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There are two elements to receiving healthcare in the US, while on a work visa like the H-1B:Valid visa status and health insuranceLet’s start with the first, valid visa status.One cannot overstate the fact that when you are on an H-1B visa, your ability to work, is directly linked to your ability to stay in the United States.This is how the USCIS defines the H-1B visa program -The H-1B program allows companies in the United States to temporarily employ foreign workers in occupations that require the theoretical and practical application of a body of highly specialized knowledge and a bachelor’s degree or higher in the specific specialty, or its equivalent.[1][1][1][1]On an H-1B visa, you are a temporary foreign worker, who has been employed for a specific, specialized occupation, for your skills and knowledge.It then stands to reason, that if you are unable to work for any reason, you no longer meet the stipulations of your visa status and this should therefore invalidate the legal basis for your presence in the US.And this is precisely the case.An immigrant on long term illness will, at some point, be terminated from employment, as per company policy.This is, of course, common to all employees.But, when this happens to an immigrant worker, it will render the individual illegal in the US, unless they are able to find a new employer or transfer their visa status to a different one, within the grace period, which I believe is 60 days.Next, is the question of insurance.In the US, health insurance for H-1B workers is typically provided through the employer as part of benefits.As a result of termination of employment, the individual loses health insurance and are therefore, on the hook for their own medical bills.And it is, quite simply, impossible for your average H-1B worker to bear medical bills from treatment for illnesses like cancer, without insurance.Long story short, if an H-1B worker becomes incapacitated by illness that affects their ability to work, they will have to leave the US, through a combination of immigration requirements and financial concerns.If this is all you wanted to know, the answer ends here.For a slightly more elaborate discussion on the why’s, how’s and what’s of this specific scenario, please read on.While it may seem quite heartbreaking to force a person battling a life-threatening illness to quit their life in the US, because of their visa status, it is necessary to explain just why the H-1B visa takes this, somewhat utilitarian view of foreign workers.You see, any country will put foreign nationals through a “test” period, during which stringent work/ salary/ educational criteria apply, to evaluate their ability to be productive to its economy.And I’m sure we can all agree that this is sensible for a country to do, for a reasonable period of time, so that it can determine the best candidates for Permanent Residency.And this is where US immigration, runs into issues.The H-1B visa, is a dual-intent visa, meaning it provides employers the opportunity to hire foreign talent, while also providing productive foreign nationals working on H-1B, to make a case for Permanent Residency, through their employers.The H-1B visa was never intended to be a long term status, for working professionals and in that context, the stringent conditions of the visa make sense.But, due to a complex combination of factors*, the system became inundated in applicants from India and China, causing massive backlogs for candidates from those countries, awaiting Green Card processing.And to cover this time gap, the H-1B is continually extended way beyond the 6 years that it is capped off at, with the same stringent stipulations, far, far beyond a timeframe that would make any semblance of sense.It is, quite simply, a grossly inadequate, band-aid solution, to what has now become an immigration hemorrhage.The backlog has become somewhat bearable since, for Chinese nationals.However, it is currently the reality that Indians who applied for Permanent Residency, in early 2009, under the two most common skill categories (Employment- based 2nd and 3rd category) for their Green Cards, are only now, being processed.[2][2][2][2]They have spent more than a decade, on a visa that was specifically meant to be temporary, restrictive and utilitarian.It is quite reasonable for a country to want an immigrant worker, unable to satisfy the conditions of their visa, even due to health concerns, to leave if they were here specifically for work, for a short period of time, say 3–6 years, right?We would all agree, that it is completely acceptable for a country to test the productivity, health and skills of a foreign worker and assess their ability to assimilate and function in a new culture, for a specific period of time, before offering them the opportunity of Permanent Residence.But, for an Indian person that applied for their Permanent Residency in 2011, at the age of 30…It is entirely possible that after more than a decade of living in the US- buying a home, making investments, raising American-born children, well, building a life…That it can all be uprooted, should they fall victim to long term illness that affects their ability to work which, in middle age, is not a distant threat.And when you treat a human being, as a temporary, immigrant worker, for the better part of their productive life….That utilitarian view, becomes unjustifiable.