NarraPulse

Health Insurance for Expats in the US

March 20 , 2021 by: Leah Martin

If you don’t have health insurance becoming ill or injured in a new country can be stressful, overwhelming, and expensive. The healthcare system in the US is unique as the nation does not have a universal healthcare system. This means that if you are not insured, you could be left paying huge medical bills.

Health Insurance

There are different types of health insurance programs offered to US citizens. Although there is no universal healthcare system, there are two federal support programs: Medicare and Medicaid.

Most expats do not qualify for these plans and must pursue other options.

Whether or not you are required to have health insurance depends on the state you are living in. Some states require expats to acquire insurance, where others do not. If applying for an immigration visa, you must prove you have health insurance within 30 days of entering the country.

If you do not have health insurance and needed emergency healthcare, e.g., you broke your leg, you would end up with an expensive medical bill. America has some of the highest medical costs in the world, and you will be on the hook for paying if you don’t have health insurance. As you can imagine, this can have dire financial consequences for expats.  Fortunately, there are options available to you, as an expat, to obtain insurance.

International Health Insurance Plans (iPMI)

This type of insurance is for expats staying longer than 6 months. It covers many medical expenses, including maternity care, doctors’ visits, emergency medical care, dental, vision, and on-going medical treatment for chronic conditions.

Different iPMI plans accommodate different needs and budgets. This means, if you want to omit some coverage like dental, you can do so, and it will make your rate cheaper.

The annual cost of your insurance will vary between $500 and $8000. Your insurance premium (the amount you pay) is affected by your age, medical history, deductible, and maximum coverage. Generally speaking, the younger you are and the bigger your deductible is, the lower your annual premium will be. You can access a free quote by visiting the website of the insurance provider. Here are a few of the most popular iPMI providers for expats in the U.S:

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How does Insurance Work?

The insurance company will be billed directly for your medical expenses, so long as these medical expenses are included in your insurance plan. In some cases, you will have to pay a deductible. A deductible is a certain amount that you will need to pay that goes towards the medical expense. You will set your deductible when purchasing your plan. If you are with an employer insurance provider, they will tell you what your deductible is.

The deductible may differ based on the medical service or be a set amount each year. Some health services will not require a deductible like doctors’ visits, outpatient prescriptions, or vaccines. Again, this depends on the insurance plan you sign up for.

You may also have copayments or “copay” attached to certain services. A copay is a fixed amount that you pay before receiving the service. For example, your insurance plan may require a $20 copay for every doctors’ visit. When you go to the doctor, you pay $20, and the remaining amount is billed to your insurance provider.

There is also something called “cost-share.” This is very similar to copayments. However, it is often a percentage versus a fixed amount. If your cost share amount is 10%, you will pay 10% of every medical expense. For example, let’s say you had a claim (medical bill) of $10,000. Your deductible is $500, and you have a 20% cost share with a maximum of $2000. You would be required to pay $2500 ($500 deducible + $2000 cost-share) out of pocket, and the insurance company would pay the remaining $7500.

Deductibles and copayments are ways to reduce your annual insurance premium. If you have higher deductibles and more copayments, your premium will be less. Even if you have insurance through your employer, you will likely also have to pay deductibles and copayments.

 

Before seeking medical care, it’s important to note that not all doctors nor hospitals will accept your insurance. For this reason, you want to have an insurance provider with an extensive network.  GeoBlue Xplorer is associated with Blue Shield of America and Blue Cross and has a superior network of doctors and hospitals.

Additionally, some healthcare providers and doctors will not “direct bill,” which means they won’t send the bill to your insurance company. Instead, you will have to pay out of pocket and then submit a claim with your insurance provider. After reviewing your claim, the insurance company will reimburse you the amount.

 

How much coverage do I need?

It is hard to predict when a medical emergency will occur. If you were to experience a heart attack suddenly, it could cost you hundreds of thousands of dollars in medical bills. If you plan to stay in the US for an extended period, you should consider higher maximum coverage amounts. The costs of treatment can vary greatly depending on the hospital. For example, treating a urinary tract infection could cost $100 at a doctor’s office or over $70K if you visited the hospital.

If you aren’t sure what type of insurance you need, it is best to start looking and comparing the different plans. Everyone’s personal needs are different. If you have a recurring condition or need treatment often, you will need to consider this. By adjusting your deductible, copay, and cost-share amounts, you can find comprehensive health insurance within your budget.

 

Kate Manigold

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