Start Here – Steps to a Medical Clearance

Let’s get started on acquiring or renewing your Department of State Medical Clearance.

To be eligible for MED Medical Privileges, including Health Unit access and assistance with a medical evacuation, any individual abroad for more than 30 consecutive days must meet the following criteria per 16 FAM 120.

• Have a valid medical clearance
• Sponsoring agency must subscribe to the medical portion of the post ICASS package on behalf of the individual
• Sponsoring agency must fund a medical evacuation or the individual have personal medical evacuation insurance

First-Time, Pre-Employment, Pre-Assignment Medical Clearance under Sponsoring Agency

This section applies to any employee, contractor, or Eligible Family Member (EFM) who will be assigned abroad for 30 or more consecutive days and has never had a Department of State medical clearance under the sponsoring agency.

First-Time, Pre-Employment, Pre-Assignment Medical Clearance under Sponsoring Agency

This section applies to any employee, contractor, or Eligible Family Member (EFM) who will be assigned abroad for 30 or more consecutive days and has never had a Department of State medical clearance under the sponsoring agency.

1. Complete the following physical exam forms based on age:
   DS-1843: Medical History and Examination for Individuals Age 12 and Older 
   DS-1622: Medical History and Examination for Children Age 11 and Younger 
2. If you or your family members have ongoing medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
3. Contractors must show evidence of local ICASS participation on their behalf at their post of assignment and ability to fund a medical evacuation. For detailed information see Contractors.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
   A medical clearance physical exam should be completed by a licensed medical provider.
5. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
6. For more detailed information about the pre-employment medical clearance process go to Pre-Employment Guidance.
7. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
8. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“
9. Specific Reminders and Caveats:

• Moving Agencies. Any individual with a current medical clearance who is moving to a different sponsoring Government agency is treated as if he or she is obtaining a first-time medical clearance
• Foreign Service Candidates. All potential Foreign Service Officers (candidates), Fellows, and some LNAs must be issued a Worldwide Available (Class 1) medical clearance. Eligible family members of a Foreign Service Officer Candidate may have a Post Specific (Class 2) clearance. Newly hired Civil Service and other Limited
• Non-Career Appointment may have a Post Specific (Class 2) Clearance. LNAs should discuss with their assignment’s officers
• TDY Orders. An individual on TDY orders for 30 or more consecutive days abroad and who has never had a medical clearance is treated as if obtaining a first-time medical clearance
• Active-duty military members and their EFMs are medically cleared by the military and do not require a MED Medical Clearance
• Department of Defense Civil Service employees, contractors and their EFMs must have a Department of State Medical Clearance

In-Service: Permanent Change of Station (PCS), Home Leave, Extending, End of Tour, or Bidding (Big Five)

This section applies to employees, contractors, or their eligible family members (spouses and dependents under the age of 21) who are in-service. You may do an In-Service Medical Clearance if you already have a medical clearance and undergoing or eligible for; a Permanent Change of Station (PCS) to an overseas post, Rover position, CONUS based but will perform TDY travel of 30 or more consecutive days, home leave, extension, or bidding.

1. Complete a DS-3057: Medical Clearance Update (MCU) form .
2. If you or your family members have on-going medical, mental health, or educational needs, MED Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
3. Contractors must show evidence of local ICASS participation on their behalf at their post of assignment and ability to fund a medical evacuation. For detailed information see Contractors.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. An MCU can be submitted to your Health Unit (preferred) or directly submitted to MEDMR@state.gov if you are in the USA or at a post without a Health Unit.
6. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov. 
7. For more detailed information about the in-service medical clearance process go to In-Service Medical Clearance Guidance.
8. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
9. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

ESCAPE Post – Iraq, Afghanistan, Libya, Somalia, Yemen, Syria, and Peshawar

This section applies to employees, contractors or an eligible family member who are bidding on, assigned to, undergoing a permanent change of station to, extending in, roving to, or TDY for 30 or more consecutive days to an ESCAPE post. Current ESCAPE posts are Iraq, Afghanistan, Libya, Somalia, Yemen, Syria, and Peshawar.

