US Health Insurance - Guide to the US Healthcare System in English 2022


US Health Insurance - Guide to the US Healthcare System in English 2022:  

How Does the US Health System Work?

Healthcare in the United States is organized in a complex bureaucracy. While healthcare facilities in the rest of the world are mostly owned by governments or private sector businesses, a large proportion of hospitals and clinics in the US are owned by private non-profit organizations.

US Health Insurance
US Health Insurance

Nevertheless, the United States is the country with the highest health care spending in the world. While these expenses are covered in large part by public payers, federal institutions, or state and local governments, they can also be covered by private insurance and individual payments.

Also, unlike most developed countries, the US health system does not provide health care to its entire population. Since there is no single nationwide system of health insurance, the United States relies primarily on employers who voluntarily provide health insurance coverage to their employees and dependents.

In addition, the government has programs that cover health care expenses for vulnerable sections of society such as the elderly, the disabled and the poor. These programs differ from one another, and all have a specific type of people who are subject to it.

Getting health insurance in the US is not an easy thing. One might think that once you have the money everything becomes easier, but in reality things are a bit more complicated. One must be very careful and choose the right insurance.

Health Insurance in the United States for non-Citizens

The United States government does not provide health insurance for all of its people, and health insurance is not mandatory for those living in the US. This is optional, but highly recommended and necessary as health services are very expensive anywhere in the world compared to any other country.

US Health Insurance
US Health Insurance

There are two types of health insurance in the US, private and public. Most people use a combination of both. American public health insurances are: Medicare, Medicaid, and the Children's Health Insurance Program.


Medicare is a national health insurance program that has been in place since 1966. It provides health insurance for US citizens over the age of 65, but also health insurance for people with end-stage kidney disease, ALS, and certain other disabilities.
US Health Insurance
US Health Insurance

Data shows that in 2018, Medicare provided healthcare to nearly 60 million individuals in the US, of whom more than 51 million were over the age of 65.

The Medicare program is divided into four parts:
Part A - which includes hospital, skilled nursing and hospice services.
Part B - Covers outpatient services including services of certain providers during inpatient in hospital Outpatient hospital fee

US Health Insurance
US Health Insurance

Part C - an option called Managed Medicare, which allows patients to choose health plans with at least the same service coverage as Part A and B, often Part D benefits, and an annual out-of-pocket expense The limit in which a and b fall short of . Part A and B must be signed in fist to sign this part.
Part D - Covers mostly self-administered prescription drugs.


Medicaid is a federal and state program that helps people with limited income and resources cover medical costs, while benefits not normally covered by Medicare are covered such as nursing home care and personal care services. goes.

US Health Insurance
US Health Insurance

It is the largest source of funding for medical and healthcare services for low-income people in the United States. The data shows that the US provided health insurance to people with low income or disabilities, who make up 23% of the total US population.
Children's Health Insurance Program

Formerly known as the State Children's Health Insurance Program (SCHIP), this is a program that covers health insurance children from families with modest incomes that are not high enough to qualify for Medicaid.

The Affordable Care Act – Obamacare

The Patient Protection and Affordable Care Act is a federal statute signed into law by President Obama that makes it mandatory for every citizen to have health insurance or be penalized. The Act subsidizes low-income families by taxing healthcare providers and high-income families, as it was designed to lower health care costs while providing better health care for Americans.

The Affordable Care Act allowed parents to advertise their children in their policies until the age of 26, to pay premiums to young healthy people. It also allowed poor people to seek treatment for chronic diseases instead of using the emergency room.
US private health insurance

There are about a thousand private health insurance providers in the US, each offering different plans with different prices, depending largely on an individual's medical history. However, where there are individual plans, covering only one person, there are also group plans specifically targeting families.

Usually, there are three types of health insurances in the United States:

Traditional fee-for-service health insurance plans that are usually the most expensive are hard to buy for people with below average incomes in the US. However, these are the best plans as they provide you with the most flexibility.
A health maintenance organization (HMO) that offers a limited choice of healthcare providers, yet also offers a lower co-pay and covers the cost of more preventive care. They are evaluated and accredited by the National Committee for Quality Assurance.
Preferred Provider Organizations (PPOs) that offer lower co-pays, like HMOs, but give you more flexibility when choosing a provider, as they give you a list of providers from which you can choose.

How to Choose a Good US Health Insurance Plan?

When looking for a good health insurance plan make sure you ask questions like:
Does that plan entitle you to visit any doctor, hospital, clinic or pharmacy of your choosing?
Are specialists such as ophthalmologists and dentists involved?
Does this plan cover special conditions or treatments such as pregnancy, psychiatric care and physical therapy?
Does the plan cover home care or nursing home care and prescription medications?
What are Deductibles? Is there a co-payment?

What is the most you will have to pay out of my own pocket to cover expenses?

Make sure you also understand how a dispute about a bill or service is handled by your provider, as in some plans, you may need to ask a third party to decide to resolve the issue. We recommend the GeoBlue Explorer plan for foreigners in the United States
Health Insurance Requirements for Foreign Visitors to the US

Although the United States authorities have not mandated health insurance for short-term travelers to the country, as B-1/B-2 visa holders, it is highly recommended for each traveler to obtain insurance before traveling to the country .

The main reason you should get insurance is because healthcare is extremely expensive in the US and even a simple headache will cost you hundreds of dollars for a check-up, while a broken limb will cost you thousands. Have to do

Health related events are never foreseen, so it's best to be prepared and get insurance, so you save yourself money when you need it.

Health Insurance Options for Legal Immigrants

Immigrants legally residing in the United States are eligible to obtain private health insurance in the United States. In addition, lawful immigrants may also be eligible for reduced monthly premiums and lower out-of-pocket costs, depending on your income, as follows:
Those whose annual income is 400% or less of the federal poverty level may be eligible for premium tax credits and other savings on Marketplace Insurance.
While people with annual household incomes that are below the 100% federal poverty level are not otherwise eligible for Medicaid, they are eligible for premium tax credits and other savings on Marketplace insurance, provided they meet all other eligibility requirements.

Most of the time, "qualified noncitizens" are eligible for coverage through Medicaid and the Children's Health Insurance Program (CHIP), given that they meet the income and residency regulations of the state where they are located.

“Qualified non-citizens” are considered the following:
lawful permanent resident
Refugee, refugee, victim non-citizen and spouse, child, or parent, victim of trafficking and his or her spouse, child, sibling, or parent or individual who has a trafficking visa pending for victim application is
Cuban/Haitian Entrants,
who are on parole in the US for at least one year
Conditional entrant granted before 1980
A member of a federally recognized Indian tribe or American Indian born in Canada, prohibiting deportation.

However, after qualifying, most of them will have to wait up to 5 years in the US to receive Medicaid and CHIP coverage in the US. Refugees and asylum seekers are exempted from the waiting period.

In addition, states have the option to eliminate the 5-year waiting period for children and pregnant women so that they can be covered by Medicare and CHIP.

You can get a free US health insurance quote here. While you are free to choose the plan that suits you best, we recommend GeoBlue Explorer.
Health Insurance Options for Illegal Immigrants

Illegal immigrants in the US can only obtain health coverage from private providers, as health insurance funded by the US government does not cover them.

Community centers can provide medical assistance to undocumented immigrants in the US, called safety net providers, if the healthcare seeker can participate in a fee for service medical assistance.

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