USCIS Rewrites the Rules on Form I-693 Validity

USCIS has issued a series of policy changes over the past two years that together reshape the I-693 immigration medical exam process, from how long the completed form stays valid to what applicants must submit and when.

The most significant reversal concerns validity. USCIS previously stated, in an April 2024 update, that a Form I-693 signed by a civil surgeon on or after November 1, 2023 would not expire and could be used for any future immigration benefit application. Effective June 11, 2025, USCIS revised that guidance: a Form I-693 is now generally valid only for the specific application — typically Form I-485 — it was originally submitted with. If that application is denied or withdrawn, the medical exam cannot be reused. Forms signed before November 1, 2023 remain subject to the older two-year validity rule.

A related rule change removed the requirement that civil surgeons sign Form I-693 no more than 60 days before an applicant files for the underlying benefit. With that 60-day rule gone, USCIS will accept a properly completed exam for up to two years after the civil surgeon’s signature date. Separately, since December 2, 2024, applicants must generally submit Form I-693 at the same time as Form I-485; filing the I-485 without it can result in rejection.

Public charge policy has also moved. Effective January 22, 2025, USCIS stopped requiring documentation of COVID-19 vaccination on Form I-693, and applicants will no longer face denials, Requests for Evidence, or Notices of Intent to Deny over COVID-19 vaccination status. USCIS has also clarified that receiving COVID-19-related benefits — vaccines, food assistance, housing support — does not count against an applicant in a public charge determination, which otherwise weighs factors such as age, health, family status, assets, and education. More broadly, the Department of Homeland Security has issued a final rule rescinding the 2022 public charge regulation, effective September 18, 2026, which will let USCIS officers weigh all relevant facts on a case-by-case basis for each applicant.

The form itself has been revised as well. USCIS announced a new edition of Form I-693, dated January 20, 2025, on June 2, 2025. Both the March 2023 and January 2025 editions were accepted during a transition window, but starting July 3, 2025, USCIS accepts only the newer edition — and the edition date must match the date the civil surgeon signs it, so an outdated form can invalidate an otherwise complete exam.

On cost, one thing has not changed: USCIS charges no filing fee for Form I-693 itself. The expense applicants see comes entirely from the civil surgeon, whose fees typically range from $100 to $500 for the exam, with additional charges for any vaccinations or follow-up testing. Because the exam is treated as an administrative immigration requirement rather than medical care, insurance generally does not cover it.

USCIS revised its Form I-693 validity guidance effective June 11, 2025, tying the form to the single application it was filed with instead of allowing indefinite reuse.

Taken together, these changes put more weight on timing and paperwork accuracy than in past years — a form signed too early, filed separately from the I-485, or printed on an outdated edition can all derail an otherwise straightforward case.