Knowing About and How to Get Access to American Healthcare
Learning how to navigate the US healthcare system can seem like a difficult endeavor for newcomers to the country. However, it’s crucial to comprehend how the system functions and how to get medical care when you need it if you intend to live in or visit America.
This is particularly relevant given that neither US citizens nor foreign visitors are entitled to universal healthcare. The healthcare system in the United States is also the most costly in the world. Therefore, if you do not have sufficient health insurance to cover the expenditures, paying for medical care might be very costly.
Learn where to go in case of an emergency, how to get healthcare in the US, and how to keep costs down while visiting or living abroad.
An Introduction to American Healthcare
In the United States, hospitals, clinics, and other healthcare facilities are operated by a combination of public, private, and academic entities. The Affordable Care Act (ACA), often known as Obamacare, is a significant piece of healthcare legislation that was passed in 2010, despite the lack of a universal system. Most Americans now have easier access to health insurance, and there is a government healthcare portal for locating coverage.
For those who can afford it, the United States provides top-notch healthcare services. As a result, every year between 100,000 and 200,000 foreign patients come to the nation for medical care. However, because healthcare expenses in the United States are higher per capita than in any other developed country, this high-quality care comes at a high cost.
However, results are worse even when healthcare spending per person is higher. The United States came up at number 23, below nations like Italy, Singapore, and South Korea, in the 2023 U.S. News and World Report ranking of highly developed public health systems.
Finances and Spending on Healthcare
Compared to all other wealthy, developed nations, the United States spends a larger proportion of its GDP on healthcare – roughly twice as much per capita on average.
The majority of healthcare facilities in the US are privately owned and financed by a combination of out-of-pocket expenses, private insurance, and state programs. Consequently, the majority of people use a combination of personal cash and health insurance to pay for their medical expenses.
The American Healthcare System’s Advantages
The advantages of the American healthcare system set it apart in terms of innovation and medical care. Despite the fact that it might be costly and complex, individuals who are able to use it benefit from numerous advantages, including:
Choice of Care: If your primary care physician is in your insurer’s network, you are free to select them if you have health insurance. This enables you to choose a physician who best suits your requirements.
Emphasis on Prevention: Screenings for conditions like colorectal and breast cancer are easily accessible to Americans. Early detection aids in locating and addressing health problems before they worsen.
High-Level Care: The United States is home to internationally recognized medical institutions like the Cleveland Clinic and the Mayo Clinic, which are famous for their cutting-edge therapies and first-rate care.
Modern Medical Care: The nation is also home to some of the top hospitals in the world for specialty care, including brain surgery, heart problems, and cancer. These hospitals address severe conditions using the newest technology.
Numerous Facilities: Public and private hospitals, surgery centers, urgent care centers, and specialized clinics are just a few of the many healthcare alternatives available in major cities. This guarantees that patients will be able to get the care they require.
Telehealth Infrastructure: Patients can now see doctors from a distance because to the expansion of telehealth services. This facilitates access to medical care and guidance without requiring travel.
The American Healthcare System’s Drawbacks
Conversely, the American healthcare system has a number of drawbacks, including
Expensive: The cost of treatment can vary from few thousand to hundreds of thousands of dollars, depending on the disease or damage. Medical bills accounted for 58% of all American debts that were collected in 2021.
Unknown Coverage Gaps: In order to prevent increased costs, patients should confirm whether their physicians and hospitals are covered by their insurance. Your insurer might not pay the entire amount if you utilize an out-of-network provider, so you will be liable for the discrepancy.
Restricted Care in Rural Areas: Many rural hospitals are closing, and care alternatives are increasingly limited in smaller communities. This implies that in order to receive quality care, some patients must travel great distances.
High maternal mortality: is a persistent issue, particularly for women of color. A greater rate of C-sections than in other nations, untreated chronic illnesses, and inadequate prenatal care are all contributing reasons.
Inconsistent Women’s Healthcare: The U.S. Supreme Court decided in 2022 that states had the authority to decide for themselves whether abortion was permitted. Since then, certain regions have not managed pregnancy issues in accordance with accepted medical practices.
US Healthcare: Who Can Get It?
In the US, access to healthcare is not dependent on having health insurance, and it is not required at the federal level. Nonetheless, obtaining insurance is a smart move in order to prevent hefty medical bills in the event that you become ill or are hurt. Additionally, if you don’t have coverage, certain states may charge you a tax penalty.
Your employer might offer you health insurance if you’re employed in the United States. Additionally, Healthcare.gov offers “Marketplace” coverage, which satisfies the ACA’s minimal requirements. Both citizens and “lawfully present” immigrants can enroll in these schemes.
Most states do not allow undocumented immigrants to enroll in Medicaid programs. However, Medi-Cal, the state’s Medicaid program, is open to all Californians, regardless of their status of immigration.
