In France, we’re used to seeing healthcare reimbursed, whatever the cost, but that’s not the case everywhere. Even less so in the USA. If you’re thinking of moving to the U.S., passports, visas andU.S. health insurance are among the essential documents you’ll need for your expatriation!
A brief look at the healthcare system
In the United States, there is no universal social security system like in France. The system relies mainly on private insurance, although public programs such as Medicaid (for low-income people) and Medicare (for people over 65 and some disabled people) do exist.
Medical care in the USA is also very expensive, among the most expensive in the world. In fact, it is one of the leading causes of debt and insolvency in the country. Healthcare costs account for over 16% of the average American household’s monthly expenses. Medical care is among the most expensive in the world, making health insurance essential for expatriates, with costs continuing to rise every year. The price of a consultation with a general practitioner in the USA, for example, can vary from $100 to $300, depending on the state. A deposit of between $1,000 and $3,000 is often required before admission to an emergency room in the USA. In the event of hospitalization, costs can vary from $14,000 to $30,000, depending on the city. You should therefore take out expatriate health insurance before arriving in the United States.
What is Obamacare and what does it mean for expatriates?
The Affordable Care Act (ACA), also known as Obamacare, was designed to expand access to healthcare. Although the federal government removed the requirement for all US residents to purchase health insurance in 2019, some states still maintain this requirement. For expatriates, application of the ACA depends on the state of residence. It is therefore essential to check whether the state you are moving to still imposes this compulsory coverage.
MEDICAID and MEDICARE
There is no social security system like in France. However, there are programs to help the most disadvantaged.
- Medicaid is designed for low-income individuals and families, with eligibility criteria that vary from state to state.
- Medicare, on the other hand, mainly covers people over 65 and certain disabled people.
Recent expatriates generally do not have access to these programs, which are financed by income taxes. For expatriates, these programs offer few coverage options.
What kind of health insurance do I need for the USA?
Health insurance, or French social security, can no longer cover you once you’re working on foreign soil, here in the United States of America. To be covered, you have two options: take out international health insurance in France or local health insurance in the USA. Not having health cover in the USA is not an option, not only because of the cost of care, but also because it’s a legal requirement.
1. Joining a private healthcare organization in the United States
As we said, there are mainly private complementary health insurance plans (PPO, HMO and II). That said, if you want to take advantage of them, we strongly advise you to ask your employer (and if possible, your partner and/or children too) to cover the cost. Indeed, these health organizations can be expensive (average of $1,000 per month if you join a PPO or HMO plan).
Paid for by the hiring company
- PPO for Preferred Provider Organization: with private health insurance, you benefit from reimbursements similar to those in France, and the monthly contribution is paid by the company. Here, healthcare professionals are chosen by the plan (network doctors and hospitals).
- HMO plan (Health Maintenance Organization): brings together the insurance company and the care providers (who are sometimes salaried employees of the company) under the same umbrella. University students benefit from this HMO plan.
- plan II for Indemnity Insurance: these are entirely private companies, with no wage-earning activities.
Whatever health insurance plan you take out, before you move to the U.S., be sure to check the benefits offered and the coverage limits, to see if they are sufficient to cover your healthcare needs (medical, pharmacy, optical and dental).
Not covered by the company
In this case, you have several options:
- turn to ACA contracts (if available in your state)
- take out health insurance for expatriates in the United States (known as an IPMI expatriate contract)
- subscribe to the same type of international health insurance, in France, with French rates
FYI: expatriate health insurance policies, IPMI, are quite flexible and advantageous. You’re covered in France as well as in the U.S., there are no out-of-pocket expenses and you have a choice of healthcare providers. To keep costs down, you can take out a deductible to cover part of your expenses, and join the CFE(Caisse des Français de l’Etranger) to top up your coverage. For a single person, premiums can vary from $300 to 400 per month, and for a family, from $1500 to $2000 per month.
2.Expatriate health insurancein the USA
This is the option we recommend: the USA health insurance contract offers a degree of flexibility and coverage for the duration of your expatriation. Expatriate health insurance covers you in the U.S. as well as in France, and the offer is adapted to your family situation (single, couple, with or without children) as well as to your country of residence. Your healthcare costs are reimbursed in line with prices in the USA.
This option offers a certain amount of freedom. Please note that we are talking here abouthealth insurance for expatriates, whose benefits and coverage go beyond simple travel insurance.
A few tips for choosing health insurance in the USA
Given the high cost of expatriate health insurance in the USA, we advise you to find out all you can about your healthcare needs before you leave. Whether it’s for medical, optical or dental needs, check with the various expatriate health insurance companies to find out what cover they offer and what the maximum reimbursement is.
Don’t hesitate to contact our international health insurance comparator, Santexpat.fr, the CFE reference for the United States, now with a local subsidiary. Depending on your situation, age and country of destination, our experts will select the most suitable offers for you. Find out more before you move to the U.S. to anticipate any medical emergencies or accidents. Insurance can take several weeks to arrange, so it’s best to plan ahead.
