Healthcare in the USA

The USA has an excellent standard of healthcare, with cutting-edge facilities and highly trained doctors. However, federal health insurance coverage is limited to children, the elderly, the disabled, and low-income patients. Many expats don’t fall into any of these categories, meaning they must pay for treatment privately. This is expensive, however, and expats will need to be well insured in order to make use of the high-quality healthcare on offer.
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While public hospitals do exist across the country, they are few and far between compared to the number of private hospitals. The good news is that standard of care is likely to be high at both, and public hospitals are cheaper than private hospitals. However, treatment at public and private hospitals alike is still much more expensive compared to many other countries worldwide. Another downside is the long waiting times.
The majority of hospitals in the US are privately run, whether by non-profit community organisations or private boards of investors. While medical treatment is more expensive in private hospitals, adequately insured expats won’t have to worry about the bill at the end. Waiting times at private hospitals are much shorter than their public counterparts, and they also generally offer more comfort and privacy.

Some employers offer health insurance as part of relocation packages, so expats should find out whether this is in their contract. If not, it may be worthwhile to attempt to negotiate its inclusion. 

Private hospitals often ask for proof of the ability to pay for treatment – whether in the form of insurance, cash or a credit card. Unless it’s a medical emergency, those unable to show this may be turned away from private hospitals. Public hospitals, on the other hand, are legally unable to turn a patient away regardless of whether they are able to pay – but that’s not to say that patients won’t have to pay at all. They will still be expected to settle the bill.

There are plenty of chain and independent pharmacies throughout America. These are well stocked with both brand-name and generic medications, and expats are likely to find anything they need. Generics are preferable as they cost less, but not all medications have generic variants, in which case prices can be high. Receipts from medication purchases should be kept and submitted to one’s insurance company as proof of purchase for reimbursement.

In an emergency, expats can dial 911. Operators are able to assist in English and, in states with a large Hispanic population, Spanish. Paramedics are well-trained. However, ambulance response times vary by region, and while service is often fairly swift within city centres, more isolated, regional locations typically take longer to reach. The national average response time is 15 minutes.

By law, all hospitals must provide assistance in the case of a medical emergency, regardless of whether the patient is insured or not. However, expats should be aware that a hefty bill will be handed to them afterwards and they (or their insurance) will be obligated to pay. Also, once a patient is stabilised, private hospitals may refuse to provide further treatment.