Do I Need a New Medical Exam for My Green Card Interview?

USCIS has changed how long a green card medical exam stays valid, and that change affects what many applicants should bring to their adjustment of status interviews. The key factor today is the date the civil surgeon signed your Form I-693 (Report of Medical Examination and Vaccination Record) and whether your Form I-485 (Application to Register Permanent Residence or Adjust Status) is still pending.

If your Form I-693 was signed before November 1, 2023, it is valid for two years from the civil surgeon’s signature date. If it was signed on or after November 1, 2023, it is valid only while the related Form I-485 is pending. If your I-485 is withdrawn or denied, the medical becomes invalid and you must get a new exam for any later filing.

USCIS introduced an indefinite validity policy in April 2024, then reversed course on June 11, 2025, to limit validity to the life of the pending application. This shift aims to ensure timely medical exams and treatment. If you have an interview coming and your exam might be too old, or you received a Request for Evidence (RFE) for a new medical, act quickly to avoid delays.

Who is affected

• Applicants whose Form I-693 was signed before November 1, 2023
  • Your medical is valid for two years from the civil surgeon’s signature date. If more than two years have passed by the time of your interview, you need a new medical.
• Applicants whose Form I-693 was signed on or after November 1, 2023
  • Your medical is valid only while your Form I-485 is pending. If the I-485 was withdrawn or denied, the medical no longer counts for a later filing.
• Anyone who receives an RFE or a Notice of Intent to Deny (NOID) for a new or updated medical
  • You must complete a new exam with a USCIS-designated civil surgeon and submit a new Form I-693 by the deadline in your notice.
• Applicants with long-pending cases
  • If your case has been in process for a long time, officers may ask for a fresh medical if the original is no longer valid under the current rules or if they believe an update is needed.

Effective dates and policy timeline

• November 1, 2023: Signature date that determines which set of rules applies to your Form I-693.
• April 4, 2024: USCIS announced that Form I-693 signed on or after November 1, 2023, would be valid indefinitely, removing the two-year limit.
• June 11, 2025: USCIS reversed that indefinite policy. Now, Form I-693 signed on or after November 1, 2023, is valid only while the related Form I-485 remains pending. This updated policy applies to all applications pending or filed on or after June 11, 2025.
• December 2, 2024: Submitting Form I-693 with Form I-485 became a formal filing requirement, which reduces later requests and speeds up decisions.

For the official policy alert on the June 11, 2025 change, see USCIS’s newsroom alerts page: https://www.uscis.gov/newsroom/alerts

What this means for your interview now

• If your Form I-693 was signed before November 1, 2023:
  • Check the civil surgeon’s signature date. If two years have passed by the time of your interview, you need a new exam. If you are close to the two-year mark, consider bringing a new sealed medical to avoid a delay.
• If your Form I-693 was signed on or after November 1, 2023:
  • If your Form I-485 is still pending, your medical is valid under the new rules. If the I-485 was withdrawn or denied, the medical is no longer valid for any future filing, and you must get a new one.
• If the officer has doubts:
  • Officers can ask for an updated medical if they suspect changes in your health or if the original no longer meets current policy.

At your interview, bring the original sealed Form I-693 signed by a USCIS-designated civil surgeon if it was not already submitted or if the officer asked you to bring it. If USCIS already has your valid medical in the file, you do not need to redo the exam unless told otherwise.

How RFEs and NOIDs change your medical exam needs

USCIS may send an RFE or a NOID asking for a new or updated medical exam. This can happen if:

• Your Form I-693 has expired under the pre–November 2023 two-year rule.
• Your Form I-693 is no longer valid because your original Form I-485 was withdrawn or denied.
• The officer believes your medical information should be updated.

If you get an RFE or a NOID:

1. Read the notice carefully. It will state exactly what is missing and the deadline to respond.
2. Book a new exam with a USCIS-designated civil surgeon as soon as possible.
3. Complete the exam, and have the civil surgeon fill out a new Form I-693.
4. Submit the new sealed Form I-693 by the RFE or NOID deadline. Late responses can lead to denial or long delays.

