Fact vs. Fiction: Who’s Really Responsible for H2A Program Worker Insurance?
Accidents happen, and they say most accidents occur close to home. As an ag employer participating in the H2A Visa Program, your farm and provided housing are a home away from home for your H2A employees.
While catastrophic accidents are rare, when they do occur, medical costs in the U.S. can be financially devastating without insurance. This blog is designed to educate both H2A Program employers and workers on the realities of what insurance protection is required and what options are available to help avoid unexpected and devastating financial consequences.
Accidents are rare … but they do happen
When you consider that just shy of 400,000 H2A Program visas were issued in 2025 (according to the U.S. Department of Labor), it’s inevitable that accidents and medical emergencies may occur. And, they don’t always happen during work hours. For example, one of USA Farm Labor’s clients recently had an H2A Program worker who went to the doctor complaining of chest pains. The emergency room cleared him. He went home and died of a heart attack that night.
Here are some other examples of unfortunate worker injuries and medical emergencies USA Farm Labor has seen over the years:
A worker died of a heart attack at a Chicago airport on his way home
A worker got very sick just after arriving, had a heart attack followed by a mini stroke
A worker and his friend were burned in a fire caused by oil left on the stove
A worker ended up needing a heart transplant
A worker lost his leg in a runaway truck accident
Not only may these incidents involve surgeries, recovery, and sometimes the loss of a loved one—medical bills can easily exceed $100,000 or more, not to mention unplanned travel costs—which can create an impossible financial burden.
USA Farm Labor has worked to help ease these burdens by launching GoFundMe pages, as well as providing several different insurance coverage options (detailed below). Having coverage provides peace of mind for both workers and their families and can prevent a medical emergency from becoming a long-term financial crisis.
Who is really responsible for providing off-the-clock insurance protection for H2A Program employees?
It’s a widely held false assumption that H2A Program employers are responsible for all H2A Program worker medical expenses. This perception is perpetuated by articles like a recent NPR article on the H2A Visa Program that stated the following about ag employers’ requirements:
“… the program's provisions, such as wages that regularly increase and other costs, including responsibilities to pay for housing, transportation and medical care for each worker …”
In reality, H2A compliance only requires employers to provide:
Workers' Compensation Insurance to cover injuries or illnesses that occur while the employee is performing work-related duties.
Vehicle insurance for transportation provided between employer-provided housing and the worksite (or other employer-provided transportation).
Outside of work hours, workers are generally responsible for their own medical expenses resulting from illnesses, injuries, or accidents that occur during their personal time. H2A Program employers are also not on the hook for unexpected travel during the season, such as a worker’s family member having to fly in or the worker having to resign due to medical issues and fly back home before the end of their contract. While it’s not a pleasant thought, it’s important to note that the cost to fly a body back to South Africa can run as much as $12,000 – $15,000. This is why USA Farm Labor strongly encourages workers to obtain personal medical and travel insurance coverage.
Travel and medical insurance options for H2A Program workers
Rather than simply react to unexpected emergencies (and possibly face prohibitive costs), USA Farm Labor encourages both our team and our clients to educate H2A Program workers on how to prevent catastrophes during the season and avoid astronomical costs.
USA Farm Labor’s travel agents assist workers with booking their flights and our recruiters recommend purchasing the optional travel insurance offered with their airline tickets to provide additional protection during travel.
USA Farm Labor provides access to two of the many available worker insurance options through our proprietary database:
Before departing South Africa: H2A Program workers can purchase travel insurance through Santam, which provides coverage while traveling to the U.S.
After arriving in the United States: H2A Program workers have access to medical insurance through Insubuy/Alliant Federation, which offers plans with coverage limits of $100,000 or $500,000, and includes emergency room visits, hospitalization, ICU, surgery, medical evacuation, telehealth, and other emergency medical benefits.
