HOW DOES HEALTH INSURANCE WORK IN THE USA?

Las Vegas, New York, Miami, Los Angeles… With your ESTA , you have the possibility of traveling the USA for a maximum of 90 days. However, globetrotting life can quickly turn into a nightmare without purchasing health insurance. Health spending in Uncle Sam’s country is among the highest in the world. This is why it is strongly recommended to take out health insurance even if you are going on vacation for a very short period or for a simple 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, taking out health insurance is a recommended formality before leaving for the United States. Indeed, in the event of an unforeseen event, the costs incurred (hospital costs, medical repatriation, etc.) could ruin you. For example, a scanner can cost you between $ 4,000 to $ 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 health insurance system to cover the sometimes exorbitant medical costs. It is however complicated to find your way among all the travel insurance that is offered to you.

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 are going to cross the Atlantic to work or study, be aware that insurance offering medical assistance is also available: student insurance, expatriate insurance, etc. There are many. Again, it is important to be well informed before leaving to make sure it is well suited to your needs. In addition, it is important to pay attention that it is compatible with the Obamacare system because if it is not the case, you can receive a fine in the event of control.

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.

In order to best prepare for your trip , it is also advisable to make a quote with different health insurances to choose the most advantageous 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.