- Download our Moving to the USA Guide (PDF)
Healthcare in the US is a contentious issue. The US invests nearly 20 percent of its GDP in healthcare, amounting to trillions of dollars a year. Despite this, the country has significantly poorer healthcare outcomes compared to its economic peers, including lower life expectancy and higher mortality rates.
The US is the world's only developed nation without universal healthcare, and medical services in the US are some of the most expensive in the world. About half of the population receives private health insurance from their employers, while 35 percent rely on government-funded programmes such as Medicare and Medicaid. A small percentage pays for their own private insurance, and approximately 10 percent of the nation is uninsured.
Hospitals are required by law to provide emergency medical services to anyone, including the uninsured, though patients can nevertheless expect to receive a hefty bill afterwards. Outside of an emergency, hospitals can refuse to treat a patient if they're unable to present a means of payment, although this does not apply to federally qualified health centres and community health clinics.
Government health insurance in the USA
Medicare is a tax-funded initiative for those aged 65 and older who paid social security taxes. In very limited cases, including disability, renal failure and sclerosis, some residents under 65 are also covered under Medicare.
There are four coverage components to Medicare. The original Medicare consists of Parts A and B. Part D can be added at an extra cost. Part C provides an alternative way of getting Medicare benefits.
- Part A: Provides coverage for inpatient hospital care, nursing and hospice
- Part B: Provides coverage for outpatient physician services
- Part C: Formed as an alternative to Medicare, Part C is also known as Medicare Advantage, Medicare Supplement Plan or Medigap. This plan allows patients to select private insurance plans with benefits equal to Parts A and B, and in some cases, Part D. Unlike a traditional Medicare plan, this plan has out-of-pocket payment limits.
- Part D: Provides coverage for prescription drugs
For further details, see www.medicare.gov
Medicaid is funded by state and federal resources and provides healthcare for eligible patients with low income, such as pregnant women, elderly adults and people with disabilities living in poverty, as well as their children. It is managed at the state level, with each state determining its own eligibility requirements.
To learn more, visit www.medicaid.gov
Children's Health Insurance Plan (CHIP)
Families who earn too much to qualify for Medicaid may be eligible for low-cost treatment for their children under CHIP, also funded by federal and state resources. Again, eligibility rules vary from state to state. In some states, pregnant women are also eligible to use CHIP. In addition, some states charge a monthly premium for access to CHIP. By law, this may not be more than 5 percent of the family's annual income.
Private health insurance in the USA
The USA doesn't require expats to have health insurance, although some states do. However, it would be wise for expats moving to America to invest in the best health insurance policy they can afford or negotiate one into their employment contract. Anyone without appropriate health insurance in the US runs the risk of paying colossal bills or alternatively getting no medical attention.
Expats who receive any sort of medical treatment in the US should keep all their receipts in order to make an insurance claim.
Healthcare facilities in the USA
The majority of hospitals in the US are privately owned and are typically run by either non-profit associations or boards of investors.
The standard of medical facilities in the US is high. Patients who can afford it will have access to some of the best medical technology. Doctors are highly trained, and many of the best specialists can be found in the US.
The advantages of private healthcare in America include short waiting times for operations and specialists as well as competing medical services.
Pharmacies in the USA
Pharmacies can easily be found in US cities. They are located in drug stores, grocery stores and large department stores, and are often attached to hospitals and medical clinics.
Almost all prescription medication can be found at a pharmacy in the US. However, medication is generally expensive. It is therefore best to keep all receipts in order to claim the costs from the health insurance provider.
If bringing medication from another country, expats must have a prescription from a doctor to prove that they are strictly for personal use. If regulations aren't followed, the drugs will be confiscated at customs.
Pre-travel restrictions and vaccinations for the USA
Expats planning on settling down in the US for extended periods must undergo a medical exam and will be asked to show proof that their immunisations are up to date. If requirements aren't met, the expat will have to receive the vaccinations during the medical exam. The Centers for Disease Control and Prevention (CDC) has an up-to-date list of required vaccinations for immigration.
Emergency services in the USA
Emergency medical services in the US are regulated by individual state governments and, by law, must be provided to anyone in need.
In the case of a medical emergency, dial 911. The operator will then dispatch an ambulance to the location of the emergency. Paramedics in the US are highly trained and can provide an excellent level of care at the scene of an accident. Alternatively, make your way to the nearest hospital with an emergency room for immediate treatment, or head to a nearby Urgent Care clinic.
Emergency Department or Urgent Care?
Emergency Departments are staffed 24/7 with physicians and nurses trained in administering emergency care, while Urgent Care clinics are ideal for urgent but non-emergency situations. They are typically staffed with physician assistants. Urgent Care providers can do basic lab and imaging tests, such as X-rays, and provide diagnoses and offer treatment plans. Urgent Care clinics have set hours and an established list of conditions that can be treated. As a result, Urgent Care clinics are generally less expensive and have shorter wait times than Emergency Departments.
►For a more in-depth insight into health insurance in the USA read Understanding Health Insurance in the USA
"In the US, you don’t really choose: you get the healthcare that you can afford, and the health plan you have dictates which hospital(s) you can go and which doctors you can see. If you work for a large company you probably have various options to choose from in terms of health plans."
Read Italian expat Simona's interview with Expat Arrivals for more about her new life in Northern California
"The healthcare in Houston is expensive but second to none. My son was born in Methodist in Sugar Land and my PCP was based in Memorial Hermann. Houston is one of the biggest medical hubs around. If you’re sick – it’s the place you want to be."
Read more about Irish expat Las's life in Houston, Texas in her interview with Expat Arrivals.
Are you an expat living in The USA?
Expat Arrivals is looking for locals to contribute to this guide, and answer forum questions from others planning their move to The USA. Please contact us if you'd like to contribute.
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