How does the American health care work?

Question

I`m not from the US and wonders how it works, I`ve heard it is real bad. Please give costs, examples and such. Thanks.

Answer 1

It really depends on what type of plan you have. HMO (Health Maintenance Organizations) really aren't so great. You pay less out of pocket per month (usually) for your actual insurance coverage, but it's a hassle...you have to pick your primary care doctor from the insurance company's list of providers, or they won't pay anything. Once you see this doctor, if you need bloodwork, tests, a visit to a specialist, you have to get referrals from this doctor for EVERYTHING. Many doctors who accept HMOs lose a cut of the money that the insurance company gives them every month each time they refer a patient to a specialist doctor, or order an expensive test. Many of them try to treat the patient themselves instead of referring them to a doctor who is more qualified.

A PPO is better. The monthly premium you pay is generally more expensive than what someone who has an HMO would pay, but you can pick your own doctor, don't need referrals for anything, etc. The insurance company has a list of "preferred providers" meaning that they have contracts with these doctors. You can also pick your own doctor (who may not participate/have a contract with your insurance company, but he/she will still file claims on your behalf. Generally when this happens, the insurance company will pay slightly less than they would if you chose one of their preferred doctors--about 10% less, usually.

Prescription drug coverage is really about the same for most. Most insurances have a tiered payment plan $10/$30/$50, depending on the drug you need.

I am very fortunate in that my employer pays my health insurance premium every month, so it's free for me. I pay $15 to see any doctor (my regular family doctor, my gynecologist, my neurologist, etc.), and most other tests/bloodwork/procedures/surgeries are covered at 80% of the customary rate. (In other words, if I have a test done that costs $100, insurance pays for $80 and I pay for $20.

If I go to the emergency room, I pay $100; for urgent care, a visit costs $35. I also have a deductible of $500 to meet before anything major is paid. For example, a month or so ago I was diagnosed with a stomach ulcer. My deductible was $500, and the ultrasound they did was $502. I paid for that completely. That's it though--now, everything I have done is paid at the normal 80%.

There's a lot more to it than this--really all depends on the type of plan you have. There are more than one type of PPO--with some of them, you can pay less out of pocket for your monthly premium, but then instead of your deductible being only $500, it's actually $1,000. One good thing about HMOs is that there's no deductible to meet.

My children are covered under different insurance now, but when I covered them, myself and my husband through my employer sponsored insurnace, it was about $600 per month for the whole family.

Answer 2

Well for starters you'd better have some really good health insurance. Unfortunately, we're not like Canada which has "National Health Coverage."


Also a 2 day hospital visit (depending upon your diagnosis and tests that are needed ) can run into the thousands!

Answer 3

Clearly you supposed "United Statesian well being care" no longer "American", America just like Europe is a CONTINENT with 37 American international locations. When you are saying "American" referring most effective to United Statesians you gallantly brush aside over 70% of America and over seven hundred thousands Americans. Would you adore it if seven hundred million non-Uninted Statesian Americans confer with Europeans once we talk of Germans? They are in any case essentially the most strong European country.

Answer 4

it's great if you can afford it.

if you can't, and if you're poor enough or old enough, you might qualify for a basic level of service that can vary quite a bit in quality, but tends to be of quite limited resource.

The USA has never opted to make decent medical care a right; it is still basically a commodity.

Answer 5

while your working to pay for your insurance, the insurance company sneaks up behind you. You probably can see where i'm going w/ this.