Health in the USA: Everything about Insurance

3:41 pm  |  01.01.2022

The system of health insurance in the US is very complicated. Unlike most industrialized countries, there is no uniform state health care, but various private and government systems.


Since the treatment takes place at the highest medical level, the costs include the highest in the world. This also helps that American doctors and medical institutions can be sued for high compensation for errors. As a result, most American doctors are very thorough and tend to reinsurance, which increases the cost even more. Large parts of the American population have no health insurance at all.

Private Health Insurance

About two-thirds of all Americans are privately insured against disease. The vast majority receive private insurance via the employer. About 9 percent have their own private health insurance. Mostly these are freelancers and self-employed.

Medicare

This is a state health insurance for all Americans older than 65 years or those with recognized disabilities. More than 40 million Americans are assured under Medicare.

This state health insurance is intended for low-income citizens. The costs for this health insurance will be shared by the Union and the states. Each state sets out its own prerequisites for beneficial persons. Most things are about an income limit.

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Tricare

This is a state health insurance for soldiers, retired soldiers, and their dependent relatives. The protection of Tricare can take about 5 million Americans.

In addition, there are still nationwide or federal programs for American natives, pregnant women, and other groups.

Much of the population is not insured at all. This is in most cases because they deserve too much to fall under the State Medicaid program, but too little to have private health insurance. Although in 2014 the compulsory insurance was introduced and income-weak citizens receive state subsidies for health insurance, are still 29 million Americans without health insurance.

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EMTALA

This abbreviation stands for Emergency Medical Treatment and Labor Act, a law adopted in 1986 and offers uninsured or low-income persons basic care in medical emergencies. Almost all American hospitals participate in the Emtala program and more than half of all treatments in emergency photography and intensive care units fall under this law. Since the medical institutions must bear the costs of treatment themselves, they are transferred to the other patients with health insurance, another circumstance that drives the treatment costs to the height.

What Does This Situation Mean for the Tourists?

A disease in the US can be very expensive. Travelers should therefore complete foreign health insurance in good time before the flight.

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In any case, the tourist should not only have a receipt of the costs but a detailed list of measures that have been carried out which drugs were prescribed (with active ingredient) and how much has cost. Very important is also the “diagnosis code” and the procedure code, which must be on the bill. They then submit them after returning in their health insurance and thus get the costs incurred.

However, it is quite possible that the health insurance companies have their own forms that they then have to fill out or sign from the competent doctor. You would have to ask for your health insurance before the journey. Before starting treatment, it is recommended to pass a cost estimate.

How are the Needs of Medicines Regulated?

When the doctor prescribes medication, a copy of the recipe must be canceled and filed with the insurance. Recommended is also to pick up the packing yourself.

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Medicines are available in drugstores and pharmacies. Unlike in Europe, many supermarkets also have departments in which even prescription drugs are offered.

What If a Stay in a Hospital is Needed?

NYC Health Hospitals

This is one of the worst cases that can happen to a US trip. Even for a short stay, the cost can be several thousand dollars. This makes a pre-payment of the costs most not possible.

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Before admission to the hospital, the traveler must therefore be in contact with his foreign health insurance in order to clarify the issue of taking over the costs.

All insurances have emergency numbers for such occasions, which can be reached around the clock. In addition to the personal information, the number of the insurance policy is required.

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