US Health Insurance for Expats: What You Need to Know

The American healthcare system is notoriously complex and expensive. For expats moving to the USA, understanding health insurance isn't optional - it's essential. Here's what you need to know.

Why US Health Insurance Matters

Unlike most developed countries, the US has no universal healthcare. Medical costs without insurance can be devastating:^[?]

• 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 most common option. Your employer typically pays 70-80% of premiums, and you pay the rest (usually $100-500/month). This is the best option for most expats with corporate jobs.

2. Health Insurance Marketplace (ACA)

If your employer doesn't offer insurance, you can buy coverage through the Affordable Care Act marketplace. Costs vary by state, age, and income, but expect $300-700/month for decent coverage.^[?]

3. International Health Insurance

For expats on short-term assignments or those who travel frequently, international plans from providers like Cigna Global or Allianz can be good options.

Key Terms to Know

• 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 Good Coverage Costs

For a comprehensive PPO plan with 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

Tips for Expats

• 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