USA healthcare is a constant issue that plagues not only USA citizens, but the millions of immigrants moving to America. For people with private medical insurance that offers comprehensive coverage, medical facilities in the USA can be some of the best in the whole world. For people without insurance, USA healthcare might seem rather mediocre, exorbitantly expensive and sometimes even fully inaccessible. Major operations can easily cost thousands of dollars, and medical treatment is limited for people who can’t afford them.

If you are moving to the USA, you should know that the USA government doesn’t require expats to get health insurance plans in America. But the cost of all medical services in the US is so high that you might end up spending all of your savings to pay for medical bills. So whilst it is not generally required to get medical coverage, it is extremely recommended that you have health insurance in the USA to save yourself from exorbitant hospital bills and get access to all appropriate medical care for your needs. 

The standards of medical care in the USA is high, hence the higher cost linked with it. Aside from this, public healthcare is given only to a portion of the population. This is why many people, including the locals, have private health insurance coverage in America. 

The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status of ability to pay. However, since this law’s enactment in 1986, has unfortunately remained an unfunded mandate. As such, patients may also expect to pay huge fees afterward.

As with many immigrants, it is also highly recommended that you buy international health insurance to always ensure that you are protected in all emergencies. Medicare is mostly given to people that need it the most, and the rest of medical services are all costly enough that one would think twice before getting it. We have created a guide to everything you might need to know about the USA healthcare system.

USA healthcare facilities

usa healthcare facilities
Photo credit: Adhy Savala / Unsplash

Many hospitals in the USA are privately owned and are mostly ruin by either non-profit associations or boards of investors. The standard of medical facilities in the USA is generally excellent. Patients that can afford it will have access to a some of the best medical technology in the world. Doctors are greatly trained, and many of the best specialists can be found in the USA. The benefits of private healthcare in America include relatively shorter waiting periods for operations (as compared to individuals who do not have insurance), costs (which includes government income tax exemptions for health benefits), ease of enrolment and a wide range of plan options.

USA health insurance

The USA doesn’t need expats to have health insurance as a requirement for relocation. But it may be wise for expats moving to the USA to invest in the best health insurance policy they can afford or negotiate one into the contract of employment they have. Anyone that doesn’t have appropriate health insurance in the USA runs a risk of paying colossal bills or getting no medical attention – especially for expats who are unable to benefit from citizen-based exemptions and schemes. Longer termed treatments are mostly denied to those that don’t have insurance.

Dental and optical operations are not included in general insurance and are expensive on their own. Expats who get medical treatment in the USA must keep all of their receipts to make an insurance claim. 

What is Medicare, and what services does it cover?

medicare part of usa healthcare
Photo credit: National Cancer Institute / Unsplash

Medicare is essentially a national health insurance program, created in 1965 for people aged 65 and over, regardless of income, health status, or medical history. This program was expanded in 1972 to cover some people under age 65 that have a long-term disability.

These days, Medicare plays an important role in giving health and financial security to 60 million old aged people and younger people having disabilities. The program helps pay for most medical care services, physician visits, hospitalizations, preventive services, prescription drugs, skilled nursing facilities, and home health care. In 2017, Medicare spending accounted for over 15 percent of whole federal spending and 20 percent of total national health spending.

Medicare is divided into four Parts: A, B, C and D

PartsDetails
Part ACovers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted to a hospital for three days and not for custodial care), and hospice services.  
Part BCovers outpatient services including some providers’ services while inpatient at a hospital, outpatient hospital charges, most provider office visits even if the office is “in a hospital”, and most professionally administered prescription drugs.  
Part CAn alternative called Managed Medicare or Medicare Advantage which allows patients to choose health plans with at least the same service coverage as Parts A and B (and most often more), often the benefits of Part D, and always an annual out-of-pocket expense limit which A and B lack. A beneficiary must enroll in Parts A and B first before signing up for Part C
Part DCovers mostly self-administered prescription drugs

Do note: New immigrants to the USA are not eligible to benefits like Medicare. As Medicare is a national health insurance program, regular residents of the US (citizens, permanent residents) are eligible for Medicare Part A if they have worked in the US for at least 40 quarters (equivalent of 10 years for most people) and are above the age of 65.

However, special exemptions do apply on a case-by-case basis for expats. If you are not an American citizen, but are lawfully present, you may still be able to get Medicare, depending on your circumstances. Specifically, you will qualify for Medicare even if you are not a USA citizen if you qualify to receive or currently receive Social Security retirement benefits, Railroad Retirement Benefits (RRB), or Social Security Disability Insurance (SSDI). In any of these cases, you will qualify for premium-free Part A. You will owe a premium for Part B.

To learn more about your Medicare coverage eligibility, refer to the official USA government site here.

Cost of USA healthcare services

usa healthcare ; pills
Photo credit: Myriam Zilles / Unsplash

If you become ill and need emergency care, the medical costs will start adding up right away. For instance, the ambulance you take to the hospital will start at $400.

If tests are needed, additional costs of around $100-$500 are a must per test. Also, if you need to spend a night at the hospital, an additional charge of up to $5,000 can be added to your bill. Along with medications to treat your illness, the cost of an emergency room visit in total might be $6,000 or even more. 

A visit to a doctor’s office is quite affordable as compared to an emergency room visit. But if you are ill, additional costs may become expensive very quickly. An initial consultation with your doctor will be around $100-$200 on average. Visits to specialists are mostly more expensive based on their specialty and the nature of your visit. On average, a specialist may charge $250 or more for only a consultation. 

Whether you happen to be a local traveler or an expat who has relocated to the USA for quite some time, you can not deny that healthcare in the USA is very expensive. The total costs for a typical family of around four (who are insured under their employers’ most common health plans) will be around $28,166. This is not a small sum in terms of real dollars and earnings, and these prices can be acutely felt by an average person.

Pre-travel restrictions and vaccinations for the USA

Expats planning to settle down in the USA for longer periods have to undergo a medical exam and be asked to show proof that their immunizations are all up to date. If the needs aren’t met, the expat may have to get the vaccinations in the medical exam. The Centers for Disease Control and Prevention has an up-to-date list of all needed vaccinations for immigration

Different emergency services in the USA

Emergency medical services in the USA are all regulated by individual state governments and should be given to anyone who needs them by law. In the case of a medical emergency, you can dial 911. The operator will then dispatch the ambulance service to any location of the emergency you have mentioned. Paramedics in the USA are generally highly trained and can give an excellent level of care at a scene of an accident. Alternatively, you can make your way to your nearest hospital with an emergency room for immediate treatment or go to a nearby Urgent Care clinic. 

Emergency departments are staffed throughout the day 24/7, with doctors and nurses tarried in administering emergency care, while the Urgent Care clinics are ideal for urgent but non-emergency conditions. They are mostly staffed with physician helpers.

Urgent Caregivers can do all basic lab and imaging tests, such as X-rays, and give diagnoses and offer treatment plans. Urgent Care clinics also have set hours and an established list of all conditions that can be treated. As a result, the Urgent Care clinics are less expensive and have a shorter waiting time than emergency departments. 

More on The Finder:

USA Visa Application: Visa Types And How To Apply For Them
Education In The USA: Types Of Schools And Curriculums For Your Child
How To Rent Or Buy A Car In The USA