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Guide to the US Healthcare System

Health care within the United States is organized in a complicated bureaucracy. While elsewhere in the world, healthcare facilities are mostly owned by government agencies or private sector companies however, in the US the majority of clinics and hospitals is operated by private non-profit groups.

But it is true that this United States is the country which has the highest health expenses worldwide. While these costs are paid in large part by the public sector, such as Federal institutions, as well as local and State governments, they also can be paid for by private insurance or individual payment.

However in contrast to most developed countries however, unlike many developed nations, the US health system is not able to offer health services for all of its inhabitants. Since there isn’t a universal health insurance system that is available, it is the United States primarily relies on employers that voluntarily offer health insurance for their employees and dependents.

Additionally the government also has programs which pay for healthcare costs for the vulnerable segments of society, such including the elderly, disabled and those who are poor. The programs vary from one another and all of them have a particular type of person that they are affected by.

Health insurance coverage in the US isn’t an easy task. One might believe that once they have money, everything is to do, but the truth is things can be a little more complex. It is important to be cautious and make sure they pick the correct insurance.

Medical Insurance is available is available in the United States for non-Citizens

It is important to note that the United States government does not offer health insurance for everyone in the country and health insurance isn’t required for residents of the US. It’s an option, however highly recommended and essential since healthcare services are extremely expensive and more expensive than any other country in the world.

There are two kinds of health insurances available in the US that are public and private. The majority of people have a mix of both. There are three US state-run health plans include: Medicare, Medicaid, and Children’s Health Insurance Program.

The US has the highest-priced health care system in the world. It’s the reason why having a good insurance coverage for your health is highly strongly.


Medicare is a medical insurance scheme that began in 1966. It offers health insurance to US citizens over 65 years of age as well as younger individuals with end-stage kidney diseases, ALS or other impairments.

The data shows that in the year the year of 2018, Medicare offered more than 60 million patients with health care in the US more than 51 million of whom were over 65.

Medicare is a program that includes four parts: Medicare program is broken down into four components:

Part A, which includes hospitals as well as skilled nursing and hospice services.
Part B covers services for outpatients, including services provided by providers while you are at a hospital, and outpatient hospital costs
Part C is an alternative known as Managed Medicare that allows individuals to choose health plans that have minimum protection as the Parts A and B. It also has benefiting from Part D as well as an annual out-of-pocket spending limit, which Part A and B do not have. In order to sign in this portion you must sign the Part A or B.
Part D includes mostly self-administered prescription medicines.

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Medicaid is an American and state-wide program that aids people with low incomes and resources in covering medical expenses, and also cover the benefits that are not normally provided by Medicare such as nursing personal and home health care services.

It is the most significant source of financing for health and medical services for those with low incomes within the United States. The data shows that the US covered health insurance for the 71 million individuals who are disabled or have a low income that is about 23% of the US people.

Children’s Health Insurance Program

Previously named The State Children’s Health Insurance Program (SCHIP) This is a program that provides the health insurance needs of children from families with modest incomes but not sufficient to be eligible for Medicaid.

It’s the Affordable Care Act Obamacare Obamacare

The Patient Protection and Affordable Care Act (ACA) is an act of the federal government which was signed by President Obama who mandated every citizen to be covered by health insurance or face penalties. The Act offers subsidies for families with low incomes by taxing healthcare providers and wealthy families, since it was designed to reduce healthcare costs and provide more health insurance for Americans.

The Affordable Care Act permitted parents to add their children up to age 26 to their insurance policies in order to make healthier people younger paying for premiums. Additionally, it allowed people who are less fortunate to seek treatment for chronic diseases rather than relying on an emergency department.

US Private Health Insurance

There are around 1000 private health insurance companies in the US and each offering distinct plans at different costs, which are mostly based on the person’s medical history. While there are plans for individuals, that only cover one person, there are plans for families that are targeted specifically.

