HOW DOES HEALTH INSURANCE WORK IN THE USA?
Las Vegas, New York, Miami, Los Angeles… With your ESTA, you can visit the USA for up to 90 days. However, life as a globetrotter can quickly turn into a nightmare without health insurance. Indeed, healthcare spending in Uncle Sam’s country is among the highest in the world. That’s why we strongly recommend that you take out health insurance, even if you’re only going on vacation for a very short time, or simply on a business trip.
Discover in this article how health insurance works in order to leave for the United States with confidence.
HEALTH INSURANCE IN THE USA: A COMPLEX SYSTEM
Although the United States is a dream, the healthcare system is extremely expensive. Medical costs represent more than 16% of monthly household expenses and are among the leading causes of debt.
For this reason, we recommend that you take out health insurance before you leave for the United States. In the event of unforeseen circumstances, the costs incurred (hospitalization, medical repatriation, etc.) could ruin you. For example, a CAT scan can cost you between $4,000 and $5,000, an emergency hospital stay of just 3 hours can cost you between $9,000 and $10,000, and dental care can quickly add up to more than $500. Fortunately, there is a system of health insurance to cushion the sometimes exorbitant medical costs. However, it’s hard to keep track of all the travel insurance options on offer.
PUBLIC FINANCING
First of all, it should be noted that in the United States, we are very far from French social security. Social coverage is indeed very basic. Public funding still exists, such as Medicaid and Medicare. These are reserved for American citizens according to very specific criteria. In addition, Medicare is reserved for people over 65 and certain people with disabilities. Medicaid is reserved for American citizens whose incomes are very low.
There is also the “Obamacare” law which was passed in 2010 before being brought into force in 2014 by US President Barack Obama. This law aims to guarantee health insurance to all American citizens and permanent residents, by distributing aid to the less well-off households. However, this law only encourages Americans to take out private insurance.
PRIVATE FINANCING
There are many private insurances, divided into two main insurance categories: Health Maintenance Organizations (HMO) and Indemnity insurances (II).
HMO is a system which brings together under the same organization, the insurance company and the care delivery system. The II, are undoubtedly the most expensive. They are based on a provident system similar to the mutual health insurance system. In other words, the insured contribute according to the risks they wish to cover. The larger they are, the higher the amount of the contribution.
INTERNATIONAL HEALTH INSURANCE
Many insurances offer you international insurances (Allianz, Axa…). They are generally suitable for a stay abroad. Most offer you repatriation assistance, which allows you to be covered in the event of emergency repatriation (in the event of the death of a loved one, for example). Be careful not to confuse with European insurance which allows you to be reimbursed for medical expenses on simple presentation of the European health insurance card. Of course, this insurance is only available when you stay in the European Union. It is also important to be vigilant before purchasing travel insurance. Indeed, many of them assure you a cover of the costs in the event of hospitalization, however some are scams. It is therefore essential to read the insurance contract carefully before taking out it.
OTHER INSURANCE
If you’re moving across the Atlantic to work or study, you should be aware that there are also insurance policies offering medical assistance: student insurance, expatriate insurance… There are a huge number of them. Once again, it’s important to find out all you can before you leave, to make sure it’s right for you. What’s more, it’s important to make sure it’s Obamacare-compatible, because if it isn’t, you could be fined in the event of an inspection.
UNITED STATES: WHICH MEDICAL INSURANCE TO CHOOSE?
You will understand, the field of possibilities is vast as for the choice of your medical insurance, whether you are simple traveler, intern, or foreign student. So which one to choose?
Of course choosing medical insurance is not easy, and the choice depends on the reason for your trip and especially the length of your stay in the USA. It is obvious that you run more risks during a long stay, rather than for a temporary stay of one week … In all cases, it is recommended to select a comprehensive insurance (hospitalization, repatriation, medical care …).
In order to choose a good medical insurance adapted to your needs, do not hesitate to go to an online insurance comparison which will offer you several health assistance adapted to your needs. You will then have to analyze a certain number of criteria such as:
- the mention “Cospay” which is the amount of actual costs that you will have to pay after reimbursement of medical costs by health assistance;
- the mention “out of pocket maximum” is the maximum amount of costs that may not be reimbursed to you;
- the mention “deductible” this is the deductible;
- the mention “exclusion” these are situations for which health assistance will not work;
- the mention Network which gives you information about the network of doctors compatible with your insurance.
To prepare for your trip in the best possible way, it’s also a good idea to get quotes from different health insurers, so you can choose the one that’s best for you.
NB: be aware that in many cases, the Gold card (MasterCard or Visa credit card) includes health coverage that works during a stay abroad, anywhere in the world.