Temporary medical visas (a form of B-2, tourism, visa status) are obtained by individuals with unique medical circumstances from abroad seeking healthcare in the United States (U.S.). These individuals must meet strict criteria, including proof that care is unavailable in their country, and financial ability to support medical expenses and living costs in the U.S., among other requirements (Visitor Visa, 2024). 

Patients seeking genetic services obtain temporary medical visa sponsorship for various circumstances, including seeking a diagnosis for common or rare genetic disease, expert specialists for personalized care and gene therapies only approved in the U.S. Resources to best guide patient care in these unique social circumstances remain scarce. For this reason, we hope to provide a brief overview of some ways genetic counselors can support patients on temporary medical visa sponsorship seeking our services in the U.S. 

Temporary Medical Visa Sponsorship Challenges 

Obtaining and retaining a temporary medical visa comes with its own set of challenges. These may include gaining knowledge of the application procedures and paperwork requirements from a reliable source. This process can be facilitated by the internal departments within medical institutions (U.S. Department of Health and Human Services), but it is time-consuming, complex and expensive, typically limiting its reach to people with very high financial means.

In some cases, caretakers may not be granted B-2 medical visas, leaving patients to navigate the complexities of the American healthcare system, housing and visa deadlines on their own. This increases the patients’ responsibilities requiring them to manage their own appointments, payments and keep records of treatments independently. The financial, physical and mental burden can be significant, and patients may need to rely on institutional support.

Provider Support and Considerations 

Despite the described challenges, genetic counselors can support this patient population by providing letters of support for medical visa applications or relief from deportation, connecting them with institutional resources, and providing culturally competent care. 

Medical visa support letters are typically written by a healthcare professional detailing an individual’s medical condition or diagnosis, treatment and management plan, an explanation for why treatment in the U.S. is preferable, and a statement encompassing the willingness of the healthcare professional to treat the patient (U.S. Embassy & Consulates in Morocco). Please see an example of a letter template adapted from Family Voices and Global Conference Alliance Inc., including examples of evidence to be provided.

Medical letters of support for visa purposes should include information regarding caregiver support, and the need for a patient to receive continuous follow up, treatment or medication (Martinez, 2022). The letter should also explain why an individual may be unable to live in certain conditions without medical attention for specified durations of time (Global Conference Alliance Inc., 2024).

Genetic counselors can assist with B-2 visas by also providing a letter of support for a patient’s caretaker to help other relatives abroad come to the U.S. or provide protections for caretakers in the U.S. facing risks of deportation. Providing evidence to support caretakers’ entry or stay in the U.S., thereby enabling their presence, can improve treatment adherence and help reduce stressors that would negatively impact care management and a patient's medical outcomes (Scott D. Pollock & Associates, P.C., 2024). These stressors may include financial hardships, familial separation and lack of understanding the extent of the need for care. The letter should outline the hardships that a patient faces if their caretaker’s visa application is denied (Michigan Immigrant Rights Center). 

Medical institutions often offer services for patients seeking immigration-related support. Connecting patients to international care coordinating sites at your institution, case management teams, and social workers can help organize care options by assisting with logistics such immigration, housing, transportation and meal support. Outside of medical institutions, national organizations like The Migrant Clinicians Network, can help connect migrants, immigrants and asylum seekers with additional sources of support to access care.

Providing culturally competent care for patients on a B-2 visa is essential especially given that they may have limited familial support in the U.S. Genetic counselors should assess the cultural and familial expectations, as family members may play a critical role in decision-making. We can connect patients with local immigrant communities or support groups for additional support. Furthermore, the patient’s follow-up plan should detail management after visa expiration. If necessary, have the patient contact legal services to explore options for visa extensions if medically necessary (e.g., Form I-539, an application to extend or change nonimmigrant status).  

Please visit our website for additional resources on provider support and to view a case example highlighting the ways that genetic counselors help coordinate care for patients with a B-2 medical visa. 

Key Takeaways

• Temporary medical visa sponsorship for healthcare services in the United States is offered on a case-by-case basis. 
• Patients and families on temporary medical visa sponsorships face many challenges in obtaining and retaining their sponsorships. 
• Genetic counselors can advocate for patients and their families with temporary medical visa sponsorships through medical support letters, and the sharing of institutional support resources such as translation, legal and support services. 
• Genetic counselors should provide culturally sensitive counseling services for patients and their families. 

Acknowledgements

We would like to express our gratitude to reviewers Daniela Diaz Caro, MS, CGC, Stefania Alastre, MSPH, LCGC, and Alicia Lewis, BA for their insightful suggestions and ideas that significantly improved the quality of our article through the revisions we made. 

References

Family Voices. (2023, February 2). Immigration: Long checklist/fill in the blank template letter of support request. Family Voices. https://familyvoices.org/resource/long-checklist-fill-in-the-blank-template-letter/ 

Global Conference Alliance Inc. (2024, April 29). How do I write a visa support letter?. Global Conference Alliance Inc. https://globalconference.ca/how-do-i-write-a-visa-support-letter/ 

Scott D. Pollock & Associates, P.C. (2024). Immigration recommendation letter: Tips + sample guide. Scott D. Pollock & Associates, P.C. https://www.lawfirm1.com/letter-of-recommendation-for-immigration/ 

Martinez, F.. (2022, December 7). Formatting for Letters provided by your Doctor or Therapist for Immigration Waiver Purposes. Fickey Martinez Law. https://www.fickeymartinezlaw.com/immigration/formatting-for-letters-provided-by-your-doctor-or-therapist-for-immigration-waiver-purposes#:~:text=The%20Doctor%27s%20Letter%20must%20generally,Signature%20may%20also%20be%20accetable

U.S. Department of Health and Human Services. (n.d.). B-2 Visa Information. National Institutes of Health. https://www.cc.nih.gov/patient-info/visa#:~:text=NIH%20research%20teams%20assist%20with,the%20projected%20length%20of%20treatment  

‌U.S. Embassy & Consulates in Morocco. (n.d.). Travel for Urgent Medical Treatment. https://ma.usembassy.gov/visas/nonimmigrant-visas/travel-urgent-medical-treatment/#:~:text=A%20letter%20from%20a%20physician%20and%2For%20medical%20facility%20in,all%20medical%2Drelated%20expenses). 

Visitor Visa. (2024). State.gov. https://travel.state.gov/content/travel/en/us-visas/tourism-visit/visitor.html

Writing a Letter of Support for Immigration Purposes [PDF]. Michigan Immigrants Right Center. https://michiganimmigrant.org/sites/default/files/Writing%20letters%20for%20immigration%20purposes.pdf

Image by Jaydeep Joshi from Pixabay

Jean Miriam Yasis, BS (she/her)

is a 2nd-year genetic counseling student at the University of CA, San Francisco. She is a current DACA recipient and she contributes towards community engagement to expand the reach of genetics for minority groups.

Stephanie Soto Mangandi, MGC (she/they)

is a bilingual genetic counselor and recent graduate of the University of Maryland, Baltimore training program. Her past experiences in community outreach initiatives and community-funded opportunities have inspired her passion for increased efforts to increase accessibility and advocacy, specifically for underserved communities in the genetic counseling field.

Betty Diaz, MS (she/her)

is a bilingual genetic counselor and a recent graduate of Sarah Lawrence College. As a current DACA recipient, Diaz is passionate about improving access to genetic counseling services for underserved communities and advocating for equitable healthcare interpretation services.

Dalia Vargas, BS (she/her)

is a prospective genetic counseling student and medical assistant at Colorado Heart and Vascular. She is a current DACA recipient interested in improving access to healthcare for underrepresented communities.