Typically there are three types of health insurance plans within the United States:

Traditional fee-for service health insurance plans that typically are the most costly and those with less than the average of the US will have a difficult time purchasing. But, they are the most beneficial plans since they provide the most flexibility.
Health Maintenance Organizations (HMOs) which offer a restricted selection of providers for healthcare, however they also offer lower co-payments and will cover the cost of preventative healthcare. They are evaluated and accredit from the National Committee for Quality Assurance.
Preferential Provider Organizations (PPOs) which as HMOs provide lower co-payments however they provide greater flexibility when choosing the right provider. They provide a list of providers that you can pick.

How do you choose a good US Health Insurance Plan?

When you are looking for a health insurance policy, make sure to ask questions like:

Does the plan provide you the right to visit any doctor or hospital, clinic, or pharmacy of your choice?
Specialists such as dentists and eye doctors are covered?
Does the plan include special circumstances or treatments, such as pregnant women, psychiatric treatment and physical therapy?
Does the policy cover nursing home or home care, as well as any medications which a doctor may prescribe?
How much are your deductibles? Do you have co-pays?
What is the maximum amount you’ll have to pay out of your own pocket to cover costs?

It is important to understand how a dispute over the service or bill is handled by your service provider and, in certain plans, you might require an independent third party decide on what to do about the issue. We suggest the GeoBlue Xplorer program for people who are foreign who reside in the United States

Health Insurance requirements for foreign visitors to the US

While it is true that the United States Authorities have not mandated health insurance for travelers who are traveling to the United States, as the B-1/B-2 visa holders are, however, it’s strongly advised for all travelers to purchase insurance prior to their visit to the United States.

The most important reason why you should have insurance is the fact that health care in the US is extremely costly. even a simple check-up for simple headache can cost hundreds of dollars and a broken limb could be a huge expense.

The possibility of health issues is never in the cards Therefore, it is better to be ready and purchase insurance so that should you need it, you will not be in a pinch.

Alternatives to Health Insurance Plans for Legally-Immigrants

Lawful immigrants on America. United States are eligible to obtain private health insurance coverage within the US. Additionally, legal immigrants can also be eligible to lower monthly premiums, and less costs for out-of-pocket expenses based on income.

People with an annual income of 400 percent or less of federal poverty threshold or less could be eligible to receive tax credits for premiums as well as other discounts for Marketplace insurance.
If their household incomes that are below the federal poverty line at 100% who are otherwise not qualified for Medicaid are qualified for tax credits on premiums as well as other benefits in the form of Marketplace insurance, provided that they satisfy all other eligibility conditions.

The majority of the time “qualified non-citizens” are eligible to receive coverage via Medicaid or the Children’s Health Insurance Program (CHIP) provided that they are in compliance with the rules of income and residency of the state in which they reside.

“Qualified citizens who aren’t citizen” are categorized as follows:

Permanent legal residents
Asylees and refugees, battered citizens and their spouses, children or parents who are trafficking victims and the spouse of the victim or sibling or parent or those who have a pending application to obtain the victim of trafficking visa
Cuban/Haitian entrants,
People who have been paroled into US US for at the very least one year
Conditional entrants granted prior to 1980
individuals who are that are granted withholding deportation, and people who are members of those who are part of a Federally recognised Indian Tribe or American Indian born in Canada.

But, the majority have to wait 5 year in the US before they can get Medicaid or CHIP insurance in the US once they have eligible. Refugees and asylum seekers are not subject to the waiting time.

Furthermore states can opt to eliminate the five-year time limit for waiting periods of children as well as pregnant women to allow them to be covered under Medicare or CHIP.

Healthcare Insurance options for illegal immigrants

Illegal immigrants in the US are able to get health insurance only through private health insurance companies, since the US health insurance program that is funded by the federal government doesn’t cover them.

Community centers are able to offer medical assistance to non-documented immigrants living in the US and are known as safety Net Providers, when the patient is eligible to participate in fee-for-service medical assistance.