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Challenges Faced by International Students and Newcomers: Navigating Healthcare without Social Security Numbers

Ken Lee, an international graduate student studying at Northeastern University, complained that having no social security number, or SSN, caused unavoidable inconvenience while requesting an online medical appointment.


"When I was making an appointment online, the page always required SSN, which stopped me processing the next step," said Lee. "I'm wondering why there are no alternatives to SSN, so people like me can also easily see a doctor rather than have to give the hospital a phone call."


Lee, whose first language is Chinese, recalled the trouble that describing symptoms using a second language brought him. "I suffered a long-term stomach pain last year and once it became severe. I contacted the hospital, but it took ages for waiting for a person to pick up my call," Lee said. 


"I cannot be able to tell the phone-answering person my feeling clearly, so it took quite a long time for the person to settle down the registration while I was very, very uncomfortable," Lee added.


This pain impacts many international people living in Boston, not just a few. Boston was ranked top third for the largest number of overseas students, and according to Open Door 2021, 66,000 new foreign students were coming to Massachusetts in the 2020-2021 academic year.


The Social Security Administration, or SSA, indicated that if international students who own F-1, M-1, or J-1 visas want to meet the eligibility requirements of an SSN, they have to attain authorization to work from the school either on or off-campus. This means those who are not going to get a job in the United States still have to withstand the disadvantages that come with a lack of SSN.


"As an international student, without SSN, visiting the hospital is difficult, so I always choose urgent care." Dhaval Patel, a 26-year-old student at Northeastern University said. "But once I broke my knee, they told me I have to wait one week."


In a letter published this year, the Massachusetts Office for Refugees and Immigrants says that they welcomed more than 2000 new migrants in the summer of 2022. People who first come to the U.S. and need to see a doctor face similar troubles and others find it far more than difficult to make an appointment. 


"Because my wife doesn't have a social security number, so she cannot be fully covered by MassHealth insurance plan, unlike those who have this number," said Rahmatullah Wakili, 25, a Boston-based carpenter originally from Afghanistan.


"I came to the U.S. on Oct. 31, 2021. By that time, I had just moved to the refugee camp in Virginia and there was like the instructor, the people that were supporting me and my wife," Wakili recalled. "So, they told me there is something named social security number and it is like a very important number for all people that they are living in the U.S. like it's something that without this number to live here is impossible and like it will take as an illegality to work without this number."


When Wakili mentioned his application process for an SSN, he described it as "very complicated." "There were lots of forms I needed to fill and lots of details and information I need to remember," said Wakili. "It took almost one month and a half to get it."


"If you are a nonimmigrant, there are two ways that you can apply, depending on your visa status," noted the SSA in the guide shared on their website. "If lawfully present in the United States and applying for work authorization or permanent resident status from [the Department of Homeland Security], U.S. Citizenship and Immigration Services (USCIS), you can apply for your SSN or replacement card. If you are lawfully present in the United States and your visa status permits employment, you have two options for applying: you can use the USCIS application Form I-765 (Application for Employment Authorization) or the Form I-485 (Application for Lawful Permanent Residency or to Adjust Status). It is essential to contact your local Social Security office to initiate the application process.


The SSA allows immigrants to request an SSN card in their home country alongside a visa application. Refugees aren't able to apply for an SSN in their country of origin, but an asylee is not required to present an employment authorization document as proof of employment authorization when applying for a SSN and card.

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