L-1 Visa Health Insurance: Home Plan or US Plan?

L-1 visa health insurance comes from one of two places: an international plan arranged by your home country employer, or the US entity's group health plan once you are on its payroll. Which one applies depends on how your transfer is structured, and neither is certain to be active on the day you land. Ask which plan you are on and when it starts, then use short term cover for any gap.

Key facts at a glance

• No US immigration rule requires L-1 or L-2 visa holders to carry health insurance. Cover is a matter of employer policy and your own planning.
• If you join a US group plan, federal rules cap any waiting period at 90 days (45 CFR 147.116).
• USCIS treats spouses in L-2S status as authorized to work incident to status, so an L-2 spouse may be able to get cover through a US job of their own.
• According to USCIS, total stay is limited to seven years for L-1A managers and executives and five years for L-1B specialized knowledge workers.
• HealthCare.gov counts valid nonimmigrant visa holders as lawfully present, so L-1 families can buy Marketplace plans. Under Public Law 119-21, premium tax credits for this group end on January 1, 2027.
• USCIS allows L-1 workers and dependents a grace period of up to 60 days after employment ends, or until the I-94 expires if sooner.

Will your home country employer's plan cover you in the United States?

Sometimes, and you should not assume it. There are three common setups for intracompany transferees.

• Seconded and kept on home payroll. Your employer may place you on an international private medical plan built for expatriates, with the United States included in the area of cover.
• Localized to US payroll. You become an employee of the US entity and join its group health plan like any local hire.
• Short assignment under a business travel policy. Some companies rely on a corporate travel policy for the first weeks. These often cap trip length and focus on emergencies.

A domestic plan or national health system from your home country is a different matter. Public systems generally do not pay for treatment in the United States, and domestic private plans often limit overseas cover to short trips and emergencies. Even where a home plan does extend to the US, check whether the United States is inside the area of cover, whether the plan pays US providers directly or reimburses you later, and whether the limits were set with US prices in mind. Our medical cost estimator shows why that last point matters.

When does the US employer plan start for an L-1 transferee?

If you are moving to US payroll, the US plan's own document sets the start date. It may be your first day, the first of the following month, or the end of a waiting period that federal rules cap at 90 days. Transfers add a wrinkle that local hires do not face: your payroll move, your visa start date and your physical arrival can fall on three different days.

Ask your global mobility or HR contact to confirm, in writing, the last day of home country cover and the first day of US cover. Where one ends before the other begins, you have a gap. Where the home plan runs on for a month, you may have an overlap you can use for your family's arrival. Enrollment in the US plan usually has to be completed within a fixed window after you become eligible, so do it in your first week.

How are L-2 spouses and children covered?

L-2 dependents are normally eligible for the same plan as the L-1 employee, whether that is the expatriate plan or the US group plan. Confirm that each family member is named on the plan, since some international policies need dependents added individually and some charge per person.

Families often travel in stages, with the employee arriving first to find housing. If your spouse and children land weeks later, ask how the plan treats a later arrival. The Department of Labor explains that US group plans must allow special enrollment for at least 30 days after events such as marriage, birth, adoption, or loss of other coverage. A spouse who loses home country cover on moving may qualify under that last heading, but the plan administrator decides, so ask before they fly.

Because USCIS treats L-2S spouses as work authorized incident to status, a spouse who takes a US job may be offered a second group plan. Compare the family premium, deductible and network on both plans before deciding who carries the children.

What should you do about the gap on arrival?

If there are uninsured days between landing and your plan's start date, a short term travel medical plan for people newly arriving in the United States can cover them. Plans in the new immigrant insurance comparison run from 5 days to as long as 364 or 365 days according to the carriers' plan descriptions, and several can be purchased after you have already arrived.

Know the limits before you rely on one. These plans pay for new illness and injury after the deductible. They exclude pre-existing conditions apart from a limited acute onset benefit on some plans, and they do not cover routine care, maternity or ongoing prescriptions. They also do not count as minimum essential coverage. For how they compare with full domestic plans, read ACA Marketplace versus short term plans for immigrants.

Availability varies by home country, which matters for transferees. In the current catalog, the Trawick International plans in this category are not available to residents of many European countries, including Germany, France, Italy, Spain and the Netherlands, or of Australia. Residents of those countries can still see the IMG Patriot plans, which are open to most nationalities but closed to residents of a short list of countries including Nigeria and Ghana, and which cannot be purchased from New York. If your options are narrow, the quote page will show that plainly.

What happens when the assignment ends or you lose the job?

If the assignment ends as planned, the question is how you regain cover at home. Some national systems and private insurers apply waiting periods or residence tests after time abroad, so ask before you leave rather than on your return. Keep your US cover active until you have actually departed.

If the job ends early, USCIS provides a grace period of up to 60 days for L-1 workers and their dependents. For a US group plan, the Department of Labor notes that COBRA generally applies where the employer has 20 or more employees and that the premium can be up to 102 percent of plan cost. Losing job based cover also opens a 60 day special enrollment period on the Marketplace, at full price from 2027 for L-1 households. Bridge plans for new arrivals are generally not suited to someone who has been resident in the US for years.

This article is general information, not legal, tax or immigration advice. Confirm plan terms with your employer and immigration questions with a qualified attorney.

Questions to settle with HR before you fly

Download our free L-1 Transfer Coverage Checklist below. It lists what to confirm about your home employer's plan, the US plan start date, your L-2 dependents and arrival gap cover, with the exact questions to send to HR or global mobility.

How to get covered

Get two dates from your employer: the last day your current cover applies in the United States and the first day of the plan you will use there. If days are missing in between, for you or for family arriving later, compare plans on Ombrela's new immigrant insurance page. Premiums depend on age, length of cover, policy maximum and deductible, so check live quotes. If you are unsure which category fits, the plan finder can narrow it down.

Frequently Asked Questions

Is health insurance required for an L-1 visa?

No. US immigration rules do not make health insurance a condition of L-1 or L-2 status, and consular officers do not ask for an insurance certificate. Your employer's assignment policy may require it, and a few states have their own coverage mandates for residents. Given US medical prices, the practical position is that every member of the family should be covered from the day of arrival.

Can L-1 visa holders buy Marketplace insurance?

Yes. HealthCare.gov lists valid nonimmigrant visa holders as lawfully present, which makes them eligible to enroll, and moving to the United States from abroad opens a special enrollment period. Under Public Law 119-21, premium tax credits for most lawfully present nonimmigrants end on January 1, 2027, so L-1 families should budget for the full premium on any 2027 plan.

Does an international expatriate plan replace the US group plan?

It can, if your employer has set up the assignment that way and the plan includes the United States in its area of cover. Check direct billing arrangements with US hospitals, limits for maternity and chronic conditions, and whether dependents are included. If you are moved to US payroll, you will normally be offered the US group plan and the expatriate plan will end.

Can I use travel medical insurance for my whole L-1 assignment?

It is not designed for that. Travel medical plans are short term cover for new illness and injury, with exclusions for pre-existing conditions, routine care and maternity, and a maximum period of roughly a year on most plans. They work well for the days or weeks before a group or expatriate plan starts, and poorly as the only cover for a multi year stay.

Confirm your plan dates with HR this week, then compare arrival gap plans on Ombrela so your family is covered from the first day in the United States.