A major part of applying for a US visa is getting your medical examination done by an authorized physician listed on your country’s embassy website. To make your relocation process to the US a smooth one, you will have to meet the US immigration health requirements before going for your visa interview (more on this in our Visa Section).

The US public healthcare program is not universal. Therefore, it is advisable to opt for private health insurance if you want to avoid the huge medical bills. Employers do provide health insurance coverage but mostly the plans they provide are not always sufficient and you may need to pay extra for additional coverage. Also, your health insurance provider could limit the choice of professionals available to you.

Giving birth in the US is a luxury with all the professional medical staff attending to all your needs but this wonderful experience can be rather expensive.

THE BELOW SEGMENT OF OUR GUIDE WILL GIVE YOU DETAILS ON MEDICALS, THE HEALTHCARE SYSTEM, INTRODUCE YOU TO WAYS OF FINDING A DOCTOR AND THE PARTICULARS OF GIVING BIRTH IN THE USA.

In this segment, we cover:

• Medicals for US Immigration
• Public and Private Healthcare in the US
• Private Health Insurance
• Finding a Doctor or Dentist in the USA
• Delivering a baby in the US

MEDICALS FOR US IMMIGRATION

After applying for your visa, you can get an appointment with a US embassy-approved physician who will review your medical history and perform a physical examination. You can visit this website to find the updated information and list of vaccinations, required for adults and kids. You can also check with your own physician to find out which vaccinations you do have and don’t before your move.

Keep in mind that during the procedure you may be asked to provide your identification document (passport, ID card, etc.) and the visa appointment letter.

You should get your eyes, ears, nose, throat, heart, lungs, abdomen, extremities, lymph nodes, genitals and skin checked. This examination will also include:
– A review of your medical history
– A chest X-ray
– A blood test for syphilis
Depending on the country where you complete your medical exam, your medical records will either be sent to you in a sealed envelope or mailed directly to the US embassy or US Consulate prior to your interview with them.

PUBLIC & PRIVATE HEALTHCARE IN THE US

The US healthcare system offers very first-class care to its patients. But medical bills are one of the main things that stress people out in the US. That is why, it is very important to understand the US healthcare system thoroughly, whether you are a non-resident or a green card holder.

As US has the most expensive healthcare system in the world, employers provide health insurance to US citizens as well as to the expatriates. However, having health insurance does not always mean that consultation fees are free. Also, in many cases, you may have to pay a percentage of the hospital bills yourself.

The healthcare system consists of of private and public sectors. Public healthcare is only available for citizens and permanent residents till a certain age and, even then, its coverage is limited. It has been a popular debate topic for many years now and the system undergoes constant change. However, the coverage provided by public healthcare is mostly reserved for people who cannot afford other types of healthcare. Therefore, it would be most feasible for expatriates to get private insurance.

US Healthcare Glossary
Here are a few things you need to know about the US healthcare system:
– Premium – a monthly fee that you pay for your insurance, regardless of whether you use the medical services or not.
– Deductible – a fee you have to pay before your insurance starts covering your medical fees. So, normally, you will have to pay full price for services until your payment covers the deductible.
– Coinsurance – a percentage you have to pay on services in addition to what insurance already covers after the deductible.
– Marketplace – short for Health Insurance Marketplace, a shopping and enrolment service for medical insurance created by the Affordable Care Act in 2010. Even though the rules are the same, each state has its own marketplace with different companies in it.

This elaborate US glossary will surely help you with more terms you may be unaware of.

