Medical Clearances

1. Additional Tests & Reimbursements: If requested by the Medical Clearance team to obtain additional exams/tests, you may be reimbursed through a DS-3069 payment authorization form from human resources or by submitting invoices and “Explanation of Benefits” to MEDClaims@state.gov. 
2. TDY Orders: Traveling on TDY orders for 30+ days without prior clearance? Follow the initial clearance steps detailed earlier. 
3. Changing Agencies: If moving to another agency a DS-1843 form, full physical, and labs must be completed within the past calendar year. If you have completed the above steps within the past year, please email medclearances@state.gov for guidance. EFMs will only need to complete a Medical Clearance Update (DS-3057). To get started please follow the applicable process/instructions listed under Medical Clearance Processes.
4. DoD Active-Duty & DoD Civilians: Active-duty military and their EFMs are cleared by the military. However, DoD Civil Service employees, contractors, and their EFMs assigned overseas for 30 or more consecutive days require a DoS medical clearance, following applicable steps listed under Medical Clearance Processes (i.e., “First-Time Medical Clearance: Non-Foreign Affairs Agencies” or “Medical Clearance Update/Renewal”)
5. Contractors: 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. Contractors paying into ICASS seeking MED program benefits and assigned overseas for 30 or more consecutive days require a DoS medical clearance, following specified steps listed above (section II or III). More information on private travel and medevac insurance can be found on the U.S. Department of State’s travel site on a page entitled Insurance Coverage Overseas.
6. U.S.-based Employees & Rovers: A medical clearance is not required for domestic postings.  However, domestic-based employees who will travel overseas on TDY (temporary duty) for thirty (30) or more consecutive days require a medical clearance. Please follow the applicable process/instructions listed under Medical Clearance Processes. EFMs of USG employees assigned to Washington, DC do not have MED program benefits abroad including on short-term TDY travel, and therefore, they do not need a medical clearance.
7. New Family Member: New EFMs (spouse, newborn, adoptee) traveling on official orders should begin the medical clearance process as soon as they are eligible. New family members are allowed up to 90 days of MED Program access while they obtain their medical clearance. Notify HR immediately when adding a new family member. U.S. government employees must fill out the OF-126 form to proceed with medical clearance, passports, and travel orders. The HR signed OF-126 must be submitted along with the medical clearance documentation.
8. Members of Household and Adult EFMs Over 21: Certain individuals who are on an employee’s travel orders, such as parents and other adult relatives, do not qualify for MED benefits, including Health Unit access and medical evacuation assistance. Adult children who are 21 or older generally do not qualify for MED services abroad.  However, there are two exceptions to this:
   • Adult students between their 21st and 23rd birthdays (ages 21, 22 and 23) who are on educational travel orders.
   • Adult disabled children incapable of self-support with a Certificate of Incapacitation (COI). The disability onset must have occurred before age 21. For more information, contact the Office of Medical Clearances at MEDClearances@state.gov.

     If you fall into one of these two categories, you will need to obtain a medical clearance.

9. Interns: Foreign Service Agencies’ paid interns may have limited Health Unit access. For eligibility details, contact your hiring authority to obtain confirmation on whether you subscribe to ICASS.
10. Medical Evacuees: During a Medevac, medical clearance is “pending.” Post-Medevac, clearance may be reinstated or changed based on the post’s medical support capacity. For queries, contact MED Foreign Programs at MEDForeignPrograms@state.gov.
11. Separating or REA/WAE:  Separation exams are a voluntary process for Foreign Service Officers or Eligible Family Members of one of the Five Foreign Service Agencies unless you plan on becoming an REA/WAE. If so, select “Separation” and “REA/WAE” on the DS-1843 form to avoid repeat exams. A private medical provider in the U.S. is recommended for the separation medical exam; or contact your post Health Unit. Please note that the medical exam must be done 90 days prior to or following separation to be eligible for reimbursement. After you have submitted the medical clearance documents to Medical Records, contact MedClearances@state.gov to authorize a DS-3069.

Current ESCAPE Posts include Iraq, Afghanistan, Libya, Somalia, Yemen, Syria, and Peshawar. Below are the instructions and important considerations. 

1. For First-Time ESCAPE Post Bidders/Assignments:
   1. Fill out the DS-1843 form.
   2. Fill out the DS-6570 (Pre-Deployment Physical Acknowledgement form). Have a medical provider conduct a physical examination and complete and sign the DS-1843 and DS-6570.
   3. Submit the completed DS-1843 and DS-6570 via email as a PDF to MEDMR@state.gov or fax it to 202-647-0292.
2. For Extending ESCAPE Post Tour:
   1. Complete and co-sign the DS-3057: Medical Clearance Update (MCU) form with the Health Unit medical provider at your ESCAPE post of assignment.
   2. Complete and co-sign the DS-6570 (Pre-Deployment Physical Acknowledgement form) with the Health Unit medical provider at your ESCAPE post of assignment.
   3. Email both completed forms as PDFs to MEDMR@state.gov or fax to 202-647-0292.
      • Both forms must be completed at an ESCAPE post Health Unit in collaboration with a State Department medical provider. If using a private medical provider or if at a non-ESCAPE post Health Unit, follow the instructions for First-Time ESCAPE Post Bidders/Assignments.

Important ESCAPE Post Caveats and Notes:

• Medical Clearance Expiration: Clearances expire 1 year after arrival or after an extension.
• TDY Orders: For individuals on TDY at an ESCAPE post for 30+ days, medical clearances expire 2 years after issuance. 
• DOD Civilians & Contractors: In Baghdad, Iraq/Kabul, Afghanistan, medical care is provided by Comprehensive Medical Services (CHS), with no access to Embassy Health Units. In Libya, Somalia, Syria, Yemen, Erbil, Iraq/Peshawar, Pakistan, access to Embassy Health Units is available. Obtain clearance from the U.S. Department of State. Obtain an additional form (MED 3308 or MED 3308.5) from your HR and submit to MEDClearances@state.gov.