If you’re planning on moving to the United States of America, then having health insurance there is an absolute must. Here’s everything you need to know about registering with the health system.
Understanding America’s health system
If you’re moving to the United States from a country that has a national health service in place, you’ll be in for a shock, as there isn’t a national health system in the US. Instead, American residents mostly have to fund their healthcare through private health insurance.
However, there are a few exceptions to this. For example, Medicare provides health coverage for those over the age of 65 years or who have a severe disability. There is also Medicaid, which provides funding assistance to those on a low income. Nonetheless, outside of these exceptions, obtaining health insurance is a must, because medical bills in America are incredibly high. In fact, a study from academic researchers showed that 66.5% of bankruptcies in America were tied to medical issues – this included the issue of having to take time off work for medical reasons.
Over the past decade, the health landscape has improved, with the introduction of the Affordable Care Act (ACA) and the Patient Protection and Affordable Care Act (PPACA), which was reformed under Barack Obama’s administration. These changes helped to guarantee minimum health coverage, extend Medicaid, and create an online marketplace of ACA compliant insurance plans.
Because private health insurance is the only option, plans are costly, and therefore you shouldn’t just buy the first plan you see. Instead, take time to research policies and establish whether the coverage offered is suitable for your requirements.
Finding health insurance in the United States
Some employers offer health insurance for employees and their dependants, so if you’re relocating for work, check with your company as to whether this is something they offer. As standard, companies with over 50 employees must offer ACA-compliant health insurance to those who work over 30 hours per week. However, if this does not apply to you, you’ll need to source your own health insurance.
There are numerous types of health insurance in the US, each with their own conditions and exclusions. But typically, the system is categorised into two bodies: Healthcare Management Organisations (HMO) and Preferred Provider Organisations (PPO). Each of these bodies provides discounts to those registered to their medical network. However, most expats tend to opt for an Individual Private Medical Insurance (IPMI) policy.
IPMIs offer bigger advantages to expats than local health insurance, because it offers global coverage (which is key for those who relocate often) and is tailored specifically to the individual’s medical needs. This is especially helpful for those who are chronically ill or require ongoing treatment.
Because health insurance is such a personal thing and no two people’s requirements are the same, it’s best to do your own research with regard to what policy is best. There are numerous providers that offer coverage for the States, but if you need help finding one, then third party review sites and expat groups, such as this one on Facebook, may help you.
It’s important to note that even though health insurance helps reduce medical costs, it only offers partial protection, and you’ll want to ensure you have adequate savings in place, in case you need something that isn’t covered or is more costly than previously anticipated.
How much does health insurance cost in the United States?
It’s no secret that America has some of the highest healthcare costs in the world, but knowing something is “expensive” doesn’t help! Health insurance policies vary depending upon personal needs, location, facility and circumstance, but here are some example figures to help you budget:
• For an ACA-approved insurance plan that includes dental, optical and a voluntary excess, you can expect to pay $16,000 per year
• For an ACA-approved insurance plan that includes dental, optical and doesn’t have a deductible, you can expect to pay $22,000 per year
• For a non-ACA-approved insurance plan that includes dental and optical, you can expect to pay between $9,000 and $12,500 per year
• For a non-ACA-approved insurance plan that doesn’t include dental or optical, you can expect to pay between $7,500 and $10,500 per year
The above figures are just examples, and the exact price of your policy will depend upon various factors, such as who’s covered under the policy, the health conditions of those covered, and the extent of coverage you’re looking for. But if you’re wondering whether insurance is worth the high annual premiums, here’s an example of the costs you’d face without insurance in America.
• GP visit: $230
• Blood test: $100 – $3,000
• ER visit: $150 – $3,000
• MRI: $1,000 – $5,000
• X-ray: $1,000 – $5,000
• Physical therapy: $50 – $350
• Broken bone: $2,000 (without surgery) or $7,000 – $35,000 (with surgery)
• Hip fracture: $13,000 – $40,000
• Heart surgery: $30,000 – $200,000
• Brain surgery: $50,000 – $150,000
• Baby delivery: $9,000 – $17,000 (vaginal) or $14,000 – $25,000 (C-section)
For the same treatments, but this time with insurance, you can expect to pay:
• GP visit: $90
• Blood test: $0 – $30
• ER visit: $50 – $150
• MRI: $20 – $100
• X-ray: $10 – $50
• Physical therapy: $10 – $75
• Broken bone: $0 – $500 (without surgery) or $7,000 – $10,000 (with surgery)
• Hip fracture: $0 – $500
• Heart surgery: deductible + 10-50%
• Brain surgery: deductible + 10-50%
• Baby delivery: $500 – $3,000
Taking into account the differences in these prices, we recommend taking out some form of health insurance coverage, to ensure that you and your family are protected.
The application process for American healthcare will depend upon what type you’re registering for, where you’re located, whether you’re a resident, and what you’re eligible for. You can apply for healthcare through the following channels:
• Your employer
• The Health Insurance Marketplace
• The State, if it has a mandatory health insurance plan – visit this website for more information
• Private insurance