what kind of cost is it and is it required? what options exist?
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You needed to take care of that before entering the US. When my mother came for a visit, she bought a travel health insurance plan at the same place she bought her plane ticket at. It only covered hospital/doctor's visits for accidents and sudden illnesses (like the flu) and excluded paying for any treatments for any preexisting conditions, even if there was a sudden flare-up of the illness requiring treatment.
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