How To Choose The Best Health Insurance In The USA After E2 Visa Approval
We discuss key points such as the U.S. health insurance industry, healthcare costs, Marketplace vs. Private providers, factors to consider, top insurance providers, and the process of acquiring insurance.
The U.S. Health Industry
Healthcare Is Expected To Increase to $6.2 Trillion By 2028
According to the Centers for Medicare and Medicaid Services, the U.S. national healthcare expenditure amounted to $4.3 trillion in 2021, or $12,914 per person, and is estimated to increase to $6.2 trillion by 2028.
Healthcare in the U.S. is more expensive than in most countries. The U.S. spent nearly 16.8 percent of its GDP on healthcare in 2019, followed by Germany at 11.7 percent and Switzerland at 11.3 percent. Despite the large amount spent on healthcare, most Americans are generally dissatisfied with U.S. healthcare, especially mental healthcare.
Here are some quick facts about the U.S. health industry:
The U.S. healthcare industry is worth $808 billion as of 2021.
From 2022 to 2029, experts predict a fifteen percent increase in job openings in the healthcare industry.
The average healthcare employee salary is $60,986 in the U.S.
The U.S. healthcare market is not efficient.
The amount you pay for healthcare depends largely on your city and state.
On average, employers cover eighty-two percent of healthcare costs.
Studies rank the U.S. as the thirty-fifth healthiest country in the world.
Twenty percent of American adults do not have the means to access healthcare.
Health Insurance In The USA
Cost of Healthcare And The Importance Of Having Insurance
According to the latest data on healthcare costs, the U.S. tops the list as the country with the highest healthcare cost in 2022, spending over forty percent more on healthcare per person than any other country in the world. Despite this, healthcare outcomes for residents are similar to other developed countries.
In the U.S., a single hospitalization costs staggering and can amount to around $20,000 for patients without insurance, including Medicare. Statistics from the Agency for Healthcare Research and Quality state that the average hospital day cost is around $13,600. It is no secret that the U.S. healthcare cost is more than most Americans can afford to pay on their own out of pocket, especially for unforeseen events like emergencies or accidents. Health insurance shoulders some of that financial burden. In 2019, monthly health insurance payments were around $599 per person or $1,715 for a family. The premium depends on location, age, plan, history of smoking tobacco, and whether one enrolls as an individual or a family.
Health insurance policy is, therefore, an assurance that provides immediate financial coverage in case of medical emergencies. It is an agreement between the policyholder and the insurance provider which covers medical expenses that might happen due to injury, illness, or accident. If you have a health insurance policy, then the insurance provider will pay some or all of the medical expenses, against which an insured person is supposed to pay a premium.
Health insurance is a relevant and politicized topic in the U.S. The number of people with health insurance in the U.S. was more than 300 million in 2021, or ninety-two percent of the population. The country’s health system is a mix of public and private insurers, but private is the main form of health insurance coverage for most of the population. In 2021, half of the insured population received private insurance via their employer, while over thirty-four percent were covered under public programs like Medicare and Medicaid. Due to the country’s lack of universal health insurance coverage, millions of Americans remain uninsured yearly.
Health insurance is important because it facilitates access to health care. It is associated in the U.S. with lower death rates, improved productivity, and better health outcomes. It is no wonder that over ninety percent of Americans choose to pay for health insurance, steadily increasing with almost twenty million individuals newly insured. Most newly insured individuals could pay through the Medicaid program, their employer, or the individual market due to coverage programs and market reforms brought on by the Affordable Care Act (ACA). Studies also confirm that health insurance coverage improves access to care, supports positive health outcomes, including a sense of health and well-being, and incentivizes appropriate healthcare resources. Most importantly, it reduces the financial burden on individuals, families, and communities.
ACA ensures that individuals cannot be charged more for health insurance based on gender or pre-existing conditions. It also ensures that every insurance provider covers the following, making it vital to U.S. citizens:
Outpatient care
Emergency services
Hospitalization
Pregnancy, maternity, and newborn care
Birth control
Mental health care
Substance use disorder services
Prescription drugs
Laboratory services
Chronic disease management
Preventative and wellness services
Pediatric services, including oral and vision care
Services and products required to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills
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Marketplace Vs. Private Health Insurance
Which one to choose?
The main difference between buying health insurance through the Marketplace and private providers is that Marketplace plans are offered through the government and, therefore, subject to government regulations. In contrast, private companies offer private plans and are subject to their own regulations.
Here are key differences to consider when choosing between the two options:
Cost – Marketplace plans are often more affordable. Private plans often have higher premiums but may offer more flexibility and customization.