*- The factors that led to this quagmire in the first place are a topic of charged discussion, with a lot of blaming involved on either side of the issue.It was a deliberate choice on my part, not to go down that path in this answer, to not add length and complexity to an already way-too-long answer.Footnotes[1] H-1B Fiscal Year (FY) 2020 Cap Season[1] H-1B Fiscal Year (FY) 2020 Cap Season[1] H-1B Fiscal Year (FY) 2020 Cap Season[1] H-1B Fiscal Year (FY) 2020 Cap Season[2] Visa Bulletin For October 2019[2] Visa Bulletin For October 2019[2] Visa Bulletin For October 2019[2] Visa Bulletin For October 2019

Yes, it has.But not exactly in the manner that it has been portrayed.Priyanka Snell’s answer below offers a high level summary of the two largest sources of H-1B abuse.However, this popular narrative, conveniently leaves out a lot of relevant details, in my opinion.Let’s talk about #1:Indian companies such as Infosys and TCS (and even American companies like Cognizant) who specifically used it for many years as a means to import less expensive labor from India to work “onsite”.Infosys and TCS started off as IT service companies, based in India.Cognizant is similar, but based out of New Jersey.Taken together, these companies represent, the lion’s share of H-1B workers in the United States[1][1][1][1].In the late 2000s, when the US kicked off its tech revolution as it were, the appetite for skilled labor exploded.The thing to note, is that these companies largely function to provide manpower to larger companies, for the roles they needed filled. Absent clients providing these demands, none of these companies would have been able to orchestrate the truly staggering amounts of visa applications and ultimately, Green Card filings that ensued.And to be sure, these clients were veritable tech giants, with adequate clout in the corridors of power, to allow for the sort of immigrant influx that would service their bottom-lines and their ravenous ambitions of growth.And this is a fact that gets conveniently lost in many discussions around H-1B abuse.Yes, the H-1B visas were/are abused, but not solely by random Indian IT service companies alone.Anyone believing that a non-US company, which merely provides staffing and consulting services would have the clout, by themselves, to pull off something like this….Is either hopelessly biased, or indescribably gullible.I get it, it’s easy to hate on Indian IT companies, and fall for simplistic explanations that cast aspersions on those who are already seen to “belong”.But even a weak attempt at a more balanced, realistic assessment would reveal right away, that the scale of the H-1B abuse and flooding of applications that occurred, along with the quiet complicity of the US government, was the result of a complex nexus, including some of the biggest tech players in the US.Moving onto #2:Shady staffing companies and consultancies looking to make money by promoting substandard candidates to clients with inflated resumes and taking a “cut” from the money the client pays.Having worked in a quite niche industry myself, I can tell you that the US tech-o-sphere considers itself quite the meritocracy.I for one, worked outside the tech bubble, but given that a vast majority of H-1B workers, happen to work in the tech sector, a domain that is known for the smarts, doesn’t it seem just a tad odd, that despite the existence of shady staffing companies being an open secret, that the trend continues?Ok, let’s assume that the managers (and co-workers) were none the wiser…Given that some of these jobs that immigrant workers are hired for, happen to be intensely competitive and require excellent technical proficiency, it is surprising to me that people with inflated resumes manage to sustain these fairly demanding jobs that they are hired for.Surely, if workers are so very “substandard”, the managers would be dissatisfied and get rid of them, no?All of this seems to indicate an ecosystem, that is permitting these agencies to thrive, within larger industries.This is, of course, conjecture on my part and I’m absolutely certain that there are substantial bad actors in this realm, but I do believe the skepticism of consulting and staffing firms is a bit overdone.I can’t speak for the tech/ software/ IT industry, but in my neck of the woods, that is the medical device and pharma space, maintaining agility in the workers that a company has, is the new norm.A person working as a contractor in my field, is not a so much a testament to the lack of ability, as it is evidence of a changing paradigm in how hiring gets done these days.Contractors are preferred, because it allows firms many advantages:The ability to quickly and cheaply downsize teams in the event of failures. Laying off full-time employees involves substantial severance packages, potential lawsuits and elaborate protocol, while contractors are far less of a hassle to deal with, if projects hit a