TIPS ON HOW TO
BUY
INDIVIDUAL HEALTH INSURANCE
WHILE TRAVELLING IN USA
INDIVIDUAL HEALTH INSURANCE
WHILE TRAVELLING IN USA
--Luke S. Brown
If you are going to visit the US for
any extended period of time, it is a very good idea to plan ahead for the
chance that you will become ill or suffer an accident that requires medical care.
If you are coming to the US to work, you may have the opportunity to
participate in your employer’s group health insurance program. But if work is
not the reason that you are coming, you are probably on your own and may want
to purchase individual health insurance to protect you while you are here. By
“individual” I am not referring to a policy just for you; the term refers to a
private insurance policy for one person or a family.
Here is a basic checklist of how to
go about the process:
1. Find
a health insurance agent (sometimes called a “broker” if he/she represents
multiple insurers) with whom you can work and whom you feel a sense of trust.
You can get a referral from a friend, consult the telephone directory, check
the internet or locate someone whose office is nearby. You will want to make
sure that the agent is licensed to sell “life and health” insurance, although
he/she may also be licensed to sell “property & casualty” insurance.
Licensure can be verified by calling the Department of Insurance in the state
in which you live (usually located in the Capitol, there will be an office in
the Department of Insurance that can verify agent licensure)
The
agent does not have to become your best friend, but he or she should not treat
you as just “another customer”. Look for
someone who takes an interest in and understands your needs and objectives—especially
because you are unfamiliar with dealing with insurance in the US. This may take
some time, and may involve meeting with a few agents. There are many good online sources by which
to find and secure coverage, but an online transaction is often less personal
and more mechanical.
2.
When you decide on the agent that you are going to use, discuss
alternative kinds of health insurance. For example, historically, the main kind
of health insurance was called “fee for service”. This involved going to
whatever healthcare provider you wanted to go to, the provider submitting
his/her bill to the insurer and the insurer paying it. This has mostly been replaced
by forms of “managed care” where the insurer has implemented various kinds of
cost-savings devices such as requiring permission to see a specialist, or by
providing annual “wellness check-ups” without requiring you to pay a deductible
(which would be required for other kinds of doctor visits).
Sometimes
you can buy health insurance without going through an agent. This is often the
case if you wish to enroll in a form of health insurance called a Health
Maintenance Organization (HMO). There are various kinds of HMO’s, differing
mostly in the amount of choice you are given in the selection of a healthcare
provider. It is not really a question of one being better than another—it is
more a question of differences in how they operate and what you feel most
comfortable with. It may also be a question of cost, because the ones that put
the greatest limitations on choice are often the least costly (but that is not
the case all of the time or everywhere).
It is
very important that the insurer to which you will apply is licensed to conduct insurance
business in your State; this is referred to as being “authorized”. Call
Insurance Department to make sure. There are many scams, and you do not
want to get caught in one.
3.
Determine how much of the financial risk of illness or injury you can or are
willing to absorb. This will have a
bearing upon the premium that is charged for your insurance in a few ways:
●
Lifetime policy limits: Although
it is hard to predict future healthcare needs, health insurance can be
purchased with different lifetime limits.
This is the maximum that the insurer will be obligated to pay for
covered expenses while the policy is in force during your lifetime. In general, the higher the lifetime limits,
the higher the premium. The limits are
sometimes expressed in terms of an amount per person, or an aggregate amount if
multiple people are covered (such as a family).
Once the limits are exhausted, you will be responsible for the excess. This may not be a big issue if you are planning
on leaving the US after a relatively short time, but there is no telling the
amount of medical expenses that can be incurred in that time.
●
Deductibles: A deductible is
fixed amount of money that you are responsible for paying before the insurance
company’s obligation to pay for covered services is triggered. The deductible is usually expressed as an
annual amount. There can be different
deductibles within the same policy, such as a separate deductible per hospital
admission (instead of or in addition to the annual deductible). Deductibles may vary based on whether care is
received from a provider who is on a list approved by the insurer or not. You may choose the deductible that best suits
your financial circumstances from those offered by the insurer. Generally, a higher deductible will mean a
lower premium.
● Copayments:
A copayment divides or shares responsibility for medical costs between you
and the insurer. It requires you to pay
a fixed dollar amount when a medical service is obtained, and the
insurer is responsible for the remainder.
Based upon the medical services obtained, different copayments may
apply. Generally, a higher copayment can translate into a lower premium.
● Coinsurance: This refers to the percentage of covered
medical expenses that the insurer pays after the deductible has been met. Common coinsurance rates are 20-30% of the
amount the insurer has approved for the healthcare service. This means that the insurer will pay the
remaining 70-80%. Some health insurers
offer optional higher coinsurance amounts, which, if selected, usually reduces
premiums, but means that you will be responsible for a greater portion of the
charges.
4. Answer all questions on the insurance
application truthfully. The importance
of this cannot be stressed enough. If
you withhold information or lie, the insurance company may have the right to
cancel coverage retroactively. If that
happens, it will be as though you never had insurance. What’s more, depending upon the
circumstances, you may be treading dangerously near to insurance fraud, which
is a crime.
Luke S. Brown is
a retired insurance attorney who lives in Tallahassee, Florida. He assists
people with consumer and business problems including those involving insurance,
healthcare, government benefits and others. He helps by untangling issues,
making calls, writing letters and achieving mutually satisfactory outcomes. He
may be reached at Brownknows01@gmail.com,
and invites you to his website at www.YourProblemSolvers.com.
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