Coverage – Marketplace plans are required to cover essential health benefits and cannot discriminate under ACA. Private plans may have more limited options and may exclude certain conditions.
Network – Marketplace plans often have limited networks, while private plans often have a broader network of providers to choose from. This is important when considering your location and how convenient your network is for your needs.
Customer service – Marketplace plans are offered through government-run exchanges; thus, its customer service may be limited. Private plans, on the other hand, have more personalized customer service and support.
Eligibility – E2 holders are eligible to purchase both Marketplace and private plans, but they are not eligible for premium tax credits or other financial assistance that often come with Marketplace plans. By default, private plans are not eligible for financial assistance. Thus, it makes no difference as both options do not allow E2 holders to acquire financial assistance.
Factors to Consider When Comparing Different Health Insurance Providers
Other than checking for the health insurance provider’s reputation and reviews from satisfied customers, there is other important information to consider to make an informed decision when comparing different health insurance providers, namely:
What are your medical needs for the coming year? Estimating how often you may require doctor visits or whether surgeries or hospital stays may be needed throughout the year is important. While it is difficult to account for emergencies and the unpredictable nature of needing healthcare for most people, this is easier for people with regular healthcare needs. Calculating how often you see a doctor on average or whether or not a condition will send you to the hospital to see a specialist will help determine which plan is best to cover your needs.
How much will it cost? How much do you want to pay out of pocket? The health insurance premium is paid for coverage, typically every month. Determining how much you can afford to spend on the insurance policy helps narrow your options. The premium is commonly the first and sometimes the only thing people scrutinize when choosing a plan. Finding the right insurance provider or plan is more challenging than picking the cheapest premium option. A lower premium only sometimes means lower cost overall. Generally, plans with higher premiums pay more of the total costs of your healthcare, while plans with lower premium pay less of the total costs of your healthcare. Thus, for those with conditions or who visit the hospital frequently, it is best to go for a higher premium to get the most coverage, which will otherwise be too expensive in the long run. In addition to the premium, other costs to consider include deductibles (how much you have to spend before your insurance starts covering further costs), copayments, and coinsurance (payments to the healthcare provider each time you receive health care. I.e., $20.00 for a doctor visit or thirty percent off hospital charges), and out of pocket maximum (the maximum you spend for covered services annually. After reaching it, the insurance starts to cover 100 percent of the proceeding costs).
Do you take regular prescriptions? Under the ACA, all health insurance plans must have some prescription drug coverage, one of the health law’s required essential health benefits. However, its coverage scope varies. Thus, if you take prescription medicine regularly, it is best to check if your chosen plan covers all of your prescription medicines, as it may cover only one drug from each category. Many insurance policies include a list of medicines covered under the plan. If a specific medicine is not covered, you must go through a long process to avail of coverage. Overall, it is best to go for the plan that covers the maximum number of medicines required.
Is your doctor included in the network? All insurance providers have a network of doctors and medical facilities they work with and are involved with. Receiving healthcare from out-of-network doctors may result in the insurance provider not covering the entire cost or denying your claim altogether. Thus, your regular healthcare providers must be part of the network you choose unless you are willing to find a new doctor who is in the network. In addition, your chosen plan must cover a good mix of facilities and providers in your area for convenience to avoid situations where you require urgent medical care but must drive a while to reach a healthcare provider in your network.
Does it come with practical benefits and features that you will actually use? Some insurance comes with additional benefits that may be of use, such as wellness programs, telemedicine services, discounts on gym memberships, and so on. It is best to consider if these features are worthwhile for you.
What is the insurance provider’s claim settlement ratio? This ratio points to one vital thing—what percentage of claims the company settled in a financial year. A higher ratio means the company is steadfast in settling its claims, which works in the insurer’s favor.
How to apply for health insurance?
The Process of Acquiring Health Insurance
Getting health insurance in the U.S. varies depending on individual circumstances and the type of health insurance you seek. Here are the general steps that may be involved:
Understand your eligibility – Health insurance is based on income, age, and employment status. As an E2 visa holder, you may not be eligible for government-sponsored programs like Medicaid or Medicare. Generally, only qualified immigrants are eligible for Medicare. Since E2 is a non-immigrant visa, you must opt for private health insurance providers. As for Medicaid, eligibility is based on income. Since E2 holders are not considered low-income individuals, they will not be eligible either.
Choose a health insurance plan – there are many private providers. It may be wise to consult with an insurance broker or agent to navigate options and select a plan that meets your budget. It might also be wise to consider international health insurance since E2 visa holders typically only stay in the U.S. for a limited period. International health insurance is designed for travelers or expatriates and can cover emergencies, illnesses, or accidents internationally.
