Have you ever thought of having to pay $210 for a simple GP consultation? Amounts like this may seem staggering, but they are part of the reality of the more than 331 million people who live in the United States! Are you moving there soon? To avoid surprises, think now about choosing a suitable insurance plan to cover your healthcare expenses.
Until 2013, health insurance was not mandatory in the United States. But since the Obamacare reform, anyone not covered by their employer must take out private insurance—the amount of which depends in particular on the annual resources of each household.
This rule has been relaxed since January 1, 2019: people who have not taken out health insurance recognised by the US authorities no longer face financial penalties (as was previously the case) at the federal level. This change follows the amendment of the federal Tax Cuts and Jobs Act.
There are other US healthcare coverage systems in place. These are often complex, since the United States does not have a universal social protection system. They include:
Medicaid: medical assistance for low-income households (up to 138% of the federal poverty level).
Medicare: covers healthcare for certain categories of seniors and disabled people.
However, most people insured in the United States are insured through their workplace. In fact, since 2015, employers with more than 50 employees have been required to fund health insurance for their employees working at least 30 hours per week (unless they can prove an individual health insurance plan).
The US medical system is among the most expensive in the world. Consider, for instance, the following costs (1):
$290 for a specialist consultation
$210 for a GP consultation
$46,230 for appendectomy hospitalisation
Needless to say, taking out health insurance is therefore essential to cope with these high expenses.
To get cover via an American insurance plan, there are several possibilities:
PPOs (Preferred Providers Organizations) offer preferential rates from specific networks of doctors.
HMOs (Health Maintenance Organizations), which are less expensive, require their policyholders to consult doctors and healthcare facilities on limited lists.
IIs (Indemnity Insurances), or “classic” health insurance packages, are often the most expensive solution.The price of them depends on the level of benefits taken out.
When choosing your cover option, pay attention to the “copay” offered, i.e., the remaining cost for each type of care. Most US healthcare plans also have a “deductible”, which is an amount that must be met by the insured before being reimbursed. Note: Some plans do not cover care provided in another state. Travellers beware!
According to the Henry J. Kaiser Family Foundation, the average annual cost of an individual US health plan is $7739, and $22,221 for a family of four... (2)
Taking out international insurance offers several advantages to French expats across the Atlantic:
Continue to benefit from the French social security system by joining the Caisse des Français de l'Étranger, and by taking out a complementary international healthcare plan.
Take out an expatriate healthcare policy whose global cover is then effective from the 1st euro/dollar spent.
The advantage of these options? Benefit from a clear and readable reimbursement schedule, comparable to that of French healthcare solutions... but also, the ability to freely choose your doctors, and access to services that are very useful to expats (medical advice, care networks, repatriation assistance, etc.).
Going on a simple assignment, or moving more permanently? APRIL International accompanies you across borders every day. Discover the different levels of our MyHealth International solution for optimal cover of your healthcare expenses and those of your loved ones in the US.
(1) Reasonable costs of care in the private sector, APRIL International Care 01/2023
(2) Average annual premiums paid by employers
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