I-693 Medical Exam Validity in 2026: Does the Medical Expire?

Does the I-693 medical exam expire in 2026?

For most of its history, Form I-693 — the Report of Immigration Medical Examination and Vaccination Record — came with an expiration clock. Under earlier rules an I-693 was valid only if the civil surgeon signed it within a set window before filing, and it then expired two years after the surgeon's signature. Many applicants had their I-693 go stale while their I-485 sat in the queue, and were forced to redo and repay for the exam.

That changed. Effective November 1, 2023, USCIS updated its policy so that a properly completed Form I-693 generally does not expire. Once a civil surgeon completes and signs the form correctly, it remains valid for the immigration benefit it was submitted with — there is no two-year cutoff and no "signed within 60 days of filing" window any longer. As of 2026 that no-expiration policy is the rule in effect.

What the no-expiration rule does and does not mean

The change is real, but it is not a blank check. Here is the precise scope.

• What it means: a properly completed and signed I-693 stays valid for the associated application no matter how long that application is pending. You no longer lose the exam to a two-year clock.
• What it still requires: the I-693 must be complete, internally consistent, and properly signed by an authorised civil surgeon. An incomplete or defective I-693 is not valid at all — expiration was never the only way an I-693 fails.
• What USCIS can still do: USCIS retains discretion to require a new or updated I-693 if there is reason to believe the applicant's medical condition has materially changed, or if the exam is missing required elements such as updated vaccinations.
• What it is tied to: validity attaches to the specific immigration application the I-693 was submitted with. It is not a transferable, all-purpose health certificate.

In plain terms: a clean, complete I-693 should carry you through even a long I-485 wait without a redo — but a sloppy I-693, or a major health change, can still put you back in the civil surgeon's office.

The civil surgeon process, step by step

The I-693 medical exam must be done in the United States by a USCIS-designated civil surgeon. (Applicants going through consular processing abroad are examined instead by an embassy-designated panel physician on a different form — the civil surgeon and Form I-693 are the adjustment-of-status path.)

1. Find a civil surgeon — use the official locator on uscis.gov (Find a Doctor) to find a USCIS-designated civil surgeon near you. Only a designated civil surgeon may complete Form I-693 for adjustment of status.
2. Book and prepare — bring photo ID, your vaccination records, and any documentation of prior treatment for conditions of public-health significance. Costs vary widely; the exam plus required vaccinations commonly runs $200–$500 and is not a USCIS fee.
3. The exam — the civil surgeon reviews your medical history, checks for communicable diseases of public-health significance, screens for certain mental-health and substance-related conditions, and reviews your vaccination record, administering any missing required vaccines.
4. The surgeon completes and signs I-693 — the civil surgeon fills in the findings, signs, and seals the form. Under current practice the surgeon typically gives you the completed form in a sealed envelope; do not open it.
5. Submit it with or after your I-485 — file the sealed I-693 with your I-485 packet, or provide it later if USCIS requests it. Keep a copy of the front page for your records before sealing, if your surgeon allows.

Timing the I-693 with your I-485

With the no-expiration rule, timing is far less stressful than it used to be — but a few practical points still matter.

You can file the I-485 first and submit the I-693 later. USCIS often issues the I-693 with the I-485 receipt instructions, and many applicants now complete the medical after filing rather than rushing it beforehand. Some applicants still prefer to file the I-693 inside the original I-485 packet to avoid a later Request for Evidence.

Because the exam no longer expires, getting it done early no longer risks wasting it. The thing to avoid is the opposite problem — filing the I-485 and then forgetting the I-693 entirely, which draws an RFE and adds months. Whether you bundle it or send it later, make sure it actually reaches USCIS.

Why USCIS removed the expiration window

The old two-year clock created a recurring, avoidable problem. I-485 processing times routinely exceeded two years for many applicants, so a perfectly valid medical exam would expire while the case sat in the queue through no fault of the applicant. USCIS would then issue an RFE for a fresh I-693, the applicant would repay $200–$500 and repeat the exam, and the case would slow further.

Removing the expiration window eliminated that churn — fewer RFEs, fewer repeat exams, and less cost for applicants caught in long backlogs. It is one of the more applicant-friendly procedural changes of recent years. The trade-off USCIS kept for itself is the discretion to ask for an updated exam when there is a genuine reason to, so the public-health screening purpose of the I-693 is preserved.

How Visacub handles the I-693 in your filing

Visacub's $99 Family Self-File Kit builds your I-485 packet and tells you exactly where the sealed I-693 fits, whether to bundle it or send it after filing, and reminds you so it is not the missing piece that triggers an RFE. Visacub does not perform medical exams — you must see a USCIS-designated civil surgeon for that — and Visacub is a software platform, not a law firm. Always verify current I-693 policy on uscis.gov, since USCIS can revise it.

Official sources

This guide is based on official U.S. government sources. Forms, fees, and processing details change — always confirm current requirements directly:

• USCIS — Form I-693, Report of Immigration Medical Examination and Vaccination RecordOfficial I-693 form and instructions — the immigration medical exam completed by a USCIS-designated civil surgeon.
• USCIS — Form I-485, Application to Register Permanent Residence or Adjust StatusOfficial I-485 form and instructions for adjusting to lawful permanent resident status from inside the United States.

Frequently asked questions

Does the I-693 medical exam expire in 2026?

Generally no. Since a USCIS policy change effective November 1, 2023 and still in force in 2026, a properly completed Form I-693 does not expire — the old two-year validity window was removed. Once a civil surgeon completes and signs it correctly, it stays valid for the associated application. The exam must still be complete and accurate. Confirm the current rule on uscis.gov.

What is the validity period of Form I-693?

Under current USCIS policy there is no fixed validity period — a correctly completed and signed I-693 remains valid indefinitely for the immigration application it was submitted with. This replaced the previous rule, under which an I-693 expired two years after the civil surgeon's signature. USCIS can still require a new exam if it believes the applicant's health has materially changed.

Can I still use an old I-693 signed before 2023?

Often yes. An I-693 signed before the November 2023 policy change can still be usable under the current no-expiration rule if it is complete and properly signed by an authorised civil surgeon. If your I-693 is old or you are unsure whether it is complete, confirm the current guidance on uscis.gov or have a civil surgeon review it before relying on it.

How much does the I-693 medical exam cost?

It varies by civil surgeon and location. The exam plus any required vaccinations commonly runs about $200–$500. This is paid directly to the civil surgeon and is not a USCIS filing fee. Prices are not regulated, so it is worth calling a few USCIS-designated civil surgeons to compare.

When should I do the I-693 relative to filing the I-485?

You can either file the completed, sealed I-693 inside your I-485 packet or submit it later — USCIS commonly accepts it after filing or requests it. Because the exam no longer expires, completing it early no longer risks wasting it. The main thing to avoid is filing the I-485 and then never submitting the I-693, which leads to a Request for Evidence and delay.

Who can complete Form I-693?

For adjustment of status inside the U.S., only a USCIS-designated civil surgeon can complete and sign Form I-693. Find one using the Find a Doctor tool on uscis.gov. Applicants processing immigrant visas abroad are examined instead by an embassy-designated panel physician using a different form — the civil surgeon and I-693 are the I-485 path.