Expat Healthcare and Private Medical Insurance in the USA


The USA is known as being the country that spends the majority of its national wealth on health, compared to any other state but the outcome achieves relatively poor results. 40 countries, including nations such as Chile, have a greater life expectancy than the USA while the nation boasts about having the greatest medical expertise and world’s finest clinics.

In 2009 America spent 17.4% of GDP on health which is far above the rich country average of 9.6%. In the country where consumerism is very strong and residents expect value for money, it is surprising that the nation’s health is not flourishing.  Over half of the medical industry’s huge total bill is paid by individuals from their own pocket. The OECD average publicly funded health care is 72% compared to US health care which is only 48%.

In the US health care is provided by private hospitals and clinics as most citizens have medical insurance. The medical insurance is generally provided by the citizen’s employer which extends to their immediate family. Employers have recently asked workers to contribute to their own medical insurance as the health care costs have continued to grow. Residents who have retired can get aid through help of the Medicare programme which is available.

 

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US Inflation and counter-measures

Compared to other advanced countries, the US has suffered higher rates of medical inflation. The attempts to take action for the price rises have centred on preferred provider organisations and health care management organisations.
Preferred provider organisations are subscription based and their aim is to give members discounted treatment rates within a broad network of preferred hospitals and primary care clinics. They negotiate with providers to set rates and settle any disputes between the members and providers.

Health care management organisations are group insurance bodies that route patients through selected clinics, hospitals and doctors where prices are pre-agreed. The aim is for greater cost containment than that offered by the preferred provider organisations.

USA land of the free

The US does not demand that holidaymakers and expatriates have medical cover, unlike most advanced countries, however the US Embassy in London recommends buying cover in advance or as soon as their arrival. The embassy have previously stated that medical insurance is important to have as only emergency cases are treated without prior payment and treatment can be refused if there is no evidence of insurance or a deposit.

Medical insurance costs

Insurance can be very costly however it is worth it if you don’t want your life savings drained after a medical emergency. Insurance advisers recommend comprehensive insurance for the US rather than budget. One reason for this is that American doctors tend to order more tests and scans than what is normally provided in Europe. Tests are often expensive and are often not covered in most budget plans. Budget plans roughly cover in-patient care only and the tests may be ordered in out-patient consultations.

The one year catch

If a person is a permanent resident in the states beyond the first year, not all providers can offer cover. After their first year in the US they may have to find cover with a US based company. Broker Stephen Walker, of Medical Insurance Services states, “If a person is considering an eventual return to the UK to live, it would be wise to look to an insurer such as BUPA or Axa PPP, who have a capability to transfer to a UK domestic policy, which is much cheaper than an international policy.” On the other hand, a US insurer offering a UK domestic plan would fulfil requirements.

 

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Within the healtcare system

An attempt to improve cost-effectiveness of US health care has overall failed.  Hospital managers, doctors and drug companies wisely maintain a system which works out more for them than their patients. In the US fraud is said to account for a 10 per cent loading on prices. The process of taking legal action by patients caught up in medical errors not only increases professional indemnity costs, ultimately paid by patients, it encourages doctors to do more hi-tech diagnostic tests than required in order to cover themselves against future claims.  In the US buying drugs is more expensive than anywhere else in the world, however a medical consultation for trivial conditions are needed.

Vaccinations Required

Up to date immunisations are a must if you have school aged children and are staying in the US for long periods of time. This protection is required against diphtheria, measles, poliomyelitis and rubella. Schools in majority of the states also require immunisation against tetanus, pertussis and mumps.

HIV Positive Visitors

USA has long relaxed its controversial entry an on HIV-positive visitors, there individuals must apply at the US embassy for a waiver of inadmissibility before entry to the US.

 

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