Eligibility Period Extension: “Accepted” but No Pay Button

IMGs whose My Cases shows Enrollment Verification = Accepted for a Step eligibility period extension, but there’s no “Pay Extension” option anywhere.

Summary: After your school confirms enrollment (status = Accepted), ECFMG typically generates the extension invoice and a Pay link within 24–48 hours. If your Financial Account already shows a negative balance (e.g., –$100 or the current extension fee) dated days/weeks ago, the invoice likely exists but hasn’t been linked to the front-end request. You can often pay directly from the Financial Account page or ask ECFMG to link/reissue the invoice.

Before you start (quick checks)

• You requested the extension before your eligibility period ended.

• You have not already used your one allowed extension for this registration.

• Your enrollment verification shows Accepted in My Cases.

• Your Financial Account shows a balance due for “Eligibility Period Extension” (amount may vary by year).

If any of these aren’t true, see Edge Cases & Exceptions below.

Fast Path (most users)

1. Try to pay from Financial Account directly

   • Go to MyECFMG / MyIntealth → Financial Account → Make a Payment.

   • If you see an open invoice for “Eligibility Period Extension” (e.g., –$100), pay it there—even if the Manage Applications/Requests page doesn’t show a button yet.

2. Refresh the front-end

   • Log out → log in again.

   • Use a desktop browser, clear cache/cookies, and check:
     Exams/USMLE → Manage Applications/Requests for a Pay or Continue link.

3. Give it a little time

   • Newly accepted cases often need 24–48 hours to surface the front-end payment step, even after the invoice exists.

If you’re stuck >48 hours (or invoice is dated long ago)

Contact ECFMG and ask them to link or reissue the extension invoice to your current request.

• What to include:

  • ECFMG/USMLE ID

  • Case number (from My Cases)

  • Invoice date/amount visible in Financial Account

  • A concise request (see script below)

Message script (copy/paste):

Hello, my Enrollment Verification shows Accepted, and my Financial Account shows an extension invoice (amount __, dated __), but there is no Pay link under Manage Applications/Requests. Please link or reissue the extension invoice to my current request so I can complete payment. My ECFMG/USMLE ID is __ and case # is __. Thank you.

Tip: If you’re close to your window end date or have a scheduled Prometric slot soon, mention the time sensitivity in your message.

What happens after you pay

• Your Scheduling Permit is reissued with the new eligibility end date (check Exams/USMLE → Print Scheduling Permit).

• Processing is typically 1–3 business days after successful payment.

• Prometric appointments are not changed automatically. If needed, reschedule directly with Prometric after your revised permit posts.

1) Window already expired

• Extensions must be requested and paid before the original (or already-extended) eligibility period ends.

• If the window expired, you must reapply for a new 3-month window and pay new fees. ECFMG typically won’t begin processing a new application until about 4 weeks after the old window’s end date (you can submit earlier; it just won’t move until then).

2) You already used your one extension

• Each registration allows one extension. If you’ve used it, you must reapply.

3) Invoice shows in Financial Account but can’t be paid

• Sometimes the invoice is created but not “attached” to the front-end request. Ask ECFMG to link or reissue it (use the script above).

4) Name/status changes

• Recent name changes or enrollment status updates can delay the payment step until records sync. If your name changed, ensure the permit name will exactly match your passport; ECFMG must process name changes ≥7 business days before a scheduled exam.

5) You paid, but nothing updated

• Allow 1–3 business days. Then:

  • Re-download the revised permit.

  • If no change, contact ECFMG with payment confirmation and ask to confirm posting against your case.

Practical timelines (examples)

• Case flips to Accepted today: Expect Pay link or invoice visibility within 24–48 hours.

• Invoice dated weeks ago but no Pay link: Treat as unlinking; contact ECFMG to link/reissue.

• Paid today: Permit typically reissues in 1–3 business days.

FAQs

Q: The Financial Account shows –$100 (or similar) since weeks ago—what does that mean?
A: The extension invoice exists. If there’s still no Pay button or you can’t pay from Make a Payment, ask ECFMG to link/reissue the invoice to your current request.

Q: Can someone else pay for me?
A: Yes—payment can be made with a third-party card (payer name doesn’t need to match your ID). Many users also preload funds to the Financial Account, then apply them to the invoice.

Q: Does paying the extension move my Prometric date automatically?
A: No. The permit updates first; then you reschedule with Prometric if needed—within your new eligibility.

Q: What if I requested the extension on time but ECFMG didn’t post the Pay link before my window ended?
A: If the invoice exists and the request was timely, support can usually link/post it and complete the extension. If the request itself was late (or the extension had already been used), you’ll need to reapply.

Q: I can’t see “Make a Payment” on mobile.
A: Use a desktop browser, clear cache/cookies, and check again under Financial Account → Make a Payment.