A timely and complete response is critical. VisaVerge.com reports that many applicants avoid denials by responding early and including all pages of the new Form I-693, with every field completed and the civil surgeon’s signature in the proper places.

What to bring to your interview regarding medicals

• The original sealed Form I-693 signed by a USCIS-designated civil surgeon if requested by USCIS or if you are bringing an updated medical.
• Your vaccination records and any medical history documents you used at the exam, in case the officer asks basic questions.
• Any RFE or NOID notice that requested a new medical, so you can show you complied.
• A copy of your Form I-485 receipt notice, which helps the officer quickly locate your file.

If your medical is still valid under the rules above and already in your file, you generally do not need to bring a new one. But if your older (pre–November 2023) exam is at or past two years, bringing a fresh sealed Form I-693 can prevent a post-interview RFE and save weeks.

Options if an officer asks for an updated exam at the interview

• If you brought a new sealed Form I-693, you can hand it to the officer.
• If you did not bring one, ask the officer for an RFE. This gives you time to complete a new exam and mail the sealed form by the deadline.
• Do not open the civil surgeon’s sealed envelope. USCIS needs the sealed package. Keep a copy of the completed form for your records if the civil surgeon provides one.

USCIS officers have discretion to request an updated exam. The safest plan is to check validity in advance and, if your medical is expiring or expired, update it before the interview.

Step-by-step: how to get and submit a new medical exam

1. Find a USCIS-designated civil surgeon near you. Use the USCIS civil surgeon locator or ask local health providers. Not every doctor can complete Form I-693; it must be a designated civil surgeon.
2. Book the appointment quickly if you received an RFE or your interview is soon.
3. Bring your photo ID, vaccination history, and any relevant medical records to help the civil surgeon complete the exam.
4. The civil surgeon will examine you, review vaccines, and complete Form I-693.
5. Make sure you receive the sealed envelope. Do not open it.
6. Submit the sealed Form I-693 to USCIS:
   • With your Form I-485 filing, or
   • In response to an RFE or NOID, or
   • At your interview if the officer asks for it.
7. Keep copies of all records and any receipts.

USCIS states the updated policy ensures timely and proper medical exams and care, which supports public health. If you need help finding appointments, some civil surgeons provide direct scheduling support. For example, Dr. Ann Kemp at UMMC offers scheduling assistance at (601) 984-6800.

Scenarios to guide your next steps

• Scenario 1: Form I-693 signed October 15, 2023; interview November 20, 2025.
  • Impact: Under the pre–November 1, 2023 rule, it is valid two years from signature and expired on October 15, 2025. You need a new exam. Bring a new sealed Form I-693 or expect an RFE.
• Scenario 2: Form I-693 signed December 10, 2023; I-485 still pending; interview next month.
  • Impact: Medical is valid while I-485 is pending. No new exam needed unless the officer requests an update.
• Scenario 3: Form I-693 signed January 5, 2024; first I-485 denied; plan to refile.
  • Impact: Medical is no longer valid because the linked I-485 was denied. You must get a new exam for the new filing.
• Scenario 4: Filed I-485 on January 10, 2025 with I-693 signed January 3, 2025; you now get an RFE for a new medical.
  • Impact: Officers can request an updated exam. Schedule a new appointment with a civil surgeon and respond by the deadline with a fresh sealed Form I-693.
• Scenario 5: You filed without a medical in mid-2024. In late 2024, submitting the medical with I-485 became a formal requirement. You now plan to file for your spouse.
  • Impact: For the new filing, include Form I-693 at the time of filing the I-485 to meet the current rule and reduce later requests.

These examples reflect how the date of the civil surgeon’s signature and the status of the related I-485 control whether your medical still counts. The most common reasons people need a new exam are: the two-year clock ran out for pre–November 2023 signatures; the I-485 tied to a post–November 2023 signature was withdrawn or denied; or USCIS asked for a new exam based on its discretion.

