What is the immigration medical exam and what happens at it?

Almost everyone applying for a green card goes through this — either as part of adjustment of status (Form I-485) inside the U.S., or before a visa interview abroad. The exam checks for specific health-related grounds that could affect your case: certain communicable diseases, missing required vaccinations, and a few other conditions defined by law.

Who can do it matters. Your regular doctor can't sign this off. Inside the U.S., it has to be a USCIS-designated civil surgeon. Abroad, it has to be an embassy-approved panel physician. Using the wrong kind of doctor means redoing the whole exam.

What it involves: a physical exam, a review of your vaccination records (and catching up on any required ones you're missing), tuberculosis screening, and sometimes additional testing depending on your history.

The sealed envelope matters. For adjustment of status, the civil surgeon hands you the completed form in a sealed envelope. Don't open it unless you're filing online (where you're specifically instructed to scan and upload it) — a tampered or opened envelope submitted by mail can cause real problems.

On how long it stays valid: honestly, this is worth verifying directly at [uscis.gov/i-693](https://www.uscis.gov/i-693) before you rely on any specific number — the validity and reusability rules for this exam have changed more than once recently, including a shift toward each exam being tied to one specific application rather than being reusable across multiple filings. Don't assume an older exam is still good without checking.

Practical tip: budget for the cost yourself — it typically runs a few hundred dollars and generally isn't covered by insurance, since it's not really a health checkup, it's a legal requirement.