Disability Insurance for Non-US Citizens: A Guide for H1-B, J-1, and Green Card Holders

Disability insurance for non-U.S. citizens is a complex but essential step for foreign-born doctors building a future in the U.S. Nearly one in four doctors in America is foreign-born, and while some plan to return home after completing their education, many choose to stay, drawn by the high earning potential of a medical career here.

This article explores the challenges of navigating residency statuses — namely, H1-B visas, J-1 visas, and green cards — and offers guidance on purchasing long-term disability insurance.

What is long term disability insurance and why do you need it?

If you’re coming from a country with a larger social safety net, it might surprise you that the U.S. tends to be very self-reliant. Long-term disability insurance replaces your income if you’re unable to work due to illness or injury — too disabled to perform the material duties of your occupation — and the benefits often last until retirement age. 

What about Social Security Disability Insurance (SSDI), you might ask? If you even qualify for it, the numbers don’t like: in 2024, the average SSDI payout is just under $1,500 per month, with a maximum of about $3,800 — nowhere close to a livable wage and far below what many professionals need to maintain their lifestyle. 

For doctors, dentists, and other high-earners, private disability insurance helps to make sure you’re adequately taken care of if you lose the ability to earn your income for any extended period.

Disability insurance for non-U.S. citizens by visa type

H1-B, J-1, and green card holders can get disability policies from the Big 5 disability insurance companies (Guardian, MassMutual, Principal, The Standard, and Ameritas). Each visa type has specific considerations regarding disability insurance for non-U.S. citizens.

J-1 visa holders: Act early to save big

As a J-1 visa holder, you’re likely in medical schools or residency programs for medicine or dental practice. If you’re considering permanent residency in the U.S., you must apply for disability insurance before finishing your residency. 

Here’s why:

• Residency discounts: You could get a 20% residency discount, which can save you tens of thousands of dollars in additional premiums. 
• Guaranteed standard issue (GSI) policies: These are sometimes the only way to qualify for any coverage at all if you have significant medical conditions. GSI policies are typically more expensive and only available at certain medical residencies.

Waiting until you’ve been an attending physician for a year before looking into disability insurance means neither the residency discount nor the GSI option would still be available for you.

Even if you’re undecided about whether you want to stay in the U.S. after finishing school, I recommend getting a disability policy. Not having one could put you in serious jeopardy should you choose to stay. At best, you’ll end up paying more for your policy than if you bought it earlier. At worst, you could develop medical conditions that make you uninsurable, and there is no GSI program available at your institution. 

H1-B visa holders: Prepare for the future

This is the visa most people are probably familiar with. The H1-B visa is often the next step after a J-1 — it’s a natural progression once you finish residency or fellowship and become an attending physician. 

However, it has some unique problems when it comes to disability insurance for non-U.S. citizens. Since your visa depends on employment, a long-term disability might force you to return to your home country. Unless that home country is Canada, most of the traditional disability insurers won’t pay benefits for more than a year if you’re living outside of the United States.

Still, that’s not a reason to skip getting a disability policy. Many H1-B holders are working towards permanent residency. If that’s your goal, you want to make sure you’re set up for success in the U.S. long term, no matter what happens. Early coverage ensures you’re protected during the transition. Even if you only collect a year’s worth of benefits, the policy could pay for itself in such situations.

I also want to stress to workers who are newer to the U.S. that SSDI is limited and might not even cover rent in many metro areas. It also doesn’t provide the occupation-specific coverage a surgeon or specialist needs. 

Green card holders: More flexibility and security

If this is you, you’re in the green (sorry, the pun was right there). Green card holders have more stable options compared to H1-B and J-1 visa holders. If you’re a green card holder and become disabled, you can stay in the U.S. and collect disability benefits until retirement age if you’re never able to return to your original line of work. 

And if you get homesick and want to travel back home? The good news is you can do that. As long as you spend a certain amount of time living in the U.S. every year, disability insurance companies will still pay you, even if you want to spend a few months in your original country.

The only difference I know between green card holders and U.S. citizens for disability insurance is that you must maintain your green card. A criminal record could jeopardize your green card status, so maintaining your legal standing is crucial for uninterrupted coverage.

Explore disability insurance options for non-U.S. citizens

No matter your visa type, investing in long-term disability insurance ensures you’re prepared for life’s uncertainties. It’s more than a policy — it’s peace of mind. Start early, weigh your options carefully, and fill out the form below to explore coverage that works best for your situation.