Green Card Medical Exam Guide to Form and Costs
- Most Green Card applicants must complete an immigration medical exam before approval.
- If you’re required to submit a medical, USCIS generally expects this via Form I-693 filed with Form I-485 if you’re applying for within the U.S. (adjustment of status).
- Required medical tests are targeted (not a full lab workup) and often include TB testing, plus other infectious disease tests.
- In consular cases, an immigrant visa’s expiration can be limited by how long the medical exam is valid (often up to 6 months, sometimes shorter in certain scenarios).
Most people applying for a Green Card must undergo a medical exam before their immigrant visa can be approved.
Knowing how to schedule your medical examination and what to expect during and after can help you feel prepared and avoid potential problems during the Green Card process.
Why are medical exams required for Green Cards?
The Immigration and Naturalization Act (INA) outlines reasons immigrants may be denied an adjustment of status or entry into the U.S., and a few health-related issues are included on that list.
The law says an immigrant may be denied a Green Card if they:
- Have a communicable disease of public health significance
- Have or have had a physical or mental health disorder that poses a threat to their safety and welfare of others
- Have drug or substance abuse issues
- Or can’t show proof of vaccination against certain vaccine-preventable diseases, such as mumps, measles, and others
| đź’ˇ In November 2025, the State Department gave consular officers expanded discretion to deny visas based on a larger list of health conditions than are listed in the INA. Visa officers could deny applicants with chronic health conditions such as diabetes, heart disease, or cancer, under the reasoning that they may need government assistance to pay for medical care. While the guidance was reportedly issued via internal cable, not official policy, it does mirror a proposed rule submitted by the Department of Homeland Security (DHS) around the same time. |
When is a medical exam required in the Green Card process?
The timing of your medical exam will be different if you’re applying for a Green Card from outside the U.S. or within the U.S.
If you apply for an adjustment of status inside the U.S. and you’re required to submit a medical exam, you must have your medical exam done before you submit your application. You need to submit the I-693, Report of Immigration Medical Examination and Vaccination Record, along with Form I-485.
U.S. Citizenship and Immigration Services (USCIS) introduced this timing change in December 2024, so if you have friends or relatives who applied previously and gave you different advice, note that your medical exam needs to be completed before you apply for an adjustment of status.
If you’re outside the U.S. and apply through consular processing, your medical exam happens between your application and your interview. The National Visa Center (NVC) will notify you of your interview appointment. This is when you schedule your medical exam.
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What is on Form I-693?
You will complete the first part of Form I-693 with your basic details, such as your name and address.
The physician, referred to as a civil surgeon, conducts your exam and completes the rest of the form. They will record details such as test dates and results related to the specific health conditions that could make someone inadmissible to the country, or ineligible for a Green Card.
| đź’ˇ At the end of the exam, your doctor will give you the completed I-693 form in a sealed envelope. You must submit the sealed envelope to USCIS. You may also receive a copy of the completed form for your own records. |
How do I make my Green Card medical exam appointment?
A medical exam has to be conducted by a doctor authorized by USCIS.
For certain applicants with access to military treatment facilities, military physicians are generally considered civil surgeons and can conduct a medical exam for immigration purposes.
USCIS has an online tool to help you locate an approved civil surgeon near you. After locating a physician, you can contact them to make an appointment.
For immigrants applying from abroad, the embassy or consulate for your area will have details on doctors approved to perform immigrant medical examinations. You should make your appointment as soon as possible after receiving your interview appointment notice from the NVC.
How much does it cost to get a medical exam for a Green Card?
There is no filing fee for Form I-693, but there are costs associated with the medical exam itself.
USCIS suggests contacting civil surgeons in your area to ask them which medical insurance they accept and the estimated costs before booking an appointment. Your insurance might not cover all the required parts of the medical exam.
The exam, necessary tests, and potential additional vaccinations typically cost several hundred dollars, but costs can vary widely depending on your location and what services are needed.
What do I need to bring to a Green Card medical exam?
On the day of your scheduled medical examination, be sure to bring the following items.
- Form I-693: You should have already filled out the first part of the form with your details. Be sure to leave the details of the actual medical exam blank so that the doctor can complete those sections.
- Government-issued photo ID: This can be a passport or driver’s license. For children 14 or younger, you’ll need to bring a birth certificate that shows their name, date and place of birth, and parent’s name.
- Vaccination record: You will need to show whether you’re vaccinated or immunized against contagious diseases. This includes vaccines such as DT, DTP, DTaP, Td, Tdap, OPV, IPV, MMR, Hib, Hepatitis A, Hepatitis B, Varicella, Pneumococcal, Influenza, Rotavirus, and Meningococcal disease. Note that this list can change based on CDC and USCIS guidance.
- Health insurance card: If the civil surgeon you see accepts your insurance, be sure to bring proof of your medical insurance coverage.
- Payment for your exam: Be prepared to pay for your medical exam on the day of your appointment, unless the civil surgeon’s office collects payment in advance.
