How Does the US Health System Work?
The USA healthcare system is organized in a complex bureaucracy. In the US, a sizable portion of hospitals and clinics are owned by private non-profit organizations, Nor like to the rest of the world where healthcare facilities and hospitals are managed by governments or commercial enterprises.
Yet, when it comes to global healthcare spending, the United States spend more budget than any country. Although half of these costs are paid for by the USA government, state and local governments, and private insurance, individual payments may also be necessary to cover these costs.
At the same time, unlike most developed countries, the US healthcare system does not offer healthcare to every member of the populace. The United States mainly depends on companies who willingly offer health insurance packages to their employees, as there is no single national health insurance program.
Furthermore, the government offers programs that typically pay for healthcare costs for some groups of the society, such as the impoverished, the elderly, and the disabled. These programs are different from one another, and all specially made for some group of people.
In the US, Getting the health insurance is not a simple task. Although. Some people believe that everything is simple once you have money then you can buy and choose an insurance plan easily, the reality is that things can get more complicated. To choose the best insurance, one needs to exercise extreme caution and diligence.
Health Insurance in the United States for non-Citizens
Not everyone in the United States is covered by the government, and residents of the US are not required to carry health insurance. Although it is not required, it is strongly advised because in the USA the healthcare cost i must higher than any other country in the world.
There are 2 different kinds of health insurance in the USA: public and private. The majority of people combine the two. The Children Health Insurance Program, Medicare, and Medicaid are the US government health insurance programs.
Medicare
Medicare is a 1966-established national health insurance program. In addition to older US citizens 65 years of age and up, it also covers younger individuals with end-stage renal disease, ALS, and other disabilities.
According to data, nearly 60 million Americans received healthcare from Medicare in 2018, with over 51 million of those people being over 65 Years of age.
The Medicare program is divided into four parts:
Part A: Hospitals, skilled nursing facilities, and hospice services are covered in this part.
Part B: Covers outpatient services, outpatient hospital charges, and the services provided by certain providers while an inpatient at a hospital.
Part C: Managed Medicare, also known as Part C, is an option that allows patients to choose health plans with at least the same service as Parts A and B, frequently the benefits of Part D, and an annual out-of-pocket spending cap that A and B do not. One must sign in Parts A and B fist in order to sign in this section.
Part D: Covers mostly self-administered prescription drugs
Medicaid
Medicaid is a federal and state program that assists individuals with low incomes and resources in paying for medical expenses. It also include other benefits such as personal care services and nursing home care centers which are not include in Medicare insurance plan.
For low incomes families and individuals in the US, this is the main source of funding for medical and healthcare services. Recent Data shows that over 71 million individuals with low Incomes, or 23% of the US population overall, had access to health insurance in the USA.
Children’s Health Insurance Program USA
In This children’s Health Insurance Program, also known as the State Children’s Health Insurance Program (SCHIP), provides health insurance to children of families with modest incomes who do not meet the requirements for Medicaid.
The Affordable Care Act – Obamacare
President Obama signed the “Patient Protection and Affordable Care” Act, making it mandatory for all citizens of the USA to obtain health insurance programs or face the penalties. In order to reduce the healthcare costs while improving access to healthcare for Americans, the Act implements taxes on high income people and healthcare providers, and subsidizes low-income families.
In an effort to get younger, healthy people to pay, the Affordable Care Act allow parents to add their children up to the age of 26 to their insurance policies. And also this act made it possible for those with less money to receive chronic illness treatment insted of visiting the emergency room.
US Private Health Insurance
In the US, there are estimated to be a thousand private health insurance companies providing services. These companies offer different plans at varying cost points, which are mostly determined by an individual’s medical background. Though there are individual plans that only cover one person, there are also group plans designed specifically with families in mind.
In the US, there are three different kinds plans of health insurance:
Traditional fee-for-service health insurance plans
Health Maintenance Organizations (HMOs)
Preferred Provider Organizations (PPOs)
How to Choose a Good US Health Insurance Plan?
Make sure to inquire about the following when searching for a suitable health insurance plan:
Does that plan give you the freedom to visit any doctor, hospital, clinic, or pharmacy of your choice?
Are specialists like dentists and optometrists covered?
Does the plan include coverage for unique ailments or therapies like physical therapy, mental health care, and pregnancy?
Does the plan cover prescription drugs that a doctor may recommend as well as home care or care in a nursing home?
It’s important that you are aware of how your provider handles disputes pertaining to bills or services, as certain plans may need that the matter be resolved by a third party.
Requirements for Foreign Visitors to the US with Health Insurance
It is strongly advised that all visitors obtain health insurance prior to their trip, even though B-1/B-2 visa holders and other short-term visitors are not required to do so by US authorities.
The primary justification for getting insurance is the high cost of healthcare in the US; a simple headache check-up can run you hundreds of dollars, while a broken limb can cost thousands.
Since health emergencies are never predicted, it is best to be ready for them and obtain insurance so that you can save money in the event that you need it.