1. For…
   1. All individuals deploying to an ESCAPE post as a permanent change of station or as a TDY for 30 or more consecutive days must complete the following two clearance forms:
      1. DS 1843: Medical History and Examination for Individuals Age 12 and Older 
      2. DS-6570: Pre-Deployment Physical Acknowledgement Form co-signed by your medical provider 
   2. Individuals extending their assignment/deployment at their current or at another ESCAPE, may undergo a shorter process. However, this shorter process requires completing these two forms, but only if completed at an ESCAPE post Health Unit. Individuals being seen at a private provider or at a non-ESCAPE post Health Unit must complete the process outlined in 1a above.
      1. DS-3057: Medical Clearance Update
      2. DS-6570: Pre-Deployment Physical Acknowledgement Form co-signed by your medical provider 
2. A medical clearance to an ESCAPE post expires at:
   1. 1 year after arrival at post for all individuals deploying to an ESCAPE post.
   2. 1 year after issuance of a medical clearance of all individuals who extend at an ESCAPE post.
   3. 2 years after an issuance of a medical clearance to all individuals who perform TDY travel of 30 or more consecutive days to an ESCAPE post.

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This section is for DOD Civilian and/or Institutional (third party, private company) Contractors ONLY. This section DOES NOT apply to direct hire employees, LES, or Personal Service Contractors contracted directly by a sponsoring agency that pays into post ICASS for medical services.

1. DOD Civilian and/or Institutional (third party, private company) Contractors DO NOT have access to the Embassy Health Units in Baghdad or Kabul. Instead, Comprehensive Medical Services (CHS)  provides medical care to Institutional and DOD contractors at these two posts. Therefore, contractors posted in Baghdad and Kabul SHOULD NOT submit medical clearance information to MED. DOD Civilian and/or Institutional Contractors should contact their Contacting Office Representative (COR) if they have questions.
2. DOD Civilian and/or Institutional (third party, private company) Contractors do have Embassy or Consulate Health Unit access in Erbil, Libya, Peshawar, Somalia, Syria, and Yemen and must submit medical clearance information. DOD Civilian and/or Institutional contractors at these posts are required to complete one of the two ICASS forms below to show proof of their sponsoring agency contribution to the medical portion of the post ICASS package on their behalf. DOD Civilian and/or Institutional Contractors should have their company’s Contracting Office Representative (COR) to assist in completing these forms.
   • MED 3308: DOD ICASS Verification Form.
   • MED 3308.5: Institutional Contractor ICASS Verification Form

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3. If you or your family member have/has on-going medical or mental health needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
6. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Contractors

This section applies to contractors and their Eligible Family Members (EFMs) who will be assigned abroad for 30 or more consecutive days.

1. A contractor and their EFMs should complete the following:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older  if this is a first-time medical clearance for the sponsoring agency
   2. DS-1622: Medical History and Examination for Children Age 11 and Younger  if this is a first-time medical clearance for the sponsoring agency
   3. DS-3057: Medical Clearance Update (MCU) form if this is an in-service under your current sponsoring agency
2. If you or your family members have ongoing medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.This section is for DOD Civilian and/or Institutional (third party, private company) Contractors only. This section does not apply to direct hire employees, LES, or Personal Service Contractors contracted directly by a sponsoring agency.
   1. MED 3308: DOD ICASS Verification Form.
   2. MED 3308.5: Institutional Contractor ICASS Verification Form
3. Contractors are required to demonstrate their own private medical evacuation insurance as well as health insurance if their sponsoring agency or institutional contractor does not fund medical evacuations.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. A medical clearance physical exam should be completed by a licensed medical provider.
6. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
7. For more detailed information about the pre-employment medical clearance process go to Pre-Employment Guidance.
8. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
9. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Washington DC or USA Assigned Employees or Contractors

This section applies to all employees and their Eligible Family Members who are assigned to Washington DC or another location in the USA.

No medical clearance is required to be posted in the USA. Everyone is “medically cleared” to be in the USA.

This section does not include employees who are Rovers or will be doing overseas TDY travel of thirty or more consecutive days. These employees or contractors require a medical clearance.

EFMs of anyone assigned to Washington DC do not have MED program benefits abroad including on short-term TDY travel.

All persons must update their clearance before returning overseas.

Rover: Washington DC or USA Based

This section applies to employees who are assigned to Washington DC or the USA, but as a rover. EFMs of anyone assigned to Washington DC do not have MED program benefits abroad including on short term TDY travel.

1. Complete a DS-3057: Medical Clearance Update (MCU)  form.
2. If a Rover has an on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance. IMPORTANT: You must obtain a Post Approval to any post you will travel to for 30 or more consecutive days.
3. Send your completed forms and medical reports:
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. For more detailed information about the rover clearance process go to In-Service Medical Clearance Guidance.
6. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

TDY: Washington DC or USA Based

This section applies to employees or Contractors who are assigned to Washington DC or the USA but will perform TDY travel of 30 or more days of consecutive days abroad. Individuals whose travel abroad for less than 30 consecutive days do not require a medical clearance. EFMs of anyone assigned to Washington DC do not have MED program benefits abroad including short term TDY travel.

