Health insurance USA simply explained
Again and again one hears that people in the USA have to pay enormous costs for hospital stays themselves, because they have no health insurance. But this does not have to be the case.
This article shows which health insurance USA is recommended for travelers, emigrants or those on a work trip. One thing in advance: there is a suitable insurance model for every case.
Is health insurance mandatory in the USA?
During 2010 and 2018, U.S. residents were required to have health insurance as part of Obamacare, a law that made it mandatory for most residents to have health insurance. If one did not do so, a penalty had to be paid in the form of extra taxes.
However, as of 2019, health insurance is no longer mandatory in the U.S.¹ The American health care system is generally very different from the German health insurance system.
Does German health insurance apply in America?
If there is insurance coverage in Germany via the statutory health insurance, this coverage also applies in other EU countries. For this, the European insurance card is required.
The situation is different if you want to use the German GKV in the USA. Because in third countries usually no costs are refunded. As always, however, there are exceptions, e.g. if it was not previously possible to take out private supplementary insurance due to age or pre-existing conditions.
In this case, however, the rejection of the application must be submitted to the patient’s own health insurance company before departure. In addition, a prior confirmation of insurance coverage by the health insurance company is required.
Another exception concerns the case that a treatment is only available in the USA. In this case, the costs may also be covered in part or in full.²
A work assignment by the employer can also be a reason for the German health insurance to continue to pay for treatment abroad.³
In short: German health insurance only applies in a few cases in the USA.
Just visiting? International health insurance for the USA
If you are only traveling to the U.S. for a certain foreseeable period of time, then travel health insurance for the U.S. is sufficient. If you are sent abroad by your employer for work, in many cases even the German health insurance will continue to be responsible for you.
The travel health insurance for tourists
If you are planning a trip to the USA, you should take out travel health insurance for this time. This is usually tied to your stay abroad and is quite inexpensive to get.
However, in return you get protection in case of illness abroad. Depending on the health insurance you have to pay the premiums yourself and get reimbursed afterwards or the insurance pays from the beginning without you having to pay for the costs yourself.
Since the costs of treatment in the USA can quickly amount to five-digit sums, the former option is recommended.
Be ideally prepared for the trip to America.
In addition to your health, sooner or later you will also have to think about how you will pay and receive money in America. With the free multi-currency account from Wise, you can convert euros into US dollars without an exchange rate surcharge. You also get your own American bank account if you wish. Use your account anywhere in the world with the optional debit card.
International health insurance for business travelers and work stays
Not every travel health insurance for the USA includes business trips at the same time. If it is not explicitly included, the insurance coverage usually only applies to personal travel.
For business trips, it is therefore advisable to take out international health insurance for business travelers. This will cover the costs even in a business context and you will not get into trouble.
It is often the case that the German statutory health insurance also covers the costs abroad, as long as it is a work assignment. In this case, the employer pays the treatment costs incurred, but is reimbursed by the insurance company.