- Your interview appointment letter: If you’re going through consular processing, you need to bring the interview appointment letter you received from the NVC to your medical exam.
What is the doctor looking for during a Green Card medical exam?
The civil surgeon who conducts your exam will review Form I-693. You will receive a physical exam and may be tested for specific conditions identified by the CDC as being of public health significance.
Those include:
- Gonorrhea
- Hansen’s Disease (Leprosy), infectious
- Syphilis, infectious stage
- Tuberculosis (TB), currently active
The doctor will also evaluate you for drug or substance abuse and will screen you for any physical or mental health conditions that may be harmful to others or make it difficult for you to support yourself.
A visa applicant with any of those conditions could be considered inadmissible.
| đź’ˇ It may require more than one visit to a civil surgeon to complete all the required tests and vaccinations, particularly if you are missing required vaccines. |
What happens after a Green Card medical exam?
At the end of your exam, the doctor will ask you to sign the completed Form I-693. Now your form is complete.
The doctor will put the completed form in an envelope and seal it. The sealed envelope is what you submit to USCIS.
If you’re going through consular processing abroad, you may bring the envelope to your appointment at a U.S. consulate, or the doctor may send it directly to the consulate or embassy.
Need support for your medical exam questions?
If you’re worried about how your unique medical history will affect your Green Card case, an experienced immigration lawyer can give you advice ahead of a medical exam. At Manifest Law, our attorneys have handled thousands of cases and stay up to date on the latest guidance from USCIS and the State Department. They can help you anticipate any potential red flags and plan how to address them before or after your exam.
Request a consultation to learn more.
FAQs
How long is a medical exam for a Green Card valid?
USCIS has updated the validity period for a Green Card medical exam a few times. As of June 11, 2025, USCIS guidance says an I-693 signed on or after Nov. 1, 2023, is valid only while the underlying application for permanent residency (I-485) is pending. The exam becomes invalid if the I-485 is withdrawn or denied.
For consular processing, medical exam records are generally valid for 6 months or 3 months, depending on TB-related factors. Your visa validity may be shorter if your medical exam is valid for a shorter period. After your visa is approved, your visa validity is how long you have to travel to the U.S. and request entry to the country.
What medical conditions disqualify you from a Green Card?
A Green Card can be denied on health-related inadmissibility grounds if the medical exam shows any of the following.
- Communicable disease of public health significance
- Missing required vaccinations
- Certain physical/mental disorders with associated harmful behavior
- Drug abuse or addiction
Some issues can be treated and re-evaluated, and some situations may qualify for a waiver.
How long does it take to get a Green Card after a medical exam?
The medical exam is just one required step, and overall processing for a Green Card depends on your case type and how quickly USCIS or your local U.S. embassy or consulate is handling applications. Medical results can take days to a few weeks to finalize due to lab testing, or if you need a referral for additional tests or treatment. Missing or expired medical exams can cause delays if USCIS issues a Request for Evidence (RFE).
What if I fail a Green Card medical exam?
Usually, it means the civil surgeon (or panel physician, as they’re referred to in consular processing) found something that must be treated, documented, or followed up on before you can be approved. For example, TB screening can require additional steps like a chest X-ray and possible referral, depending on the results.
In some cases, you may be able to request a waiver. USCIS decides those on a case-by-case basis.
What medical tests will be done for a Green Card?
The exam generally includes a review of your medical history, a physical exam, a review of your vaccination record, and screenings for specific infectious diseases.
Common required screenings include:
- Tuberculosis screening, which is usually a blood test (IGRA for applicants age 2+, plus a chest X-ray or health department referral when required)
- Syphilis testing, which is usually a blood test, for applicants 18 to under 45
- Gonorrhea testing, which is often a urine test, for applicants 18–24
Can USCIS approve a Green Card without a medical exam?
For adjustment of status, USCIS generally requires a completed medical exam to show you’re not inadmissible on health grounds.
There are limited circumstances in which USCIS may not require a new full exam. For example, if you have a recent exam that qualifies and is already in your immigration record, you may not need a new exam. But your exam record must still show that you meet the medical and vaccination requirements for immigration.
K and V visa holders may not need to repeat the full medical exam if they file for an adjustment of status within one year of their overseas medical exam and otherwise meet USCIS criteria. Refugees often submit only the vaccination record portion of Form I-693, unless a certain medical condition requires a full exam. Immigrants who object to vaccines for religious reasons may request a waiver from USCIS for the vaccine requirements. For individuals who are pregnant or immunocompromised and can’t complete certain vaccinations, the doctor who completes the medical exam and Form I-693 can document when the requirements are not medically appropriate.
Are children required to have a medical exam to receive a Green Card?
Yes, children generally must complete the immigration medical exam, but the tests vary by age. For example, TB screening rules apply starting at age 2, and syphilis/gonorrhea testing is typically required only in certain age ranges unless there’s a reason to suspect infection.
Vaccination requirements are also age-based and are documented as part of the exam.
