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Foyer Global Health covers expats’ health in the United States who are seeking for a private health insurance solution tailored to their needs.
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Ready to venture across the Atlantic to the richly diverse country of Uncle Sam? While the United States is a coveted destination for millions of expatriates, many are apprehensive due to the cost and complexity of its healthcare systems. Because medical costs are one of the main causes of debt in the USA, it is essential to have comprehensive and effective healthcare coverage and to understand the specificities of the American healthcare system.
Foyer Global Health has put together a complete health guide for your relocation to the United States that explains why international health insurance will always be your best ally.
How does the US healthcare system work?
The US healthcare system is one of the most complex in the world. It is based on a wide variety of healthcare infrastructures (public hospitals, private hospital not-for-profit hospitals, and others. Unlike Canada and many European countries, it does not support a universal and public healthcare system.
Access to medical services is regulated by insurance policies, most of which are private, and premiums are generally prohibitively expensive. In the United States, the majority of residents who work full-time for a company with more than 50 employees are covered by their employer’s health insurance policy.
Public health insurance, funded by the federal government, includes three specific programmes targeted at different groups of population: Medicare for people aged 65 and over; Medicaid for people with low incomes; Children’s Health Insurance Program (CHIP) for children. Access to these public health insurance programmes is mainly restricted to American citizens and permanent residents.
However, there are large segments of the population who are not covered either by their employer’s private health insurance or by public health programmes, and who are not covered because they cannot afford the high insurance premiums.
What is the ACA?
The Affordable Care Act (ACA), also known as Obamacare, is a law enacted by the Obama administration in March 2010 with the aim of making health insurance more accessible and fairer.
Under this legislation, most US residents are required to have health insurance. Low-income families are eligible for coverage thanks to government subsidies designed to help them pay their premiums, and companies with more than 50 employees must provide health coverage to their employees. In addition, the ACA requires insurers to provide the same level of protection at the same cost to similar customers, regardless of their state of health at the time of enrolment.
What does ‘ACA compliant’ mean?
An ACA-compliant health insurance is a private health insurance that has no limits on medical expenses. This type of insurance guarantees you full reimbursement with no waiting period, regardless of the cost of medical procedures and services.
Is health insurance compulsory in the USA?
Yes, not only is health insurance mandatory, but it is also highly recommended, due to the exorbitant cost of medical care and the stress involved in the event of a medical emergency or serious health problem.
All residents of the United States, including expatriates, are required to have health insurance. While expat employees, entrepreneurs and investors must have health insurance that meets the requirements of the ACA, students are not obliged to be covered by an ACA-compliant policy.
Only employers with more than 50 employees are legally obliged under the ACA to provide health insurance to at least 95% of their employees and their children (not their spouses!), or pay a penalty.
How much does it cost?
As in Switzerland, Canada , Australia and Singapore, healthcare services for expats are very expensive in the United States. For example, a visit to a general practitioner costs between $120 and $230; a visit to a specialist around $300; surgery between $65 and $170 per minute; and an uncomplicated delivery between $20,000 and $50,000.
The two types of emergency services (Urgent Care; Emergency Room) are dedicated to dealing with everyday accidents, in the first case, and extreme emergencies where the patient’s life is in danger, in the second. It should be borne in mind that ambulance services (the vast majority of which are private) come at a very high cost. The emergency number in the United States is 911.
Health insurance prices in the United States
Just as the cost of healthcare services in the country is high, the cost of health insurance (local or international) for expatriates is also significant. For a single person, you can expect to pay between $250 and $1,000 per month, and for a family with two children, between $1,200 and $3,600 a month, depending on your profile, needs and type of health insurance (local or international).
Local health insurance: specific features to consider
Health insurance in the United States has a number of specific features:
- The out-of-pocketmaximum is the maximum annual amount you will pay for healthcare.
- Copayment is the fixed amount you must pay for a covered medical service after you’ve paid your deductible.
- Coinsurance refers to the sharing of expenses between you, the insured person, and the insurance company. There are different ‘co-insurance’ plans (e.g. 80/20, where you pay 20% of healthcare costs).
- The annual deductible is the amount you have to pay out of your own pocket every year, after which the insurance company will reimburse you for treatment.
- Health network: local health insurance companies are linked to specific health networks. When you take out an insurance policy, you must go to a health professional who is a member of the health network to which your health insurance company is affiliated with for optimum reimbursement. It is important to choose a wide healthcare network.
- PPO (Preferred Provider Organization) & HDHP (Health Deductible Health Plan) are two types of local health insurance plans that operate differently, with different structures and costs. In the case of PPOs, they offer geographical flexibility, with high premiums, relative low deductibles and no need for a preferred doctor. HDHPs have higher deductibles and lower premiums than PPOs. HDHPs also allow you to contribute to a Health Savings Account (HAS), which you can use for out-of-pocket medical expenses.
Which health insurance plan should I choose?
Before moving to the United States, you will need to choose between American and international health insurance to cover your healthcare costs. Although both types of insurance may cover you for the same type of treatment, they operate differently and cover different geographical areas.
Local health insurance policies have a number of specific features, most of which have been mentioned above, that can be restrictive and are limited to national or even state medical coverage which means linked to a particular state in the United States.
International health insurance, on the other hand, offers effective, comprehensive cover with no geographical limitations and no restrictions on access to certain healthcare providers. This type of health insurance is much better suited to the expats’ lifestyle and is essential in a country like the United States.
The only drawback is that some international health insurance plans are not ACA compliant, i.e. they do not meet the requirements of the Affordable Care Act legislation and, in some states, policyholders are required to pay the ACA Penalty Tax. It is important to take these tax implications into account when calculating your premiums if you choose a non-ACA compliant health insurance plan.
Why choose Foyer Global Health for your expatriation to the United States?
- Our specialty is to cover expats’ healthcare needs.
- We offer you comprehensive and effective international health insurance from the very first step upon enrollment.
- You are covered in the United States, in your home country and worldwide.
- You get an evacuation/repatriation plan in the event of a major health problem or medical emergency.
- You are free to choose the healthcare provider and the cover that best suits your profile, needs and plans.
Want to find out more? Contact our international private insurance experts to discuss your plans and get a free quote!