Prepare your documents – some of the documents required are passport, visa documents, and other I.D.s (including your immigration status and proof of age), proof of residency (i.e., bank statement, utility, or lease agreement), proof of income or employment (i.e., pay stubs or tax returns), and medical reports if any (information about any pre-existing medical conditions). You may also need to provide documentation for your dependents, if any.
Enroll in your chosen plan – once you have made an informed decision on your chosen plan, you will need to register or enroll in it through the insurance company, the broker, or the agent. The simplest way is by enrolling online, which can be done in minutes. Review the policies and ensure they are acceptable before finalizing. Once your documents are uploaded, it is time to make the payment.
Pay your premiums: like any insurance, you must pay a premium to maintain your coverage. The amount will vary depending on your chosen plan, which typically factors in your health status, age, location, and so on. Insurance companies generally take a week or more to complete the full process and hand over the policy document to you.
You can get health insurance through:
A plan offered by employers
A parent’s plan for those under 26 years old
A health insurance company’s website
State health insurance marketplaces
The federal health insurance marketplace (healthcare.gov)
Online insurance brokers
In-person insurance agents
Government assistance programs like Medicare, Medicaid, and CHIP
The Veterans Administration or TRICARE for military personnel
Marketplace Vs. Private Top Providers
Top Marketplace Health Insurance Providers
Healthcare.gov – Healthcare.gov is the official Marketplace for health insurance under the ACA. It offers plans from various companies.
eHealth– eHealth is a private online marketplace offering plans from major insurance companies. It offers a wider range of options than Healthcare.gov, but these options may vary by state.
HealthSherpa– HealthSherpa is an online marketplace offering plans from major insurance companies, including Medicaid and Children’s Health Insurance Program (CHIP) options. It is known for its user-friendly interface and online tools to help customers find appropriate plans.
Pivot Health – Pivot Health is an online marketplace offering short-term insurance plans, a good option for those between jobs or who need temporary coverage only. The coverage may be more limited, but it typically has lower premiums.
Top Private Health Insurance Providers
UnitedHealthcare– UnitedHealthcare is one of the U.S.’s largest private health insurance providers and offers a variety of health plans for individuals, families, and businesses. It includes 1.3 million healthcare professionals and 6,000 hospitals and facilities.
Anthem Blue Cross Blue Shield – Anthem Blue Cross Blue Shield is another well-known private provider that offers various plans in many states. It includes 1.7 million healthcare professionals and 89,000 hospitals and facilities.
Aetna– Aetna offers a variety of plans, including Medicare Advantage and Medicaid plans. It is important to note that E2 visa holders are not eligible for both. It includes 1.2 million healthcare professionals and 5,700 hospitals and facilities.
Humana– Humana, like Aetna, also includes Medicare Advantage and Medicaid plans. It is also well known for its focus on wellness and preventive care. It includes over 550,000 healthcare professionals and 3,500 hospitals and facilities.
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Other Types of Insurance to Consider
Common Insurance In The USA
Here are other types of insurance for E2 visa holders to consider other than health insurance:
Car Insurance – Car insurance is required in almost every state. It can help protect you from huge expenses. By investing a small amount now in your protection, you can avoid costly expenses in the future. It can include coverages such as collision insurance, comprehensive insurance, property damage liability, and bodily injury liability. Additionally, the fallout from a car accident can be time-consuming and tedious. With the right coverage, you can avoid negotiating with the other parties involved and properly manage the cost of vehicle repair or replacement. Everyone makes mistakes, but sometimes another driver’s mistake can easily become your problem. With car insurance, you can have the peace of mind that you will be covered regardless of whose mistake resulted in an accident.
Property Insurance – Property insurance covers property protection for property owners in the form of financial reimbursement to the owner or renter of a structure and its contents in case of theft or damage. It can also provide coverage to a person other than the owner or renter if that person is injured on the property. Some common inclusions to the policies are homeowners insurance, renters insurance, flood insurance, and earthquake insurance.
Liability Insurance – Liability Insurance can protect against claims or lawsuits against you or your U.S. business. Unlike other types of insurance, liability insurance policies pay third parties and not the policyholders. It protects against claims resulting from injuries and damages to people or properties. It also covers legal costs and payouts on behalf of the insured party. However, it is important to note that intentional damage, contractual liabilities, and criminal prosecution are not covered.
Workers’ Compensation Insurance – Workers’ Compensation Insurance includes coverage for medical expenses and lost wages in case of a workplace illness or injury. It pays benefits to workers who are injured or become disabled as a result of their job. By accepting the benefits, the employee also waives the right to sue their employer for damages. Thus, it protects the employer while providing employee benefits, benefiting E2 business owners.