Moving to the USA? Health insurance is non-negotiable. One uninsured hospital night can run into five figures. This guide explains types of US health insurance, costs, employer coverage, and what expats need to know before relocating.
Factor healthcare into your budget: New York | San Francisco | Austin
Why US health insurance matters
The US has no universal healthcare. Without a policy, medical bills can wipe out savings in a single visit:[?]
- Emergency room visit: $1,000-5,000
- Ambulance ride: $500-2,000
- Hospital stay (per day): $3,000-10,000
- Appendectomy: $15,000-50,000
Types of coverage
1. Employer-sponsored insurance
The default for most corporate hires. Employer covers 70-80% of premiums, you cover the rest (usually $100-500 a month). If you can negotiate this into an offer, do.
2. ACA marketplace plans
If your employer doesn't offer coverage, the ACA marketplace is the next stop. Costs vary by state, age, and income, but budget $300-700 a month for decent coverage.[?]
3. International health insurance
For short-term assignments or frequent travelers, global plans from Cigna Global or Allianz can make sense.
The terminology that will trip you up
- Premium: Monthly payment for coverage
- Deductible: Amount you pay before insurance kicks in (often $1,000-5,000)
- Copay: Fixed amount for specific services ($20-50 for doctor visits)
- Coinsurance: Percentage you pay after deductible (typically 20%)
- Out-of-pocket maximum: Most you'll pay in a year (typically $5,000-15,000)
What decent coverage actually costs
Ballpark for a comprehensive PPO plan with a reasonable deductible:[?]
- Single (through employer): $150-400/month
- Single (marketplace): $400-700/month
- Family (through employer): $400-1,200/month
- Family (marketplace): $1,200-2,000/month
What to do before you land
- Negotiate health benefits as part of your relocation package
- Choose a PPO over HMO for more flexibility
- Keep your home country insurance active during the transition period
- Budget for out-of-pocket costs beyond premiums
- Use HSA (Health Savings Account) if available for tax benefits
Run the numbers for yourself
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