Study Overseas

Studying in the USA will be a defining time in your life, full of new people, exciting opportunities and unforgettable experiences. Hopefully, you will stay healthy and have no need for medical care while you are there. But here's a short guide to healthcare and health insurance in the USA, just in case.

The healthcare system in the USA is excellent, but it can be complicated and expensive to access. There is no national or socialized health system except Medicare (for retired people) and Medicaid (for low-income people), neither of which are available to international students. Therefore, private health insurance is a necessity for international students, just as it is for most Americans.

Most Americans receive their health insurance through their employer, though many employers now require payment of some portion of the premium by the insured employee. And regardless of insurance coverage, there are still out-of-pocket costs that an insured must pay. Deductibles, co-pays, co-insurance, out-of-network charges, uncovered expenses -- even for Americans, trying to decipher an "explanation of benefits" from an insurance company can be extremely difficult. However, if you are planning to study in the US, a little bit of effort to understand health insurance basics will pay off greatly.

Here are some tips and factors to consider for maximizing the benefit you get from your health insurance and accessing the US healthcare system.

1. University Insurance vs. Private Insurance.

All US colleges and universities require international students to have health insurance, and many provide a health insurance plan available for purchase. A few schools require that you purchase the university health insurance plan, with no exceptions. Most schools allow you to "waive" out of the school plan if you show proof of comparable coverage, and they will typically have a specific waiver form to do that. Many students want to waive the university insurance plan, because it is often overly comprehensive and expensive in relation to an international student's needs and budget. Some schools offer no plan at all, and simply leave it up to you.

2. Understanding your policy.

Whether you are required to purchase your university plan, or you find an alternative private insurance plan, you should invest a little effort to read and understand the plan. This will also help you compare plans as you shop. Does your plan have a network, or can you go to any provider with no financial penalty? Does your plan provide maternity, mental health, and sports coverage? Does it cost more in co-pay or co-insurance to go to the emergency room at a hospital? To help you get started, here is a brief explanation of some important common terms:

Deductible

This is the amount you must pay out of your pocket towards medical expenses before the insurance company is obligated to pay - outside of the USA this is also known as an excess. Typically, deductibles are anywhere from $50 to $500, and they can be applied per year, or per injury or illness. Often, deductibles are reduced if you visit the Student Health Center at your school.

Co-insurance

This refers to the portion of expenses that you must pay after the deductible is met. A typical co-insurance provision may require that you pay 20% of the first $10,000 in covered expenses, which could require up to $2,000 out of your pocket.

Co-pay

Many plans require a co-pay for a doctor office visit, a hospital stay, or other care. Like co-insurance, this means that you pay a portion of the cost of each visit - often $20, $30, or $50 for a doctor office visit, and sometimes $200 or more for a hospital stay.

In-Network/Out-of-Network

If your insurance policy has a network, your out of pocket expenses will be greatly increased if you visit a provider outside of that network. Make sure your plan either has no required network, or if there is a network, make sure there are plenty of in-network healthcare providers (doctors and hospitals) in the area where you will be attending school.

URC (Usual, reasonable and customary)

This refers to the amount that an insurer will typically pay for a service or procedure. Insurance companies will not pay $5,000 for a procedure that should cost $2,000.

3. Use your university health system.

Even if you do not purchase your school's healthcare plan, it will save you money and time if you visit your school's student health center. Often services are available for free or at greatly reduced rates. When you do have to pay, many private student insurance plans will discount the deductible if you use the student health center instead of an off-campus provider.

4. Plan on some healthcare expenses.

Even with your insurance plan, you should plan on having to spend additional money out of pocket for your healthcare. It's important to remember that American healthcare is extremely expensive, so even though the $700 or $1200 or $2000 per year that you will spend for your insurance seems like a lot, it is not. Most Americans pay a whole lot more -- for example a healthy family of four would expect to pay an insurance premium of $750-1,000 per month, and still have significant out of pocket expenses. You are purchasing protection against traumatic expenses, and you are buying access to an expensive system. Unfortunately, you are not buying the right to all necessary healthcare at no additional cost.

Doing a little research before you leave can pay big dividends in health, financial security and peace of mind while you are away, which will allow you to concentrate on the exciting adventure of your international education.

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