US health insurance – oh, the headache!

If there is one thing that unites foreign residents in the US in bafflement and frustration it is the US health insurance system. I have yet to meet anyone who has an uncomplicated relationship to their health insurance policy or who is completely happy with the effects it has on decisions regarding wellness and health care.

Most people who come to the US for work get health insurance through their employer as part of a benefit package — so far so good! Typically, the confusion and trouble start when you sit down to fill out the necessary paperwork. It’s not just that there are details needed that you may not have access to yet as a new arrival. There are decisions to make that have a real impact on what your health care will be like, ranging from what doctors you can see, to what extent certain types of care is covered and what kind of medications are available.

In addition, deciphering and comprehending the very specific language of health insurance is not easy. If you manage to figure out what the difference between a PPO and a HMO will mean in practical terms for you and your family, you are off to a good start! But, you will still have to decide what kind of monthly premiums you can bear and what type of co-pays make sense and whether you need access to specialist care or certain drugs. The fine print holds the details but I know from personal experience how impenetrable that text can be.

Too many times have I signed up for health insurance, after having researched and fretted for days only to later be confronted with the reality that nothing is quite as I thought. It could be that the particular medication I was sure was covered is only eligible for those under 25 years of age, or as a generic, or between the hours of 6am and 6:01am… I think it’s safe to say that I have never ended up with the insurance I thought I had signed up for – even when I have done my due diligence.

If you are staying in the US for a longer term then you are likely to encounter the hassle of having to switch insurance plans or even insurance companies. Not only is it a lot of work to once again fill out the paperwork, you are also faced with the possibility of your doctor not being part of your new insurance network, or the medication you have relied on not being covered to the same degree.

The cost of health insurance is another shocker for many newcomers. When I tell friends back home what my family’s monthly premium is, they are sure I’m kidding; as some of them point out, I pay close to half of what they make a month. When I explain that these are by no means the only costs, that we also have co-pays and deductibles, well, then they just laugh and shake their heads.

There is no doubt that you can get great health care in the US, there are many good hospitals, doctors and nurses. There is cutting-edge technology and specialists of all kinds. The tricky part is making sure that you have access to this amazing care and that is not always easy!

A couple of useful sources for information on health insurance:
Obama care facts
Health insurance glossary

By: Felicia Shermis