Expat's guide to the American health system

Many thousands of British expats move to the United States of America for work purposes every year. It offers so many great opportunities, both for career prospects and family life. However, as with any relocation, there are some hurdles that need to be overcome to make the transition as smooth as possible.
One key area to consider fully before moving is that of healthcare; in the event of falling ill abroad, ensuring that the right treatment is available, accessible and affordable is very important. The US healthcare system is a common topic in international media, and it’s a contentious issue. Debate aside, British expats need to know where they stand and how they pay for services before moving to the country.

Essential health insurance

First and foremost, health insurance is essential. While it’s not law that expats are required to have medical insurance in place, without it, the cost of medical treatment is incredibly high and many facilities simply won’t treat without the right insurance. As hospitals are all privately owned, there is no NHS equivalent to fall back on. Apart from emergencies, most clinics won’t do any form of treatment without prior payment, evidence of insurance or a deposit – and not all insurance is valid at all hospitals.
Expats don’t qualify for government medical aid, so if it’s possible to get health insurance included in a work benefits package, this is a high priority – most employers will offer health insurance to its employees, although they may only pay part of the premiums. It’s also advised to get the very best within budget to cover all eventualities and not get stung by high costs for procedures outside of the policy. A low-budget plan might not cover all the tests and scans that American doctors are prone to ordering, which all need to be paid for by the individual.
The cost of the health insurance itself is also incredibly high – the US is the world’s most expensive country for seeking and receiving medical care. This is why many Americans might find themselves in a job role that they aren’t happy with, but it offers a good health plan for their family, which is seen as a huge incentive to stay put. There are UK insurance companies that can offer cover, but many have limitations after the first year for long-term residents in the US, which means finding a US-based insurer instead.

Research and claims

Picking the right insurer and policy is essential. Some have more limited access to doctors and hospitals, but are cheaper. For freedom of choice over facilities and medical staff, higher-level policies are recommended. Those with pre-existing conditions will have a harder time negotiating a good deal, or may find it hard to get insured at all – which is why it is so important to have everything in place before a planned move.
As the theme of healthcare in the USA is high cost, it comes as little surprise that prescription medicines are expensive. It’s important to keep all receipts to be able to claim back from the insurance company. In fact, for every doctor’s trip, medicine taken, treatment received, etc, paperwork will need to be filled in and receipts kept so that claims can be made to the insurance company, which can take some getting used to when coming from the NHS system in the UK. Claims are not always straightforward either, as insurance companies love to find a reason not to pay out, so be mindful of the wording in the policy.
On the positive side, the hospitals and medical staff are world-class, modern and highly trained, so once in the doors, the level of care is fantastic and expats are well looked after.
If you’re moving to the USA, find out how our international removals team can help to arrange packing, storage and transportation on your behalf.
Information correct at the time of publication.