Coverage by the Public Healthcare in the US Over 50% of the US population are assisted by a few publicly funded programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP). Medicare Medicare is a four-part program by the US government: – Part A – covers hospital inpatient care – Part B – helps pay for services from doctors and outpatient care – Part C – Part A and B with additional benefits – Part D – helps to cover the costs of prescription drugs. Medicare Part A covers citizens and permanent residents over the age of 65 so you would be eligible for this part of Medicare if: – you are entitled to receive disability benefits for 24 months – you have permanent kidney failure – you have Lou Gehrig’s disease (ALS). Medicare Part B can be purchased separately or added to your Part A plan, if you are 65 years old or older and belong to the below two categories: – A lawful non-citizen who has lived in the US for at least five years – A US citizen. You can buy additional supplements for the Medigap plan from private insurance companies. Medicare Part C is the Medicare Advantage Plan which includes extra benefits like more days at the hospital, vision and dental coverage, etc. This plan is usually provided by Medicare Advantage Organization or a private company. Medicare Part D allows you coverage for prescription drugs so you will have to pay a monthly premium for the same. You will automatically be registered with Parts A and B, once you become eligible for any Medicare plan. However, you can always opt out of part B as the states provide financial support for people who cannot afford the additional parts of Medicare. Medicaid Medicaid is a program run by the state that helps with medical costs for people with low income and offers additional benefits that are not covered by Medicare. Like mentioned above, each state has their own rules of eligibility that would include your age, income, state of health and immigration status. But in most cases you are entitled to receive Medicaid only after holding a US residency for five years. Children’s Health Insurance Program (CHIP) The Children’s Health Insurance Program (CHIP) provides health coverage to children, through separate CHIP programs and Medicaid. CHIP is administered by the states, according to federal requirements and is funded jointly by states and the federal government. It covers healthcare (both medical and dental) for eligible children less than 19 years of age. 50% of the states in the US are able to provide Medicaid and CHIP for immigrant children and pregnant women. Public Healthcare Costs Though fees for public healthcare depend on many factors, here are the approximate prices, in case you are not eligible for a free program.

If admitted into hospital with Part A alone, you may need to pay a deductible of around USD 1,500. Nevertheless, always make sure to check the exact amounts you need to pay before selecting your healthcare plan. Why is Healthcare Expensive in the US? One of the main reasons why US Healthcare is so expensive is because the government hasn’t put any cap on the prices of healthcare procedures, private insurance, medicals or pharmaceutical products. Also, the medical staff in the US gets higher wages when people choose costly tests and procedures. The Pros, Cons and Facts of the Healthcare System in the US Though the US healthcare has the best quality service with an extensive range of options and less waiting times, it is extremely expensive and therefore not accessible to all as you have to pay a huge sum for most of the procedures. Some facts of the US healthcare system are: – The public coverage is not universal. – Mostly employers provide you and your family with a suitable health insurance plan. – Ambulance rides depend on your location but can still get very costly (USD 300 to USD 1500) if you are not insured. – Cardiovascular diseases and cancer are most common in the US causing many deaths too.

PRIVATE HEALTH INSURANCE

Most healthcare plans that provide complete coverage are expensive, so everyone cannot afford it. But, the marketplace offers plenty of private health insurance options that differ in coverage and pricing so that everyone can find a plan feasible for them. Ways to get Private Health Insurance There are other ways to get health insurance in the US which are: – Employment-based coverage (you, your spouse or your parents). – Health insurance through the Marketplace. – Health insurance directly from a health insurance company. Employees are usually covered by employment-based health insurances but many plans may not have complete benefits so people pay extra for the premiums for full coverage. In case of self-employment, you can purchase your medical insurance from the Marketplace or directly through any insurance company. Health Insurance Plans available You can either opt for insurance plans that comply with government standards (Obamacare or Affordable Care Act plans) or choose a short-term plan offered by insurers. If opting from a government plan, you can select from the following networks of the Marketplace: – Health Maintenance Organizations (HMO): This covers healthcare services within the network and emergency services out of the network. The members’ primary doctors refer them to specialists if required. – Exclusive Provider Organizations (EPO): This covers healthcare services provided only by specific specialists and hospitals that are within the network. – Preferred Provider Organizations (PPO): Members are free to visit doctors inside and outside of the network without a referral though the costs for specialists outside the network may be higher. – Point of Service Plan (POS): Same as above but members need a referral to visit doctors outside their network. You can choose easily according to the appropriate acronym allotted to each plan in the network at the Marketplace. They will have a description of the plans they are offering. Also, there are different plans like bronze, silver, gold and platinum where the percentage, of the amounts, changes between you and your insurer. Costs for the US Health Insurance Prices depend on your age, health, state you live in and what is inclusive in your plan. Below is an average of what you would pay monthly.

You may have to pay an extra USD 50/- for dental and vision care per person per month. You can also pay for extra bonuses from insurers in case your employer’s plan does not cover you and your family sufficiently. The Affordable Care Act (Obamacare) This was a new program which was created to make healthcare more available to the public, with a few changes as below: – Lifetime and yearly coverage limits have been eliminated. – No coverage to be refused based on gender or pre-existing conditions. – People can purchase health insurance through government-regulated Health Insurance Marketplace. – Adults, till age 26, can stay under their family’s insurance plan. – A yearly fine for people who do not purchase any insurance or the ten essential healthcare benefits that are covered by the health plans. However, it is important to stay updated with regards to any healthcare related policies. The need for Private Health Insurance Having a health insurance in your name is in your best interest considering the huge expenses you can avoid on medical bills. Also, according to the current laws you can still be fined for not being insured.

