam, the doctor will review your medical history and vaccination records. They will ask questions about your health, any medications you take, and your past or current treatment.

The doctor will perform a physical exam, checking your eyes, ears, nose, throat, heart, lungs, abdomen, skin, and lymph nodes. They will also screen for specific health issues that matter for immigration:

• Communicable diseases like tuberculosis (TB), syphilis, and gonorrhea 
• Drug abuse or addiction 
• Mental health conditions linked to harmful behavior 
• Any physical or mental condition that might prevent you from supporting yourself 

For TB, the test depends on where you are applying from. If you’re in the U.S., the doctor will do a blood test called the IGRA for applicants aged 2 and older. If the test shows signs of TB, you might need a chest X-ray. If you’re applying from abroad, applicants 15 and older in high-TB countries usually get a chest X-ray first.

Blood and urine tests are done for syphilis and gonorrhea for applicants aged 15 and older, no matter where you apply.

The doctor will also ask about drug and alcohol use and may do a mental health evaluation related to immigration rules.

If you’re missing any required vaccines, the doctor can give them during the exam or tell you to get them before your green card interview.

Vaccination Requirements

Vaccinations are a key part of the immigration medical exam. USCIS requires that applicants have certain vaccines to protect public health. The list of required vaccines changes over time, but typically includes common ones like measles, mumps, rubella, tetanus, diphtheria, pertussis, polio, hepatitis A and B, influenza, and others based on your age and medical history.

As of 2025, USCIS no longer requires the COVID-19 vaccine for the immigration medical exam, so you won’t need to bring proof of that anymore.

If you don’t have records showing you received the required vaccines, the civil surgeon will give you the missing shots during your exam or tell you to get them before your interview.

It’s best not to get new vaccines right before your exam without consulting your doctor, as some vaccines might cause side effects that could delay your process.

Medical Conditions That Affect Immigration Eligibility

During the medical exam, the doctor looks for certain health conditions that could affect your ability to immigrate to the U.S. The law identifies four main categories that might make someone inadmissible:

• Communicable diseases of public health significance, like active tuberculosis, infectious syphilis, gonorrhea, and infectious Hansen’s disease (leprosy). If you have one of these, you may be denied entry unless you get treatment or a waiver.
• Failure to show proof of required vaccinations. If you don’t have the necessary vaccines, you won’t pass the exam until you get them.
• Physical or mental disorders linked to harmful behavior. This means if you have a condition that causes dangerous behavior to yourself or others, it could affect your eligibility. Mental illness alone without harmful behavior usually does not make you inadmissible.
• Drug abuse or addiction. If you have a history of drug abuse or addiction, you might be denied unless you can show you’ve been treated.

The doctor will classify any serious health issues as either “Class A” or “Class B.” A Class A condition means you are inadmissible on health grounds, while Class B means you have a condition that doesn’t block entry but might cause other concerns, like being unable to support yourself.

If you have a health condition that makes you inadmissible, there may be waivers available depending on your situation.

After the Medical Exam

Once your exam is complete, the doctor will fill out Form I-693, which summarizes your medical history, exam results, and vaccination status. This form is sealed in an envelope and given to you to submit with your immigration application, usually Form I-485 for adjustment of status.

The medical exam results are valid for up to two years, so timing your exam close to your application filing is important. If your results expire before USCIS reviews your case, you may need to repeat the exam.

If the doctor finds any health issues that could make you inadmissible, USCIS will review the findings and may request additional information or treatment. In some cases, you might be asked to get a waiver or provide proof of treatment before your application can move forward.

Special Considerations

Certain groups have special rules for the medical exam:

• Children and seniors: Applicants under 14 or over 79 may have different vaccination or testing requirements.
• Pregnant women: Some vaccines may be delayed or avoided during pregnancy, and the doctor will adjust the exam accordingly.
• Applicants with disabilities or mental impairments: If you have a physical or mental disability that affects your ability to complete parts of the immigration process, you may qualify for exceptions or accommodations, but you still need the medical exam.
• Applicants outside the U.S.: The exam is done by panel physicians approved by the U.S. Department of State, and some tests or procedures may differ slightly from those inside the U.S.

Common FAQs and Tips

• How much does the exam cost? 

Fees vary by doctor and location but usually range from $200 to $500. Check with your doctor beforehand.

• Can I prepare for the exam? 

Bring all your medical records and vaccination history. Be honest about your health and medications.

• What if I need vaccines? 

The doctor can give you missing vaccines during the exam or advise you to get them before your interview.

• What if I’m nervous? 

The exam is straightforward and focused on immigration-related health issues. Take deep breaths and ask the doctor questions if you’re unsure.

• What if I fail the exam? 

You may be treated or asked to get a waiver. USCIS provides options depending on your condition.

Conclusion

Knowing what to expect and preparing well can help you complete your test smoothly. Always use an authorized doctor and follow the latest USCIS guidelines to avoid delays and keep your application on track.