1. The TDY employee or contractor should complete the following:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older if this is a first-time medical clearance for the sponsoring agency
   2. DS-3057: Medical Clearance Update (MCU)  form if this is an in-service
2. If a TDY employee or contractor has an on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance. IMPORTANT: You must obtain a Post Approval to any post you will travel to for 30 or more consecutive days.
3. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
4. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
5. For more detailed information about the TDY clearance process go to In-Service Medical Clearance Guidance.
6. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Language Training

This section applies to employees or their eligible family members (spouses and dependents under the age of 21) who require language training, then have a linked assignment to an overseas post. The employee must be medically cleared for your future overseas language post before starting language training.

1. Complete a DS-3057: Medical Clearance Update (MCU)  form.
2. If you or your family members have/has on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
3. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
4. An MCU can be submitted to your Health Unit (preferred) or directly submitted to MEDMR@state.gov if you are in the USA or at a post without a Health Unit.
5. For more detailed information go to In-Service Medical Clearance Guidance.
6. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Linked Assignment

This section applies to direct hire, career employees of one of the Five Foreign Service Agencies or their eligible family members (spouses and dependents under the age of 21) who have a linked assignment to an overseas post. You must have been medically cleared for both the post you are bidding on now and your linked assignment post.

1. Complete a DS-3057: Medical Clearance Update (MCU) form.
2. If you or your family members have/has on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
3. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
4. An MCU can be submitted to your Health Unit (preferred) or directly submitted to MEDMR@state.gov if you are in the USA or at a post without a Health Unit.
5. For more detailed information about the in-service medical clearance process go to In-Service Medical Clearance Guidance.
6. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Interns

This section applies to interns for one of the Foreign Service Agencies.

Health Units may grant access to Health Units to short term and seasonal interns without a medical clearance on a limited basis.

To determine if an individual intern is eligible to access a post’s Health Unit, Health Units should freely provide the more detailed information to the intern and to management found in:

– MED ISO Document #3003: Health Unit Access and Provision of Limited Medical Services to Unpaid Short-term or Seasonal Interns (Available on OpenNet Only)

State Department unpaid interns are required to supply their own international medical evacuation and health insurance. Interns of do not have U.S. Government funded medical evacuation nor can they be issued a DS-3067 for hospitalization.

Fellow

This section applies to the following Fellows programs candidates and their Eligible Family Members at the Department of State:

• Pickering Fellows
• Rangel Fellows
• Foreign Affairs Information Technology (FAIT) Fellows

1. Complete the following physical exam forms based on age:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older 
   2. DS-1622: Medical History and Examination for Children Age 11 and Younger 
2. All potential Foreign Service Officer Candidates, which include Fellows, must be issued a Worldwide Available (Class 1) medical clearance. Eligible family members of a Foreign Service Officer Candidate may have a Post Specific (Class 2) clearance.
3. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
4. A medical clearance physical exam should be completed by a licensed medical provider.
5. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
6. For more detailed information about the pre-employment medical clearance process go to Pre-Employment Guidance.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

New Family Member

This section applies to new eligible family members of an employee or contractor. New eligible family members include new spouses, newborns, and adoptees. Your new family member has up to 90 days to obtain a medical clearance and has access to the MED Medical Program during those 90 days.

1. Immediately notify your human resources that you have a new family member. For most direct hire Federal employees this requires filling out an OF-126 form. A medical clearance, insurance, passports, and travel orders cannot be proceeding without completing this form.
2. Complete the following physical exam forms based on age:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older 
   2. DS-1622: Medical History and Examination for Children Age 11 and Younger 
3. If a new family member has on-going medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. The medical clearance exam may be completed for you and your family members by a licensed medical provider of your choice, to include medical doctor (MD), doctor of osteopathic medicine (DO), nurse practitioner (NP), physician’s assistant (PA) or a post’s Health Unit medical provider, if resources are available.
6. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
7. For more detailed information about the pre-employment medical clearance process go to Pre-Employment Guidance.
8. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Student Age 21 or 22 on Educational Travel Orders

This section applies to students who travel to post on educational travel orders between their 21st and 23rd birthdates (age 21 or 22).