rough patch.The ability to rapidly hire temporary, hands-on-deck for labor intensive, limited period projects, like responding to FDA warning letters, major audit findings that need extensive re-work etc.The advantage of being able to “test drive” an individual as a contractor, before putting in the work and substantial resources required to hire the worker full-time.The ability to carry on with downright ridiculous hiring practices, like requiring 2–3 years’ experience for entry level positions.In total, it seems to me that larger companies, forming the client base that hire contractual skilled workers on H-1B, are likely to have actively participated in any systematic effort to abuse the H-1B visa.Simple explanations, always have the greatest allure.Simple explanations that play on existing biases, have greater, even politically consequential allure.Yes, the H-1B visa undoubtedly needs fixing.The program requires an overhaul which re-examines what constitutes a speciality occupation, what educational attainment and skill level are considered “high-skill” in today’s economy and what loopholes and pressures permitted the throwing open of the H-1B floodgates and rampant abuse previously seen.But, to place the blame solely on “bad corporate actors from overseas” would be to make the tired, lazy mistake of the bad-apple argument.Abuse of this scale, does not occur due to the isolated actions of a constellation of firms, preferably located in a country and culture that’s easy to vilify.Systemic problems, require systemic solutions, which go beyond casting the stone across the pond.Every single one of the hundreds of thousands of “undeserving” H-1B employees had reams of their paperwork approved, not once, not twice, but through multiple petitions, by the US government.They were examined and permitted entry into the country, each time they left the US.They were assessed, examined and approved for visas, at US consulates abroad, multiple times, under the auspices of multiple administrations, spanning both political parties.Indeed, many of them were ultimately found deserving of US Permanent Residency, which is the sole domain of the government.The tea-time conversations of H-1B abuse may seek to dump the trash in the neighbors yard, but this is a problem that has been brought to bear on the US, despite the supposedly vigilant eyes of US immigration.And people in the US should ask their government, just why that happened.Note: To be clear, personally, I have every reason to be extremely pissed off about these IT service companies myself.As a MS degree holder from a prominent, public university in the US, I was not picked for an H-1B visa, multiple times, and the overwhelming number of applications from these companies were partly the reason.However, as I explain in the answer, my emotions about it notwithstanding, it is really quite a spurious argument to make, that IT companies just swooped in and took over the system, leaving the mighty US government helpless in their wake.Jan 28, 2020: Thank you for your interest in this answer. Please check out We The Legal for articles, news and an upcoming podcast on the topic of Legal immigration, which explores life is really like for legal immigrants in the US. You can also subscribe to our newsletter, for updates on new content by clicking the menu on the top right corner.Footnotes[1] The 25 companies with the most H-1B workers[1] The 25 companies with the most H-1B workers[1] The 25 companies with the most H-1B workers[1] The 25 companies with the most H-1B workers

TL; DR: Social Security offers overseas direct deposit for beneficiaries. There is no need to travel to the US to apply for or pick up benefits.More information can be found by reading the SSA booklet on payments outside the US, found here: https://www.ssa.gov/pubs/EN-05-10137.pdf (https://www.ssa.gov/pubs/EN-05-10137.pdf)However, if you're one of the many Indian citizens working in the US on H-1B, you may wish to read further for additional information and my answer may dispel many myths you may have heard about foreign workers and Social Security retirement benefits.Provided one is fully qualified by having 40 quarters of coverage (generally 10 years of work), they can draw a retirement benefit. In the past, foreign workers who chose not to pursue LPR status didn’t remain in the US long enough to earn 40 SSA work quarters. However, with the American Competitiveness in the 21st Century Act, this has changed, primarily for India-born workers who cannot get LPR status in a timely manner because of the diversity cap in Sec 202(a)(2) of the Immigration and Nationality Act. Those workers with an approved I-140 petition can remain in H-1B status indefinitely. These same workers are going to be the ones who are most likely to work long enough to qualify for a retirement benefit while at the same time not being LPRs or citizens of the US.How does the quarter of coverage system work? Below is a table showing the amount of Social Security taxable income that one must earn in a given year to get one quarter of coverage:A maximum of four quarters can be earned in a given year. For 2020, once one has earned $5,640, they have