How do I choose insurance for the U.S.?
It doesn’t matter which company you choose to get health insurance for your trip to the U.S. It is much more important that the policy meets the following conditions.
Valid throughout the United States. Be careful not to accidentally buy insurance that works in every country in the world except the United States. Also pay attention to make sure that the policy is valid in all states of America, especially if you plan to travel a lot.
Amount of insurance coverage. The amount of insurance must be at least $50,000. The best option is considered to be the insurance for 75 thousand dollars.
Minimum insurance package. The policy must cover expenses for doctor’s visits and hospitalization, outpatient treatment and stay in the hospital, purchase of medical medications, and return home based on medical indications.
The tourist policy does not cover treatment of chronic illnesses. However, sometimes reimbursement may be available for life-threatening, chronic ailments. Most policies also do not provide reimbursement for dental care, or for help with STDs and mental health issues.
Travel insurance is not an opportunity for free medical treatment in a country with highly developed medicine. The policy covers the financial costs only in case of unforeseen circumstances that led to the need to see a doctor. All risks are spelled out in the contract in as much detail as possible. For example, if you plan to engage in sports (especially extreme kinds) in the USA, you will need a special insurance.
The Cost of Insurance in the USA
The cost of health insurance for a tourist depends on several factors. The most important one is the list of services included in the policy. In addition, the price is influenced by:
- duration of stay in the country;
- amount of coverage;
- age of the tourist;
- the presence of chronic diseases, etc.
On average, basic insurance for a week costs $14. But do not try to buy the cheapest option, and always study the terms of the contract carefully. As a rule, a slightly more expensive policy turns out to be considerably more favorable, because it covers much more expenses.
IMPORTANT: Only non-residents may purchase travel medical insurance. If you live in the U.S., you will need an American medical insurance policy.
Insurance in the United States
Health insurance for residents has nothing in common with a travel insurance policy. It is much more expensive, operates under a completely different scheme, but also includes a wider range of services. In fact, it is a contract with the insurer, according to which the beneficiary (i.e. the insured person) pays a monthly fee. In turn, the insurance company helps reduce or fully repay the cost of medical services if needed.
Insurance is mandatory for Americans and permanent residents. If the policy is not in place, the citizen faces a penalty of nearly $700 or 2.5% of annual income. But even having a contract with an insurance company does not mean that you can be treated for free. You should still pay, and often quite a substantial amount.
How does the policy work? Important terms
You show your policy to the receptionist each time you go to the clinic. It reads all information about your insurance conditions. After your appointment at the doctor’s office you will be told if you have to pay anything or not. But it is impossible to understand what and why you pay for yourself and what is covered by the insurance company without knowing the basic terms.
Premium – a monthly fee paid by the insured to the insurer’s account.
Co-payment – a fixed amount that the insured person pays on his or her own for medical procedures or for the purchase of medications. You can find out in advance from the insurance company what Co-payment you will have to pay for a specific service. The insurer pays the necessary balance.
Deductible is the amount of money in the contract, which you must spend on medical services from your own pocket according to the Co-payment scheme in order for the insurance to work on more favorable Co-insurance terms.
Co-insurance. A percentage that reflects how much the insurance company pays for therapy or your medications and how much you pay for yourself. For example, 80/20 means 80% of the cost is covered by your insurance, but you pay 20% anyway.
Out-of-pocket limit. The maximum amount that you can expect your insurer to continue to cover 100 percent of your medical expenses when you spend out-of-pocket for treatment in a year.
Let’s look at a concrete example. Let’s assume you have insurance with all the options listed. Then the policy works according to the following scheme.
The insurance year starts and you occasionally visit doctors and buy medications. Some services you get for free according to the law or because they are stipulated in your insurance. For the rest, you pay Co-pay, which is a flat fee. If there is no Co-pay in the plan, the full cost of the service is paid.
Co-pay continues until the amount spent reaches Deductible. After that, you pay an agreed-upon percentage of the fixed Co-pay surcharge (i.e. Co-Insurance). The insurer covers the rest.
When personal expenses reach the Out-of-pocket maximum, you stop paying anything at all, and the insurance company takes care of all the costs of your treatment.
When the insurance period ends, Deductible and Out-of-pocket are reset, and everything starts over again.