A medical clearance is not required for students between their 21st and 23rd birthdates. They have access to MED Program benefits while at post. However, students with significant medical or mental health concerns should avoid traveling to a post if the medical capabilities at post cannot meet their medical needs. Health Unit access is limited to 120 days per year. Students are no longer eligible for MED Program benefits upon their 23rd birthday.

Students below the age of 21 must have a valid medical clearance. Within 90 days of their 21st birthday, eligible EFMS are encouraged to have a Separation Exam.

Members of Households who are not on educational travel orders are not authorized to use MED Medical Services benefits after their 21st birthday unless they a disabled child with a Certificate of Incapacity.

On Medical Evacuation Travel

This section applies to individuals on medical evacuation (Medevac) travel.

An individual’s medical clearance is suspended during a Medevac. The medical evacuee’s medical clearance is considered “pending” throughout the Medevac.

At the end of a Medevac, the individual’s medical clearance status may be reinstated or changed dependent upon post’s capability to meet the medical needs of the individual.

Questions? Contact your Medevac center or MED Foreign Programs, the Medevac center in Washington DC, at 202-663-1662 or MEDForeignPrograms@state.gov

Separating (Retirement, Resignation, Divorce, Transferring to Another Government Agency, Age 21)

This section applies to those separating as a Foreign Service Officer or Eligible Family Member of one of the Five Foreign Service Agencies. Reasons for separation include retirement, resignation, divorce, changing employment to a different Government agency, or an EFM on their 21st birthday. We encourage those who are currently undergoing a separation (retirement) exam and considering REA/WAE status to check both Separation and REA/WAE in box 10 of their DS-1843 Form to prevent having to do the same exam twice.

1. Complete the following physical exam forms within 90 days of the employee’s retirement date:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older 
   2. DS-1622: Medical History and Examination for Children Age 11 and Younger 
2. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
3. Where to Perform a Separation Exam: Private Provider: Employees and EFMs are encouraged to have the separation medical exam completed by their private medical provider in the US. This is an opportunity to establish or re-establish a professional relationship with your primary care provider.  Post Health Unit: If you would like the examination at post, please contact your Foreign Service Medical Provider (RMO or MP) for guidance.
4. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
5. For more detailed information, see Separation Exam Guidance.

Reemployed Annuitant/While-Actually-Employed (REA/WAE)

This section applies to those applying for a Reemployed Annuitant (REA)/While-Actually Employed (WAE) status. We encourage those who are currently undergoing a separation (retirement) exam and considering REA/WAE status to check both Separation and REA/WAE in box 10 of their DS-1843 Form to prevent having to do the same exam twice.

1. Complete the following physical exam forms:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older 
2. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
3. We encourage all separating individuals to complete their medical exam by a personal provider at their new home to establish a medical relationship with a provider. A separation physical exam can also be completed at your post’s Health Unit.
4. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
5. For more detailed information, see Separation Guidance.
6. We strongly encourage those becoming a REA/WAE to complete the required REA/WAE medical clearance exam at the same time as their separation physical. Write “REA/WAE” next to “Separation” to the box on page 1 of the DS-1843.
7. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“

Members of Household and Adult EFMs over Age 21 (Including Adult Parents and Siblings)

Members of household and adult EFMs over age 21, even if on an employee’s travel orders, do not have access to MED benefits at post. This includes access to the Health Unit or assistance with medical evacuation. Because members of household and adult EFMs do not have access to MED Program benefits, a medical clearance is not needed.

The FAM and FAH regulations on this can be found:

1. For MOHs: 3 FAM 4180 para g: MOHs are not eligible to receive the following: (4) Access to the Health Unit (HU); however, the HU may provide a list of referrals for local providers.
2. For Adult EFMs: 15 FAM 511.3 para (2) Parents (including stepparents and legally adoptive parents) of the employee or of the spouse or of the domestic partner as defined in 3 FAM 1610, under the following conditions and when the employee provides such documentation as the Department may require (parents do not receive benefits under the Department’s Medical Program as outlined in 16 FAM 211.1).

Employees are reminded that Members of Household and adult EFMS should have international health and medical evacuation insurance to cover the costs of overseas hospitalizations, medical expenses, and an air ambulance evacuation. Medicare and Medicaid do not cover medical expenses outside of the USA.

Adult children who are beyond their 21st birthday generally do not have access to the MED medical program except in these two cases:

• Adult students between their 21st and 23rd birthdays (ages 22 and 23) who are on educational travel orders.
• Adult disabled children in capable of self-support with a Certificate of Incapacitation (COI). The disability onset must have occurred before age 21.

