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The short answer
For F-1 students, health insurance rules are set mainly by the university, not by one federal law. Many schools automatically enrol international students in a school plan and bill it with fees, and allow a waiver only for plans that meet their own standards. Oakland University, for example, requires F-1 and J-1 students to buy its plan at $2,382 for 2026-27, with waivers only for listed government-sponsored plans or a US employer plan.
Nigerian students budgeting for a US degree usually focus on tuition, rent and the SEVIS fee. Health insurance is the line that surprises them: it can run to thousands of dollars a year, it is often charged automatically, and the cheaper outside plan a friend recommends may not be accepted.
Who sets the rules
For F-1 students the insurance requirement usually comes from the university. Each school decides whether insurance is compulsory, which plan it offers and what a waiver plan must cover. Your I-20 cost estimate typically includes insurance, and the consular officer will look at whether your funds cover the first year's expenses: State Department guidance (9 FAM 402.5-5(G)) says F-1 applicants need readily available funds for all first-year expenses.
One example: Oakland University, 2026-27
To show how a school's rules look in practice, here is what Oakland University's international office publishes for 2026-27:
| Point | Oakland University ISSO, 2026-27 |
|---|---|
| Who must buy | F-1 and J-1 students |
| Plan | UnitedHealthcare StudentResources plan |
| Annual cost | $2,382 |
| Winter-only enrolment | 15 December 2026 to 20 January 2027; auto-enrolment at $1,547 |
| Waivers | Only listed US-based government scholarship plans, or a US employer plan (plus $120 for evacuation and repatriation cover) |
| On-campus care | Graham Health Center: no deductible, covered at 100% |
| Elsewhere | $500 deductible |
Your school's figures will be different. The point is the structure: a compulsory school plan, a narrow waiver route, and better terms at the campus health centre.
What a student plan usually covers
- Doctor visits, specialist care and hospital stays, after deductibles and co-pays.
- Prescriptions, often with a list of covered drugs.
- Mental health care, increasingly emphasised by universities.
- Emergency care, including outside your campus area.
- Medical evacuation and repatriation, which universities often require for international students.
Read the plan summary for what is excluded. Common gaps include routine dental and vision care, pre-existing condition limits on some plans, and care received while visiting Nigeria. For J-2 dependants, Oakland lists minimums of $100,000 per accident or illness, $25,000 repatriation and $50,000 evacuation, with a deductible no higher than $500, which is a useful benchmark when you compare plans.
Waivers and outside plans
Cheaper international student plans are widely advertised. Before you buy one, check your school's waiver criteria line by line: many schools accept only specific plan types, as Oakland does. If your waiver is refused after the deadline, you may be charged for the school plan anyway. F-1 students are lawfully present and can buy Marketplace plans on HealthCare.gov, but from 1 January 2027 savings are limited to green card holders and a few other groups, so an F-1 student would pay the full premium.
Using the plan well
Having insurance and using it well are different things. Register with the campus health centre early, because on many plans, as at Oakland, care there costs less than elsewhere. Carry your insurance card. For non-urgent problems, use the health centre or an urgent care clinic in the plan's network rather than a hospital emergency department, which costs far more. Before any planned treatment, ask whether the provider is in network and what you will pay. Keep receipts for prescriptions, since some plans reimburse later. If you get a bill you do not understand, take it to the international office or the plan's student helpline before paying, as billing errors are common.
If you have a medical condition from home, such as asthma or sickle cell, bring a letter from your doctor in Nigeria describing it and your current medication, and check how the plan treats ongoing care and prescriptions before you arrive. Some medicines common in Nigeria are prescription-only in the US, so you may need a US prescriber.
Worked example: budgeting the first year
Example only. Tolu starts a master's at a school with a compulsory plan of $2,400 a year, billed $1,200 per semester. Her parents in Lagos pay her fees.
- She includes $2,400 in the first-year budget shown to the consular officer.
- She notes the waiver deadline in her calendar, then decides the school plan is simpler than meeting the waiver rules.
- She registers with the campus health centre, where care has no deductible.
- Her parents plan two naira transfers timed to each semester's bill.
What to check first
- Is insurance compulsory at your school, and is it billed automatically?
- What is the waiver deadline and what must a waiver plan include?
- What are the deductible and co-pays on and off campus?
- Does the plan include evacuation and repatriation?
- Are your dependants covered, and at what cost?
Where Pryme fits
When parents in Nigeria pay a US school bill, the exchange is the expensive part. A Pryme account holds NGN and USD, and Swap shows the rate and fee before you approve. See also money and the F-1 visa and health insurance for new immigrants.
Questions people ask
Is health insurance mandatory for F-1 students?
Usually by university rule rather than federal law. Many schools require it and enrol international students automatically. Check your school's international office page.
Can I waive my university health insurance?
Only if your school allows it and your plan meets its criteria. Some schools, such as Oakland University, accept only specific plan types.
How much is student health insurance in the US?
It varies by school. Oakland University charges $2,382 for 2026-27, for example. Use your school's figure in your budget.
Can F-1 students use HealthCare.gov?
F-1 students are lawfully present and can buy Marketplace plans, but from 1 January 2027 they will not qualify for savings.
Sources
- Oakland University ISSO: Health insurance, 2026-27 (undated) · accessed Oct 2026
- US Department of State: 9 FAM 402.5, Students and exchange visitors (rev. 29 Apr 2025) · accessed Oct 2026
- HealthCare.gov: Coverage for lawfully present immigrants (undated) · accessed Oct 2026
- HealthCare.gov: Who can buy a Marketplace plan (undated) · accessed Oct 2026
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