The U.S. Health Care System
The American health care system is the most expensive in the world. On average, it represents nearly 15% of an American household’s budget. A medical consultation can sometimes cost several hundred dollars and medical operations can reach huge amounts. It is common for patients to end up paying six figures for hospitalization. There is no mandatory health insurance plan in the United States. As a result, many citizens are uninsured and hope to never have to undergo a medical operation.
How does the U.S. health care system work?
The American health care system is financed by non-mandatory private insurance companies and two main federal programs that target only a portion of the population:
Medicare, which covers people over 65 years old and people with specific diseases. In particular, kidney disease requiring dialysis. Medicaid, which covers the poorest part of the American population (20%).
The cost of medical care in the United States is extremely high and a large majority of the population cannot afford it. This is why, in 2014, Obama introduced the Affordable Care Act or Obamacare or “the Affordable Care Act” which is a major reform of the American health care system. This law requires all citizens to purchase health insurance from a private insurer on
Healthcare.gov. The government regulates an insurance market and provides financial aid to enable 32 million Americans to obtain health coverage. This policy is based on an equal redistribution of public funding between the poor and the healthy populations in order to cover as many people as possible. Are expatriates subject to the Affordable Care Act?
The status of expatriates is very specific and President Trump has signed an executive order restricting the
conditions of application of the Affordable Care Act – ACA.
Expatriates are concerned by the ACA as soon as they live more than 12 months on the American territory or if they have a greencard. They must have health insurance. This does not mean that they have to buy a local American insurance because there are many exemptions. It is just necessary to have health insurance for the USA. If you work for a company with more than 50 employees, you will probably be required to purchase company health insurance that is mandatory for all employees in the company.
The health situation related to Covid-19 in the United States
To enter the United States, you must have a complete vaccination schedule and a negative PCR/antigen test done one day before the day of departure (at any time of the day). A person who does not have a complete vaccination schedule due to having contracted the virus within the last 6 months will not be allowed to board. Only children under two years of age are not allowed to be tested before boarding.
How to consult a general practitioner or specialist in the USA?
Consulting a general practitioner or specialist in the United States is extremely simple. If you have a network of practitioners such as with GoldExpat insurance, you can visit our website listing practitioners and if not, there are many applications offering you the possibility to connect with medical practitioners according to your geographical location. You will also be given the doctor’s level of recommendation if you are unsure.
To consult a doctor, you can also book a consultation in a hospital or clinic.
Consultation with a general practitioner: $120 to $230 Consultation with a specialist: $300 Consultation with a pediatrician: $200 Consultation with a gynecologist: $125 325 mg tablet of tylenol (paracetamol equivalent): $14 Diabetes-related medications: $500 to several thousands USD/year Pediatric service in the United States
The average cost of a pediatrician visit if you are not yet insured is about $150. If your child is a newborn and the pediatrician comes to your home frequently to make sure your child is growing well, you can expect to pay up to $3000 per year.
Paramedical care in the United States
Paramedical care (physical therapy, physiotherapy, podiatry…etc.) in the United States can be covered by private insurance. This is highly recommended given the high cost of consultations. Booking a consultation with a physiotherapist can be done on the internet. There are many physiotherapists who have websites where you can book a consultation, which can be done in their office or online.
The cost of a consultation with a physiotherapist is between $75 and $350 and the cost of a session with a training session is $225. GoldExpat insurance allows you to take advantage of a medical network in the US that offers discounts of more than 50% on these types of fees.
What is the cost of medical operations in the United States? Maternity without complications: $25,000 Appendicitis surgery: $15,000 Covid-19 treatment: $73,000 MRI: $1000 to $5000 Coronary bypass surgery: $75,000 Knee replacement surgery: $25,000 Standard dental exam: $50 to $200 Dental extraction: $50 to $900 Dental implant: $1000 to $3000 Cesarean section: +$15,000 Cataract surgery: +$3000 Root canal treatment: $300 to $2000 Tonsil surgery: $4000 to $8000 Gallbladder surgery: $10,000
A dental appointment can also be very expensive in the United States. While a simple dental consultation costs $50, a dental extraction costs $280 on average.
How much does it cost to be hospitalized in the United States?
On average, a night in the hospital costs at least $10,000. However, if your hospitalization requires intensive care, the bill may be much higher. Hospital prices are very high because insurance companies negotiate prices with individual hospitals. In addition, insurers do not have any discounts on drugs. In other countries, organizations negotiate prices with hospitals and drug manufacturers.
MRI: $1000 to $5000 Blood tests: $100 to $3000 X-ray: $150 to $3000 Health care networks in the United States
In the United States, private insurance companies dominate the market. Many private insurers are in direct partnership with healthcare networks. Sometimes these insurance companies and the health care networks are the same entity. There is a very large health care network in California, Kaiser Permanente, which is one of the largest, if not the largest, health care network in the United States, with more than 38 hospitals, more than 622 outpatient clinics and other locations. The network has more than 18,000 physicians and 180,000 employees, including 50,000 nurses. These health care networks allow policyholders and insurance companies to reduce the cost of care if policyholders only consult health care personnel from the same network.
A criterion for choosing a health insurance for the USA is the medical care network it is affiliated with. Our insurances allow you to benefit from the negotiated hospital rates of the best healthcare networks. For our expatriate insurance plans you have access to over 690,000 medical practitioners, 6700 hospitals and 68,000 pharmacies.
Emergency Department in the US
If you are looking to contact the emergency service, be aware that calling an ambulance has a price (between $400 and $1200 and $2000 to $200,000 for a rescue helicopter). Ambulances, like most of the U.S. health care system, are privately owned and therefore their service has a cost. There are two types of emergency services:
Urgent Care: emergency service designated to the management of everyday accidents such as sprains, angina etc… This emergency service is much cheaper than the second one. Emergency Room: This emergency room is designed to take care of serious accidents, extreme situations where the victim’s life may depend on it. The care will be direct without waiting, however this emergency service has a very high cost.
The emergency number in the United States is 911.
Pregnancy and Childbirth in the United States
The cost of a maternity ward in the United States is extremely high, and can be as high as $60000 for the entire maternity ward. You will be able to choose the gynecologist who will accompany you throughout your pregnancy, which will determine the hospital in which you will be assigned. During the birth, you will have 3 options: at the hospital, at the birthing center where midwives and coaches will follow you during the birth. Finally, you can decide to give birth at home with the help of midwives who will come to your home.
Price of an ultrasound: $1000 Price of an MRI: between $1000 and $5000 Do I need health insurance in the United States?
If you are an expatriate, or plan to expatriate to the United States, it is mandatory to take out international health insurance. Indeed, medical expenses in the United States reach exorbitant amounts. Taking out an international health insurance policy will prevent you from going broke at the first major medical intervention.
In addition, the French social security system will only cover you for the first 6 months or even the first 3 months. The coverage will be at the level of the rates charged in France, that is to say much lower than the rates in the United States.