Certificate of Incapacitation

A Certificate of Incapacity (COI) is issued for continuation of MED Program benefits or health insurance coverage when an unmarried dependent is physically or mentally disabled and is incapable of self-support.

Dependents normally age out of the MED Medical Program on their 21st birthday (or their 23rd birthday if eligible for educational travel). An unmarried, dependent child who has a medically documented disability that occurred prior to the child’s 21st birthday and that renders him or her incapable of self-sustaining employment may qualify for a COI under 16 FAM 122.2. An adult disabled child issued a COI could have MED Medical Program Benefits while abroad including Health Unit access, medical evacuation and hospitalization. A disabled adult child with a COI would have to have a valid medical clearance for the post of assignment if they intended to live or visit abroad for 30 or more consecutive days. Approval for MED Medical Program benefits is contingent on approval and funding by the sponsoring agency. For more information contact Medical Clearances at MEDClearances@state.gov.

In addition, under the Affordable Care Act dependents age out of their parent or guardian’s Federal Employee Dental and Vision Insurance Program (FEDVIP) on their 22nd birthday and Federal Employee Health Benefits (FEHB) on their 26th birthday. An unmarried disabled dependent with a valid COI beyond these birthdates is eligible for FEDVIP or FEHB insurance benefits regardless of whether they have access to the MED Medical Program. For more information contact MED Domestic Programs.

Active-Duty Military

This section applies to DOD Active-Duty Military Personnel and their Eligible Family Members. DOD Civilians or contractors, even if retired military members, must have a medical clearance and should return to “Start Here” and click on the employee or contractor’s most appropriate employment status.

If you are DOD Active-Duty Military or an Eligible Family Member you do NOT need a Department of State Medical Clearance.

DOD Active-Duty Military Personnel or their Eligible Family Member must have a valid military medical clearance to be at post. Eligible Family Members must be medically cleared through the Exceptional Family Members Program prior to arrival at their assigned post.

DOD Active-Duty Military assigned to a Mission must verify that local ICASS contributions are being paid on their behalf by their sponsor.

DOD Active-Duty Military must be registered to the appropriate world region with International SOS/Tricare. Current regions are Eurasia-Africa, Latin America-Canada, and Pacific. They should have contact numbers for ISOS/Tricare for guidance on any medical services obtained outside of the Health Unit. See Tricare Prime Remote Overseas .

Marine Security Guards and Seabees assigned to an Embassy are reminded that medical evacuations are authorized through the Department of State Bureau of Medical Services, but medical and hospitalization expenses are authorized by ISOS/Tricare. Contact your Embassy Health Unit for more information.

DOD Civilian

This section applies to any DOD Civilian and/or Institutional (third party, private company) contractors and their Eligible Family Members (EFM) who will be assigned abroad for 30 or more consecutive days.

1. Complete the following physical exam forms based on age:
   1. DS-1843: Medical History and Examination for Individuals Age 12 and Older  if this is a first-time medical clearance for the sponsoring agency
   2. DS-1622: Medical History and Examination for Children Age 11 and Younger  if this is a first-time medical clearance for the sponsoring agency
   3. DS-3057: Medical Clearance Update (MCU)  form if this is an in-service under your current sponsoring agency
2. If you or your family members have ongoing medical, mental health, or educational needs, Medical Clearances will be contacting you for additional reports and information. For more detailed information see Post Specific (Class 2) Clearance Guidance.
3. DOD Civilians and contractors must show evidence of local ICASS participation on their behalf at their post of assignment and ability to fund a medical evacuation. DOD Civilians and Institutional Contractors should have their company’s Contracting Office Representative (COR) assist in completing the MED 3308: DOD ICASS Verification Form.
4. Send your completed forms and medical reports:Via email in a PDF format to MEDMR@state.gov (preferred)
   Or fax to 202-647-0292
5. A medical clearance physical exam should be completed by a licensed medical provider.
6. Medical Clearance related medical expenses can be reimbursed by receiving a DS-3069 payment authorization form from your human resources and submitting your invoices and “Explanation of Benefits” to Medical Claims at MEDClaims@state.gov.
7. For more detailed information about the pre-employment medical clearance process go to Pre-Employment Guidance.
8. Going to an ESCAPE post? You should also read ESCAPE Post Guidance.
9. To determine when your Medical Clearance will expire, please see “How Long Will the Inservice Clearance Process Take?“