The agency says all fresh and pending permanent residency files must carry a brand‑new I‑693 medical form, reversing last year’s “use it forever” policy and catching thousands of applicants off guard.
Effective June 11, 2025, the United States Citizenship and Immigration Services (USCIS) will no longer accept an I‑693 medical exam completed under the open‑ended policy of 2024. If you withdrew or plan to re‑file Form I‑485, you need a new doctor’s signature—period.
Who needs to take the renewed I‑693 medical exam right away?
Applicants with green card packets in the mail, or those eyeing a summer filing window, are first in line. Civil surgeons must now sign the form close to the filing date; reused exams are out.
That means spouses of U.S. citizens, employment‑based hopefuls, and diversity‑visa winners alike should schedule fresh checkups before appointments disappear—have you booked yours yet?
What the immediate change means for adjustment of status filings this summer
The policy erases the grace period attorneys expected. Paperwork that left your desk early this week could already be invalid.
Immigration lawyer Matt Cameron warns that “everything just got harder,” while colleague Elissa Taub calls the shift “narrow but pricey,” noting exam fees run $100‑$500 and may now be paid twice. On top of clinical tests, applicants must update vaccination records, an extra chore during peak travel season.
| Date | Policy action | Impact on applicants |
|---|---|---|
| Nov 1, 2023 | I‑693 granted unlimited validity | Exam could be reused with future filings |
| Apr 4, 2024 | Policy confirmed by USCIS | Long‑term planning around single exam |
| Jun 11, 2025 | Unlimited validity revoked “effective immediately” | New exam required for every fresh application |
Consequently, anyone reopening a case must retake the medical, even if last year’s paperwork is pristine.
How much the updated medical requirement could add to application costs
Between exam fees, potential lab work, and overnight shipping, families could shell out an extra $300–$1,000. “It’s the second hit that stings,” one Boston practitioner notes. USCIS argues the step protects public health by ensuring up‑to‑date screenings for tuberculosis, syphilis, and other conditions. Still, critics say the timing piles stress onto an already backlogged system.
First, confirm your civil‑surgeon appointment. Second, assemble vaccination proof before the visit to avoid repeat trips. Finally, attach the new, sealed I‑693 to your I‑485 package and mail it without delay.
In short, the rules changed overnight—but attentive planning can keep your American dream on track. Ready to pivot?