Insurance/Finance

Find out how the System Works in the US

Find out how the system works in the US

Although the cost of medical expenses is very high in the US, there really is no local health insurance.

However, there is a public system for a certain category of people that is divided into two different programs: Medicaid and Medicare.

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Medicaid targets poor people and families (about 11% of the population), while Medicare covers people over 65 and those with disabilities (about 15% of the population).

The rest of the population has no option but to take out private health insurance, either through their employer or individually.

A significant proportion of Americans are not covered by any insurance plan, as they earn too much to qualify for Medicaid, but not enough to have private individual insurance.

In 2009, with a view to implementing a “fairer” healthcare system, President Obama introduced his new US healthcare reform (ACA, Affordable Care Act).

This reform has been progressively implemented and aims to provide all Americans with access to medical care and benefit from basic health coverage.

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See a doctor in the USA

American general practitioners see their patients in their office or in private clinics, and generally Monday through Saturday, 8:30 am to 6:30 pm.

Certain clinics are also open on Sunday.
If you have taken out private insurance, you can only go to a doctor who belongs to the medical network of your private insurance. It will be your attending physician.

During the consultation, you will be treated by a nurse who will check your blood pressure, ask you if you are taking medication and ask you to describe your symptoms.

Afterwards, you will wait for the doctor to examine you in a small room. Generally speaking, doctors see several patients at the same time and consultations only last a few minutes (10 to 15 minutes maximum).

Consultation fees vary depending on whether or not the person has insurance.

So don’t be surprised if one of the first things you’re asked when you make your appointment is whether you have health insurance and what insurance, as rates vary from one insurance plan to another.

For the same service provided, consultation fees range from $80 to $300 on average.

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Specialty doctors in the USA

If you have a more specific illness, your treating physician will refer you to a specialist doctor in your insurance company’s medical network.

These doctors are called “in-network” doctors. If you go to a specialist doctor without having been referred by your treating physician and/or an “out-of-network” specialty physician.

As is the case with general practitioners, specialist physician consultation rates vary significantly.

More often than not, fees are higher for consultations with specialty physicians than consultations with general practitioners.

Fees can start at $150 and go up to excessive amounts (about $300 for a consultation).

Being admitted to a hospital in the USA
North American Hospitals
North American hospitals use advanced technology and high quality medical equipment. Medical personnel also provide high quality care.

There are three types of hospitals in the US:

Public hospitals where you can be admitted without having an insurance plan. Still, they are not free.

If you are not covered by an insurance plan and you have to pay a significant amount for your medical expenses, hospitals may allow you to pay in installments.

In all cases, you will have to pay the invoice in full.

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US private hospitals

As is the case with GP appointments, you will be asked to show your insurance card before any medical procedure.

Consultations are carried out in the same way as general practitioner consultations: a nurse provides initial medical care and then the doctor sees the patient or the scheduled surgery is performed.

In general, there are emergency services for you to be seen by a doctor as soon as possible, who will later transfer you to the appropriate service depending on your diagnosis.
The invoice will be sent later by this service and is usually very high.

Clinics without prior appointment work in the same way as GP appointments. There are more and more out-of-the-box clinics available in the United States.

They are slightly cheaper than hospitals and also provide emergency services.

In an emergency in the US: call 911 for rapid intervention.
Buying Medication in the USA
Medicines can be bought at pharmacies, which are usually located in supermarkets and different chain stores. There are many drugstore chains in the US.
As in the case of consultations, medicines are very expensive. Generally, the cost of generics is lower, but they must be specifically indicated in the prescription to be sold.
In the United States, medicines are delivered in a personalized way: you will receive the exact number of pills or capsules needed depending on the duration of your treatment.
As for over-the-counter drugs, they can be purchased in specific stores and supermarkets

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