Health insurance for visitors to Palo Alto and Stanford

A twisted ankle on the Dish, a fever the week of a campus visit or a fall while visiting grandchildren: small medical problems happen on trips and in the United States they come with large bills. Some visitors must carry insurance by law, as J-1 scholars do. For others, such as tourists or parents visiting a Stanford student, it is a choice, but an important one.

This page gathers the rules and the plain facts in one place. It covers what care costs, where to go in and near Palo Alto, the J-1 and J-2 requirements, Stanford's own rules for visitors and how visitor medical plans work.

Why US care is expensive for visitors

The United States has no national health service that visitors can use. Visitors without US insurance are usually asked to pay their bills themselves. Doctors' fees can arrive separately from the hospital's. A few published figures give a sense of scale:

• Hospital cost of an ER visit. The federal Agency for Healthcare Research and Quality estimated that an emergency department visit ending with the patient going home cost hospitals an average of $530 in 2017 (HCUP Statistical Brief 268). That is the hospital's estimated cost, not the bill. It leaves out doctors' fees and is lower than what hospitals charge.
• What insured patients still pay. A KFF analysis of 2019 claims found that people in large employer plans paid $646 out of pocket on average for an ER visit, even with insurance.
• Urgent care. FAIR Health reported a median allowed amount of $179 at urgent care centers in 2023 for a 45 to 59 minute new patient visit. That is the price negotiated by insurers, before tests, X-rays or prescriptions.

Visitors paying out of pocket do not get insurers' negotiated rates unless the hospital offers a self-pay discount, so their bills can be far higher than these averages. An overnight hospital stay, surgery or an air ambulance adds much more.

Your rights in an emergency

Federal law protects access to emergency care. Under EMTALA, a hospital emergency department must offer a medical screening exam and, if you have an emergency condition, treatment to stabilize it, regardless of your insurance or ability to pay, according to the Centers for Medicare & Medicaid Services. Staff may ask about insurance, but not in a way that delays care. The bill still follows.

Getting a price in advance

For care that can be scheduled, Stanford Health Care's price transparency page links to a cost estimator for some services and to its published standard charges. It says the standard charges are not an estimate of what you will owe and leave out physician services. Its financial counseling team, which also handles international patients, gives personal estimates. Under the federal No Surprises Act, providers must give uninsured and self-pay patients a good faith estimate of costs. Stanford says patients can dispute a bill that is more than $400 above that estimate.

Where to go for care in Palo Alto

Hours change, especially on holidays. Our guide to urgent care and emergency rooms has the details for each site, including Stanford's walk-in clinic. The Sutter clinic is part of the Palo Alto Medical Foundation center. If someone you know is admitted, our page on visiting Stanford Hospital covers parking and visiting hours. Prescriptions can be filled at the pharmacies in town.

If the problem is not an emergency and your travel plan has an assistance line, call it before you go anywhere. It may be able to tell you which clinics can bill the plan directly.

J-1 scholars and J-2 dependents

Exchange visitors on the J-1 program, which includes many visiting researchers and professors at Stanford, must carry insurance for themselves and their J-2 family members for the whole program. The minimums are set in federal regulation, 22 CFR 62.14:

• Medical benefits of at least $100,000 per accident or illness.
• Repatriation of remains of $25,000.
• Medical evacuation to the home country of $50,000.
• A deductible of no more than $500 per accident or illness.
• Co-insurance of up to 25 percent of covered benefits is allowed.
• A waiting period for pre-existing conditions is allowed only if it is reasonable by current industry standards.
• The insurer must meet a minimum rating, such as A- or above from A.M. Best, unless the policy is backed by the home government.

The rule also says a policy may not unreasonably exclude the risks of the exchange activity itself. Sponsors can end the program of a visitor who willfully fails to keep coverage.

