Family Preference Categories Explained

Family preference immigrants are relatives of U.S. citizens and lawful permanent residents who are subject to annual numerical limits. The family preference categories are: F-1 (unmarried sons and daughters of U.S. citizens), F-2A (spouses and children of LPRs), F-2B (unmarried sons and daughters of LPRs), F-3 (married sons and daughters of U.S. citizens), and F-4 (brothers and sisters of U.S. citizens).

Because family preference visas are subject to annual caps, applicants must wait for their priority date to become current before they can file Form I-485.

Medical Exam Requirement

All I-485 applicants, including family preference visa holders, must complete an immigration medical examination with a USCIS-designated civil surgeon and submit Form I-693. The medical exam requirement applies regardless of the family preference category.

The exam must be completed by a USCIS-designated civil surgeon. Your family doctor cannot complete the I-693 unless they are a USCIS-designated civil surgeon.

What the Exam Covers

The immigration medical exam covers a complete physical examination, tuberculosis testing, required laboratory tests, and a vaccination review. The civil surgeon will administer any missing required vaccines.

There are no special medical requirements for family preference applicants. The exam is the same as for any other I-485 applicant.

Timing With Priority Date and I-485 Filing

Family preference applicants must wait for their priority date to become current before filing Form I-485. Once your priority date is current, schedule your medical exam promptly so the I-693 is ready when you file.

Do not schedule your exam years in advance — the I-693 is only valid for two years from the civil surgeon's signature date. Schedule after your priority date becomes current.

Consular Processing vs. Adjustment of Status

Family preference applicants who are outside the United States go through consular processing at a U.S. embassy or consulate and see a panel physician for their overseas medical exam. Applicants who are in the United States and eligible to adjust status file Form I-485 and see a civil surgeon.

If you are unsure whether you should adjust status or go through consular processing, consult an immigration attorney.

Common Questions

Family preference applicants often have long waits for their priority dates to become current. During this waiting period, there is no need to complete the medical exam. Schedule the exam only after your priority date becomes current and you are ready to file I-485.