Medicare and Medicaid, which are subsidised by the US government, are only available to those over 65, the disabled and the very poor.  The Affordable Care Act reduced the number of people without health insurance, but there were still around 10% uninsured.  Although under attack by the present administration its provisions are still in force.

There is no such thing as “free” treatment in America and even in urgent care clinics there is a cost. All care, including emergency care, will have to be paid for.  If your health insurance does not pay, you will need to pay and then make a claim.

As an expat moving to America will need to have good quality health insurance cover.  If your employer in the US will not be providing insurance cover you will need to be sure you have identified the cost for you and your dependents.

Doctors

It is best to identify your ‘primary-care physician’ or ‘family practitioner’ when you arrive in the US.  Recommendations from colleagues and neighbours will help to identify a suitable doctor.  Your ‘primary-care physician’ will refer you for any specialist treatment to one of the many specialist doctors in a local hospital.

For non-emergency care you should always see your primary care physician and you may need to pay for the appointment and then claim the cost back.  A visit to an Emergency Center in a hospital will be very expensive and should only be your first option in a genuine emergency.

Good records are essential to ensure you reclaim all costs and on your first visit you will need to provide details of your health insurance as well as your social security number and personal and contact details.

Doctors in America tend to refer you to specialists and carry out tests more readily than in other countries.  This driven by the litigious culture and a desire to ensure that there is no potential claim against them for failing to carry out tests or failing to refer you to a specialist.

As an expat moving to America will need to have good quality health insurance cover.  If your employer in the US will not be providing insurance cover you will need to be sure you have identified the cost for you and your dependents.

Hospitals

There are a number of different types of hospital in America.  Public hospitals are operated by the municipal authorities and are subsidised out of public funds.  These are more common in larger cities. They are not as expensive, but can be less well-equipped and can be very busy and under strain from uninsured patients.

Teaching hospitals are attached to many large universities.  They are well-equipped with high profile senior staff and can be an excellent choice for major surgery or serious illnesses.

Private hospitals provide excellent cover and are staffed by highly qualified doctors, but are expensive.  You need to ensure that your insurance cover is sufficient.  Some of these operated as chains by corporations that also sell medical insurance plans.

You should ensure that you always have proof of insurance coverage with you.  In most hospitals the insurance company will settle the costs direct with the hospital before you leave.  Without insurance, a deposit is usually required, which may run to several thousand dollars and if you are unable to pay this they will probably refuse treatment or transfer you to a public hospital where you may only receive critical treatment (ie. treatment for life threatening conditions).