Your guide to health insurance in the US
Those moving to the US will undoubtedly have many questions regarding how the US healthcare system works, how much medical care costs, and what the best ways to purchase US expat health insurance plans are. The below short guide provides practical information about healthcare and insurance in the United States, as well as health insurance options for expats living there. Read on to learn more, or click the button below to obtain a no obligation, free quote.
Healthcare for expats living and working in the US
Health insurance in the US is voluntary for citizens, expats, and tourists alike. However, to save yourselves from high medical costs in the US, health insurance is highly advisable, especially for expatriates, many of whom cannot benefit from the government-subsidized schemes.
The USA is world famous for its superior quality of healthcare services. The country is also renowned, however, for its sky high medical treatment costs. With high levels of annual medical inflation, healthcare costs for even the most basic medical services in America can be extremely high.
Why is healthcare so expensive in the US?
One of the reasons behind extremely costly medical treatments in the US might be the fact that hospitals and medical facilities are, for the most part, private entities that are looking to make a profit on their services. As such, prices are set according to their profit needs. The lack of pricing transparency between healthcare providers and insurers, as well as the high cost of drugs and medicines, are other key factors contributing to the skyrocketing costs of medical services.
For those of you interested in learning more, read our blog article which explains why the cost of health insurance in the Americas is increasing.
How does the US healthcare system work?
The US healthcare system can be challenging to understand, as unlike most countries in the world, the US doesn’t have any sort of national health system. This means that any time you receive medical care here, someone has to pay for it (either you or your insurance company).
Healthcare centers are run by multiple types of organizations, including the government, but most of them are private facilities, run for profit. Unless someone qualifies for a social healthcare program, they must pay for any medical care they receive themselves or via insurance. That said, the US government funds two types of social health programs: Medicare and Medicaid.
Expats residing in the US, however, must rely on the private health insurance they receive from their employer or bought privately.
Types of health insurance in the USA
Access to healthcare is provided through a combination of private health insurance and public health coverage – namely through Medicare and Medicaid programs.
Government-funded insurance schemes
National health insurance – Medicare
Medicare is a social insurance program funded at the federal level, and focuses primarily on aiding the older population (adults over 65 years old) by covering the cost of their healthcare. Medicare covers about half of the healthcare expenses of those enrolled, and the rest of the costs are paid by either a privately bought health insurance or out of pocket.
National social healthcare program – Medicaid
The only social healthcare program that runs in the US is called Medicaid – a federal and state program that helps offset the medical costs of certain groups of people with limited income and resources. Unlike Medicare, Medicaid provides free healthcare to eligible persons: low-income children, pregnant women, elderly people, and disabled people.
Private health insurance in the USA
Most Americans and expats residing or working in the US purchase private health insurance, or receive private health insurance for themselves and their families through their employers. Depending on the benefits and coverage provided by their employer-sponsored insurance, individuals often seek to purchase add-ons, or top-up insurance plans to increase their benefits from, for example, outpatient only, to plans that also cover inpatient treatment with pre-existing medical conditions coverage, or maternity insurance and even dental coverage.
It is advisable for expats to purchase locally compliant US health insurance, or an international health insurance plan. Since the cost of healthcare is so high in the US, even a local US plan can cost as much as an international and globally portable medical plan.
Health insurance for American expats abroad
What should a US citizen do when faced with an opportunity to work or live abroad? It’s essential for the US citizens to recognize that their local US health insurance plans are most likely not be valid abroad. Depending on your situation, there are a couple of options for the US citizens to pursue:
Short stay abroad: Travel insurance or short-term health insurance
If your travels outside the US are short in nature, you might want to consider an international travel insurance plan which covers all the major medical costs including hospitalization, medical emergency transportation, and other travel insurance benefits.
For those travelling for longer than three months but less than one year, a great value option is short-term health insurance, that will also cover your outpatient doctor visits, prescribed medicines and other health and travel benefits – making it a perfect solution for those looking for a more comprehensive coverage while not breaking the bank.
Private international insurance
If you’re moving abroad, and let’s say worried about losing coverage for pre-existing conditions, you may want to extend your current local US plan to an international coverage. That way you’ll get access to healthcare virtually anywhere in the world, including on your trips back home to the United States, and keep coverage for any pre-existing medical conditions. Private international insurance plans are highly customizable, and some of them offer renewal option for life, among other perks.
Employer sponsored health insurance: Ensuring you have coverage both in the US and abroad
If you’re going abroad for a work assignment, you will most likely be offered a company-sponsored health insurance plan. However, those plans, even if sometimes international in nature, might exclude the US, or your family. A good option for American expats in this situation is to top-up their health benefits, or add their family members to their existing plan.
How to find the best private health insurance in the US
As a leading international health insurance broker, Pacific Prime works with the top health insurance companies in the US to offer a wide selection of the best plans. We have 20 years of experience in matching expats living in the US with policies that best meet their budget and healthcare needs.
Plans that we offer can be tailored to meet specific requirements, and can include benefits for inpatient, outpatient, maternity, dental, and emergency evacuation coverage, and can be guaranteed renewable for life and globally portable.
In addition to having the best insurance policies, Pacific Prime also offers unparalleled service and outstanding claims support. Contact us today so we can help you find the best US insurance plan for your budget and healthcare needs.