earned their four quarters for the year. For a person earning six figures, they’ll earn this by the end of January. The amount a quarter is worth may not seem like much, but when one looks at a person earning the federal minimum wage working 40 hours per week, it will take them five months (20 weeks) of full time work to earn four quarters. The best way to determine SSA taxed earnings is by looking at one’s W-2:Box 3 will show the wages that were taxed for Social Security. So long as this amount is over the value for four work quarters, one has earned all their quarters for that year.The tax deduction on one’s paycheck can have many names. It can be ‘Social Security’, however other acronyms used are OASDI, FICA (the law that mandates payroll taxes for Social Security contributions and Medicare) and SSDI (which refers to the disability benefit only.) Depending on how an employer chooses to list deductions, they may be broken out into the 6.2% Social Security amount and the 1.45% Medicare amount or they may be lumped together at 7.65% of income subject to these taxes. Both the employer and the employee contribute an equal amount. Self employed persons who are sole proprietors (Schedule C) will pay both portions or 15.3%; this is commonly called the self-employment tax, but it is the same tax employees pay, just twice as much to account for the fact the the self employed person is also their own employer.Do not confuse Social Security retirement and disability benefits with the Supplemental Security Income (SSI) program, which is also administered by the Social Security Administration. It is a separate welfare program for US citizens and certain LPRs. It cannot be paid to beneficiaries who live outside the US. SSI is means tested and for the disabled and elderly who are very poor and have no or little other income and resources of their own.Another confusion is company retirement plans like 401(k)s. These plans are private. Every plan is different and rules vary. Normally contributions to these plans are refunded to the contributor if they have not become vested by contributing for the required minimum period of time. If one is forced to cash out a 401(k), they need to see a financial planner or accountant if they are not aware of the pitfalls of cashing out a 401(k) before one is 59 1/2 and/or taking the money out all at one. Read one’s 401(k) literature carefully.Edit: There is a lot of disinformation out there. If one wants to comment that my answer is incorrect or a reply to a comment is incorrect, they must post links to original research, not links to discussion groups or hearsay anecdotal evidence, news articles, etc. I will not allow the comments to this answer to be used to spread disinformation.I am open to learning new information or a correction from what my own original research has found, but such information must be substantiated. Any contrary comments without valid citations will be deleted. You have been warned - my answer, my rules.Currently, according to the Social Security Administration, there is exists no treaty, or totalization agreement, between the US and India regarding social security benefits or contributions. U.S. International Social Security AgreementsA person must contribute to Social Security and earn 40 work quarters (10 years) to be insured for a retirement benefit. Generally, H-1B status can last a maximum of six years. However, the AC-21 Act allows H-1B status to be extended indefinitely, thus it is possible for certain H-1B workers to meet the 40 quarter requirement. AC21 generally benefits those foreign workers with an approved I-140 petition but who cannot apply permanent residence yet due to the artificial backlog created by INA Sec. 202(a)(2). Those affected are mostly India-born.Please do not contribute to the disinformation that already exists. Do original research on the law for yourself, do not rely on the Internet or even my own answer. Every person’s case is unique; what applies to one may not apply to all.Edit #2: Please do not confuse the Supplemental Security Income program (SSI) with Social Security retirement benefits, referred to by many acronyms such as SSDI and OASDI. FICA is the law that mandates payroll deduction of the taxes for OASDI and Medicare. These are separate programs. SSI is a welfare benefit available only to US citizens and in limited circumstances, LPRs. SSI is means tested and is designed for those with no income or resources who cannot work for medical reasons or have reached retirement age. This is not the program I'm talking about.Edit #3: Moved some information in the prior edits into the main answer and reorganized the answer for easier reading. 25K plus views! I hope all those who have read are much better informed about Social Security than they were.Edit #4: Added information about how SSA work quarters are earned. This answer is getting really long, however I’m adding information based on questions raised in the comments. I’ve also done more revising and reorganization to shorten the answer.Edit #5: Added information that 401(k) plans and other company offered retirement savings plans are private and have nothing to do with Social Security.