Practical tips to avoid delays

• Check your signature date now. If the exam is pre–November 1, 2023 and approaching two years, update it before the interview.
• If your Form I-485 is still pending and your Form I-693 is post–November 1, 2023, you’re covered unless USCIS asks for a new exam.
• If anything in your case changed—such as the I-485 was denied or withdrawn—plan for a new medical when you refile.
• Respond fast to any RFE or NOID for medicals. Late or incomplete responses risk denial.
• Keep the sealed envelope sealed. Officers need it unopened.
• Keep copies of everything for your records, including vaccination pages and the civil surgeon’s information.

USCIS says the June 2025 policy change applies to all applications pending or filed on or after June 11, 2025. According to analysis by VisaVerge.com, this has caused extra steps for some applicants with long-pending cases, but filing a complete medical early and staying alert to notices can keep cases on track.

How this policy protects your case—and your time

USCIS’s June 2025 update ties medical validity to the life of the pending Form I-485. For exams signed before November 1, 2023, the two-year window still matters at the interview stage. For exams signed on or after November 1, 2023, the main question is whether your I-485 is still pending.

This approach helps officers confirm that your health information is current for the case they are deciding. It also reduces back-and-forth when a case ends and later restarts: a new case needs a new exam.

From a planning view, the simplest path is to submit Form I-693 with your Form I-485 at filing. USCIS made this a formal requirement as of December 2, 2024. Early submission helps avoid RFEs later and can prevent interview delays, especially in busy field offices. It also gives you time to address any vaccine gaps at the civil surgeon’s office before USCIS reviews your file.

Step-by-step checklist before your interview

• Confirm the date your civil surgeon signed your Form I-693.
• Match your exam to the correct rule:
  • Signed before November 1, 2023: valid two years from signature.
  • Signed on or after November 1, 2023: valid only while the linked Form I-485 is pending.
• Check your case status. If your I-485 is still pending, you may not need a new exam unless the officer asks.
• If your exam expired or will expire before the interview, get a new one now.
• If you received an RFE or NOID, complete a fresh exam and mail the sealed Form I-693 by the deadline.
• Bring the sealed medical to the interview if requested, plus your vaccination records and any USCIS notices about the medical.

Forms and official references

• Form I-693 (Report of Medical Examination and Vaccination Record): https://www.uscis.gov/i-693
• Form I-485 (Application to Register Permanent Residence or Adjust Status): https://www.uscis.gov/i-485
• USCIS newsroom alert on policy updates (June 11, 2025): https://www.uscis.gov/newsroom/alerts

These links cover the core documents and the policy change you need to know when planning your interview and any medical updates.

Final takeaways and next steps

• If your Form I-693 was signed before November 1, 2023, it’s valid for two years from the civil surgeon’s signature. If more than two years have passed by interview day, you need a new exam.
• If your Form I-693 was signed on or after November 1, 2023, it’s valid only while your Form I-485 is pending. If that I-485 is withdrawn or denied, the medical is no longer valid for later filings.
• If USCIS sends an RFE or NOID for an updated exam, schedule a new appointment with a USCIS-designated civil surgeon and send a new sealed Form I-693 by the deadline.
• Bring your original sealed Form I-693 if USCIS asks for it, along with any notices tied to your case.
• Plan ahead. Submitting Form I-693 with Form I-485 has been a formal requirement since December 2, 2024 and is the simplest way to prevent delays.
• If you need to book fast, contact a civil surgeon immediately. For example, you may call providers like Dr. Ann Kemp at (601) 984-6800 for scheduling help.

USCIS’s June 11, 2025 update aims to protect public health by making sure applicants receive timely medical exams and care. For you, the takeaway is simple: confirm your signature date, confirm your I-485 status, and line up a new exam only when the rules require it or an officer requests it. With a valid medical on file and a prompt response to any RFE, most applicants can move through the interview stage without added delay.

If your interview is soon, check your file today. If your medical is older than two years under the pre–November 2023 rule, book a new exam. If your medical is post–November 2023 and your I-485 is still pending, bring your documents and focus on the rest of your case. And if a notice arrives asking for a new medical, act quickly. These steps keep your green card case moving and give the officer what they need to approve your application when all other requirements are met.