Double Jeopardy: Navigating U.S. Immigration as a Non-Resident Cancer Patient – by Vivienne Duncan

For anyone, receiving a cancer diagnosis triggers anxiety and a determination to find the best medical treatment available. For those living in countries without adequate cancer care options, seeking medical treatment in the United States may seem to be their best hope, and some will pursue that option.

While visitors to the U.S. are not generally eligible to utilize government-based healthcare benefits, there is a process by which they can lawfully enter the country for medical treatment. However, U.S. immigration law can appear complicated and intimidating, and making a mistake can have serious health and travel consequences in these situations. The Cancer Advocacy Project (CAP) was contacted by the facilitator of a hospital-based cancer support group in a substantially immigrant neighborhood, and asked to organize a presentation on navigating U.S. immigration laws when entering the country for medical purposes.

In order to examine the requirements for entering the U.S. for medical treatment purposes, CAP partnered with Barbara Camacho, the Fragomen Fellow who runs the Immigrant Outreach Project at the City Bar Justice Center. Barbara began by explaining to the group that there is no separate visa specifically for “medical treatment”; individuals are admitted on a visitor’s visa. However, at the visa application stage the individual must provide evidence that the purpose of the trip is health-related.

When preparing their visa application for submission to the U.S. Embassy or Consulate in their home county, individuals must first satisfy all the usual requirements for a visitor’s visa. In addition, they must provide a letter from their doctor in the home country that includes a diagnosis of their condition and the treatment required, evidence that they have been accepted for treatment, an appointment scheduled at a U.S. medical facility and, crucially, proof that the individual has sufficient funds to pay for medical and living expenses while in the U.S. This procedure allows the U.S. authorities to confirm that the individual will not become a charge on this country’s resources if they are admitted for medical treatment. Anyone arriving in the U.S. for medical care without first completing this process risks being denied entry.

The group engaged in a lively discussion about their own experiences of cancer treatment in their home countries, and their feelings of uncertainty when arriving at U.S. airports. One woman, currently back in the U.S. for ongoing treatment, recounted a disturbing exchange on this trip. Despite having complied with all the visa requirements and providing the requisite medical-related evidence, upon re-entry a Customs and Border Protection (CBP) officer challenged her decision to seek treatment in the U.S., and asked why she did not go somewhere else, “like the U.K.” (presumably for the “free” health care); this, despite having her funding verified before her arrival. It is because of ill-informed and unpleasant interactions of this type, and the potentially serious ramifications, that the group sought clarification.

Barbara advised the group that if proper procedures have been followed and a visitor’s visa for medical purposes has been granted, they should not, as the woman had recounted, be subjected to rude or unprofessional treatment upon arrival at U.S. immigration; if that happens, a complaint can, and should, be filed online, and can be done anonymously if preferred.

CAP provides advice and assistance to cancer patients, survivors and their caregivers in three areas: life-planning, private medical health insurance appeals and cancer-related employment discrimination. In addition, the project conducts community presentations on those topics, as well as on medical debt. Although CAP does not provide assistance with immigration issues, with the support of groups like Judges and Lawyers against Breast Cancer Alert (JALBCA) and colleagues like Barbara, the project is able to establish key collaborations that allow us, as in this instance, to respond to the many and varied needs of cancer patients and survivors.

Vivienne Duncan is Director of the City Bar Justice Center’s Cancer Advocacy Project