FINDING A DOCTOR OR DENTIST IN THE USA

USA offers plenty of specialists, in the medical field, who can help you and your family.

Family Doctor
A family doctor is a general practitioners (GP) or primary care specialist who looks after the health of your family and yourself. You have to be comfortable with your doctor as you will be sharing personal details about yourself, so how you choose a family doctor is very important.
When looking for a suitable medical practitioner for your family, start by contacting your insurance company. Ideally, they should provide you with a list of local doctors that are available under your healthcare plan. Then, check online on the listed doctors and filter according to your preferences. The things you can consider, while looking for a family doctor, are his experience in the field, communication and approach to patients, proximity from your home, timings and average waiting time.
You will need your ID and medical records from your previous doctor during your first appointment. But, if after the first appointment you feel that the doctor is not right for you, continue by checking on your second preference.

Specialist Doctor
Generally, you would need your family doctor’s referral to book an appointment with a specialist doctor; however, you can always look at options available without a referral too.
Online databases that allow you to find medical professionals in your area are:
– MedlinePlus – provides directories for specialty doctors.
– Medicare.gov – Lets you compare physicians whose services are covered by Medicare. The database shows each doctor’s educational qualification, field of expertise and location of their practice.
– American Medical Association – Allows you to browse through a list of certified doctors according to location and speciality. It also shows the educational qualifications of each doctor.
– US News – lists all the available doctors according to their location while it shows each doctor’s contact information, experience, expertise, etc.
Mobile apps like ZocDoc help you look for doctors in your area and book an appointment with them. Mobile apps, like Practo, also lets you chat with the doctors online.

Finding a Dentist
The databases of American Association of Endodontists and Academy of General Dentistry can help you look for suitable dentists in your area with their contact information. Mostly, insurance plans do not cover dental care, so you can choose any dentist you prefer, but before going for a procedure, make sure you are well aware of all the costs involved. If your insurance does include a dental plan, you will mostly be able to choose a dentist only from the list suggested by your insurance company.

Wait Time for an Appointment
Though the wait time for an appointment varies depending on the hospital and the area it is located, according to a survey, you could take anywhere from 10 to 30 days to meet a cardiologist, gynaecologist, dermatologist or orthopaedic surgeon in the big cities. Sometimes, it could take weeks for a doctor’s appointment in the US hospitals and clinics.

Delivering A Baby in The US

Legally, if your baby is born in the USA, it has the right to US citizenship whether you are a citizen, non-resident, or a green card holder. However, the main drawback, of delivering a baby in the US, could be the hospital bills, so it is advisable to inform your insurance company about your intentions so your insurance plans could be adjusted to cover maternity care too.

Benefits of being born in the USA
The US is one of the countries that allow citizenship by birth. This allows the child to return to the USA whenever they may please, for school or on work. They also have access to American scholarships and ease of travel to many countries.
Secondly, the parents can obtain a green card through their child if they plan to live in the country. Until the child turns 21, the parents and other family members are expected to live in the country under their own legal visa.
Thirdly, once the child turns 21 years, their immediate relatives also become eligible to apply for a permanent residence in the USA. As US citizens, they can sponsor several relatives.

However, if the authorities find that your motives are unlawful, for example, you entered the country on a tourist visa with the intention of giving birth, you could have issues with the law and be considered inadmissible in the US.

Cost of delivering in the US
Delivering a baby in the US is an expensive affair though the prices may vary depending on hospital and state. The total price of a natural birth could cost you anything around USD 30000 while a caesarean could be more than USD 50000. You may add another USD 4000 for prenatal care.

Having a baby in the US has its advantages but without health insurance, you would need to clear all the huge bills for maternity care. Yet, if you are a pregnant, uninsured citizen, some states may suggest that you apply for Medicaid to help you with the hospital bills.

Child’s Birth Certificate, if born in the USA
While admitting yourself to deliver, you will be asked to fill forms that will be sent to the state authorities in order to issue a birth certificate while in some states, you will have to arrange all that yourself.