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USA - Insurance Cover

Health insurance coverage in America is important to consider as its own entity, separate from your normal international health insurance plan. The USA has a renowned quality of medical care, but this medical care is also the most expensive in the world. As such, many international health insurance plans do not include cover for the United States, or include it as a separate add-on.

Obtaining coverage in the USA is important for anyone who is planning on visiting, whether you are travelling there temporarily, moving there as an expat, are an American citizen living abroad who is looking to go back home for medical treatment, or whether you are one of an increasing number of medical tourists visiting the States solely to use their high quality medical facilities. Due to the complex nature of the insurance system in America, it is advised that you consult with us and we will help you to find the best plan for your needs that meets with the technical and legal requirements of the American health system.

USA Cover Flag

Who Should Get USA Coverage?

  1. American citizens living abroad - If you are American that has moved overseas, you may want to return home for treatment. This could be for ongoing treatments of a pre-existing condition with a physician you have already built a relationship with, or it may be for the familiarity of home whilst receiving treatment for a new illness or injury. You may also trust the quality of care at home more so than the country you currently reside in. If this is the case for you, then you should make sure you have USA coverage as part of your international health insurance plan.

  2. Non-American travellers and expats - It is important if you fall into this category to look into an insurance plan in the USA, as America has the most expensive healthcare in the world. Medical bills for even the most minimal of treatments can be a shock to unexpecting foreigners. Getting expansive USA coverage ensures that you will transfer these high costs on to your insurer, and so should be an important part of any plans to travel or move to the United States.

  3. Medical tourists - Medical tourists are those who plan on travelling to a country solely to receive medical treatment there. If you are planning on going to America for medical tourism, then you presumably will be intending to take out an USA insurance policy anyway. America attracts many medical tourists due to it’s high quality medical centres and healthcare professionals. Most of these tourists come from China, India, and Russia, and are visiting the USA solely to gain access to the healthcare system. If you are going to America as a medical tourist, we highly recommend obtaining USA health insurance coverage to account for the high cost of treatment at US healthcare facilities.

The Importance of Coverage in the USA

Whilst you have the option of not getting insurance coverage when you visit the United States, we would advise against it. America, whilst having high quality medical care, also has incredibly expensive medical care. The cost of treatments in America has increased through inflation year on year by an average of more than 10%. This means that depending on what treatments you receive, you could be facing a bill ranging from hundreds of thousands to even millions of US Dollars.

With insurance, you can gain access to the best hospitals, doctors, clinics and surgeons throughout the country without having to worry about massive bills. Medical facilities in America are often associated with certain insurance networks, known as PPOs, which mean that provided you have a plan with an insurer in a PPO, you can access any facilities across their entire network. Without insurance however, you may not be granted access to treatment at any medical facility in the USA, and if you are, it will be at a high cost. PPO networks run across all States, however each State’s laws may differ, so if you know where you will be living in or visiting, we can advise you on the right plan accordingly.

Things To Consider About Your Plan

Which Insurer Should I Choose?

There are a number of different health insurers, both international and in America that will give you cover for your stay in the USA. How can you choose the right one then? We have highlighted 4 important criteria to consider:

  • How long are you going to be staying in the USA? This will determine whether you need a short-term or long-term plan. If you are moving to America permanently, this limits the available insurers to you, whereas if you are travelling through, or visiting for medical tourism, then you will have a wider range of insurer options.

  • Where in America are you going to be? If you know the State(s) you will be spending time in, then make sure to tell us, as different insurers will be licensed in different States, or may only have some policies available in some States. Once we know where in America you will be staying, we can let you know the extent of the PPO network available to you.

  • Your Nationality. Whilst this may seem strange, not all insurers in the United States can cover all nationalities. We can help you to clarify if, and through which insurer you can get coverage.

  • How frequently will you be receiving treatment in America? If you need health insurance for medical tourism, then it is safe to assume you will only occasionally be receiving treatment. If you are moving to America long-term, then you will need more cover, as you may have to frequently visit treatment centres. Choosing a plan that suits you for the frequency of treatments is important as this will affect your premiums.

Can I Be Treated in Other Countries?

You can typically be treated on an International Private Health Insurance plan in other parts of the world as well as the United States. Insurers even often prefer treatment overseas as the cost of medical treatment in America is so high, and treatment elsewhere means they will save money comparatively. However, there are exceptions to this ability to be treated globally, so make sure you tell our advisers exactly what it is that you need from your coverage, and we will find you the right plan.

Can I Choose My Doctor/Hospital?

We generally only advise you to purchase plans that allow you to choose your facility and doctor or surgeon, as this grants you the most choice for your treatment. However, in America there are some exceptions that limit your treatment capabilities. These limitations surround the PPO network your insurer belongs to. PPO networks limit where you can receive treatment to those places and doctors within your insurer’s PPO network. If you want treatment anywhere not in your insurer’s network, this can be extremely challenging, or even impossible. We therefore recommend that you find out the extent of an insurer’s PPO network before signing up for a plan with them, especially if you have a hospital or doctor that you specifically want to receive treatment from.

Premiums

How much will I pay? How Is It calculated? How do I pay it?

  • How High?  - Premiums are high in America because of the high cost of treatment. As such, you will want to keep your costs as low as possible. We recommend doing this by only obtaining cover for what you will actually need cover for, as opposed to larger encompassing packages. For example, make sure you are not being charged for pre-existing cover or maternity cover if you do not need it. By creating customized plans, you can manage your costs. Customized plans are available from several insurers, and you can ask our advisers for further details on which ones are applicable.
  • How Are They Calculated? - A number of things are used to calculate your premiums, such as the extent of the coverage you want, whether you have any pre-existing conditions, your age, whether you are opting for any deductibles, and whether you are purchasing a long- or short-term plan (more information on short-term plans)
  • How Do I Pay My Premium? - Premiums are typically paid in one annual fee. Insurers realise that sometimes people would prefer to pay their premiums in monthly instalments though, and this option is available. If you choose to opt for monthly payments, then there will be a small additional surcharge added to your premium.

          Questions and Answers from Visitors

          1. Joel Miller:

            I'm an American who has a WOFE in Shanghai and also own an apartment there. I travel frequently but less than 6 months/year and on a business F visa. Any way you can save me on a worldwide plan that covers the US also?

            Reply

          2. Stephen:

            Hi Joel,

            Yes, we can certainly help you. In brief, here at Pacific Prime we are an international broker, working with 30+ insurance providers. Our goal is to offer the widest range of plans available so you can find the option that best serves your needs and budget. We are proud to offer this impartial service at no charge to you. We will be happy to send you a comparison after our consultants have understand your needs.

            Reply


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