Be advised that occasionally insurance coverage is restricted to a specific state or geographic area, even if you qualify for a U.S. plan. Consider an international insurance plan with more comprehensive coverage if you intend to travel within the United States or if you wish to visit other nations while utilizing the United States as a home base.
Is Healthcare Universal in the United States?
No, one of the few affluent, developed countries still lacking a universal healthcare system is the United States. Nonetheless, certain people do receive healthcare from the government. Medicare is available to certain younger disabled people, and the Veterans Health Administration offers medical services to veterans and elders over 65.
Medicaid is a government-funded health program that benefits low-income people, pregnant women, people with disabilities, and many children. Medicaid eligibility differs from state to state.
You will either require private insurance or be responsible for paying for your own medical treatment if you are not eligible for Medicaid. Approximately 90% of Americans have some kind of health insurance, despite the fact that it is not legally required. You can get your own insurance if your employer does not offer it.
Benefits offered by various health insurance policies vary. Large corporations that pay for their employees’ medical expenses directly are exempt from the requirements of the Affordable Care Act (ACA), commonly referred to as “Obamacare.” Plans that do adhere to ACA regulations, however, have to include the following:
- Visits from doctors
- Preventive treatment (vaccinations, for example)
- Laboratory tests
- Birth control
- Prescription drugs (but each plan may cover different drugs)
- Getting pregnant and giving birth
- Services for mental health
- Hospital treatment, both inpatient and outpatient
- Physical treatment
- Dental care for people under the age of eighteen
Notably, individuals typically require separate insurance for dental and eye care.
Can Foreigners Get US Public Health Care?
Except in specific circumstances, non-citizens are often not eligible for Medicare or Medicaid. Although there are certain exceptions, the majority of individuals who meet the requirements to be considered “lawfully present immigrants” must wait five years before they can become eligible.
However, the Marketplace, the health insurance marketplace offered at healthcare.gov, is open to the majority of foreign nationals in the United States who have any type of legal status.
Can Travelers in the United States Access Public Health Care?
Visitors cannot get public healthcare in the United States since it does not exist. Regardless of whether a patient has insurance or not, hospital emergency departments must stabilize them.
However, when traveling to the United States, it is advisable to have travel insurance that covers medical expenses. This will speed up your treatment and enable you to get more care than is necessary without incurring large costs later.
How Visitors or Expats Can Access US Healthcare
In the United States, having health insurance is a must for accessing healthcare. If you’re moving to the US for employment, you most likely have access to health, dental, and vision insurance through your employer, just like many Americans do.
Employees nearly always have to pay insurance premiums and deductibles, but your company will typically cover a portion of this coverage. Family members of an employee, including children under the age of 26, are typically covered. Adding family members, however, raises the premium and deductible, as you might anticipate.
Healthcare.gov is another way to get private health insurance. People with lesser incomes are assisted by the government in paying for this coverage. Adult dental care may be included in some of these plans, but if not, you can locate separate dental plans on healthcare.gov.
Access to healthcare for foreign visitors to the United States is typically restricted to emergency situations, such as visiting a hospital’s emergency room.
How a Visitor or Expat Can Get Emergency Care
Everyone who enters a hospital emergency room in the United States must be treated. However, going to an urgent care center is usually preferable unless you are in a life-or-death scenario.
See our article on U.S. hospitals for further information on how to get hospital treatment and what to do in an emergency.
Preventive and General Care for Foreigners in the United States
In the United States, many persons have a general practitioner or primary care physician who treats minor ailments and manages preventive care, including health screenings. In order to have a regular doctor to see for both illness and preventive treatment, parents typically register their children with a pediatrician.
Certain insurance plans may require you to see your primary care physician before visiting a specialist, but other policies let patients see a specialist right away. As always, confirm that the doctors you see are in-network, which indicates that they have a contract with your health insurance company that allows them to take your insurance’s payment schedule. Otherwise, the cost of your care will be higher.
Interestingly, you don’t need a recommendation to schedule an appointment with an eye doctor or dentist. These healthcare professionals could work alone or in a larger practice. To prevent incurring additional fees, be sure they are covered by your dental or vision insurance.
Recommended and Required Immunizations
In the United States, immunizations are available at pharmacies, clinics, and doctor’s offices. These vaccinations are frequently covered by health insurance. Vaccinations are not now necessary in order to enter the United States.
Foreign governments typically advise that routine vaccines be current prior to travel, even though the United States does not require vaccinations for entry. These comprise vaccinations against COVID-19, rotavirus, chickenpox, shingles, pneumonia, meningitis, tetanus, diphtheria, measles, mumps, rubella, pertussis, polio, hepatitis A, hepatitis B, and tetanus. Before you go, you should get personal advice from your physician.
It is required to be vaccinated against mumps, measles, rubella, polio, tetanus and diphtheria, pertussis, Haemophilus influenzae type B, hepatitis A and B, rotavirus, meningococcal disease, varicella, pneumococcal disease, seasonal influenza, and COVID-19 if you are leaving the country and intend to stay permanently.