Stanford's rules

Stanford's Bechtel International Center explains how this works on campus on its health insurance page for scholars:

• Visiting scholars are not eligible for Stanford's insurance plans. They must buy coverage that meets the J visa rules, either at home or from a US insurer.
• Visiting student researchers are enrolled in Cardinal Care automatically. They can apply to waive it through Vaden Health Center, but any other plan must meet both Cardinal Care's waiver rules and the J rules.
• Postdocs must have a comprehensive plan that complies with the Affordable Care Act. Stanford's postdoc plan meets both that and the J requirements.

Bechtel points out that many standard policies leave out repatriation and evacuation, so scholars may need to add a rider. It also says federal rules oblige it to cancel the J-1 visa of a visitor who does not obtain and keep insurance, including coverage for J-2 dependents. Check your coverage with your Stanford host department before you arrive.

How visitor medical plans work

Travel medical plans for visitors to the United States fall into two broad groups. The difference matters more than the price.

Fixed benefit plans

Fixed plans pay set amounts per service according to a schedule of benefits. If the hospital bills more than the scheduled amount, you pay the difference. Insubuy, a licensed broker, explains in its guide to the risks of fixed coverage that a $50,000 fixed plan in its example pays about $330 for an emergency room visit. These plans cost less, which is why they appeal, but the gap between the scheduled amount and a real US bill can be large.

Comprehensive plans

Comprehensive plans pay a share of eligible costs as a whole after the deductible, rather than a fixed amount per procedure. A common structure pays 80 percent of covered costs up to a set amount and then 100 percent up to the policy maximum. The premium is higher, but your share of a large bill is more predictable.

Terms to understand

• Policy maximum: the most the plan pays in total. J-1 rules require at least $100,000 per accident or illness.
• Deductible: what you pay before the plan pays anything. A higher deductible lowers the premium.
• Coinsurance: your percentage share of costs after the deductible.
• Pre-existing conditions: health problems you had before the policy started. Read exactly how the plan defines and limits them.
• Acute onset of a pre-existing condition: VisitorsCoverage describes this as a sudden and unexpected recurrence of a pre-existing condition that needs immediate care. Plans that include it set limits, which can depend on your age. One plan VisitorsCoverage describes caps it at $30,000 for ages 70 to 79.

Questions to ask before you buy

Parents visiting students, grandparents staying for a few months and conference travelers all have different needs. Age, health history and length of stay drive both the price and the right type of plan. Before you pay, find answers to these questions in the policy wording, not only the summary:

1. Is the plan fixed benefit or comprehensive?
2. What is the policy maximum and the deductible? Does the deductible apply per trip or per illness?
3. How are pre-existing conditions defined? Is acute onset included and what is its limit at your age?
4. Are medical evacuation and repatriation of remains included and for how much?
5. Can the hospital bill the insurer directly, or will you pay first and claim later?
6. When does coverage start? Make sure it begins on the day you leave home, not the day after.
7. Are sports, hiking or other activities you plan excluded?
8. Who handles claims and how do you reach them at night?

Comparison marketplaces let you see many plans side by side. VisitorsCoverage is a US-based company whose agents are licensed in the United States. You can compare visitor medical plans on VisitorsCoverage. Insubuy describes itself as a licensed broker and notes that it does not process claims, which are handled by the insurer or its claims administrator. You can also browse visitor plans on Insubuy. Either way, the insurer named on the policy is the one that pays, so check who it is.

Practical tips for your trip

• Carry the card. Keep the insurance ID card or policy PDF on your phone and on paper, with the assistance phone number.
• Keep receipts. Ask for itemized bills and keep every receipt and medical report for a claim.
• Bring medicines. Pack enough prescription medicine for the whole trip in original containers. A refill in the US may need a US prescription.
• Stay reachable. A working phone matters if you need help. See our guide to eSIMs and phone service.
• Plan for older travelers. Our page on visiting with older travelers covers pacing, accessibility and where to rest.

If you are moving to Palo Alto rather than visiting, your options are different. Our guide to health insurance in Palo Alto covers Covered California and employer plans. Before buying any policy, compare visitor plans or talk to a licensed agent and read the full wording.

Frequently asked questions