The US Health system is probably the biggest concern for most Brits when moving to the USA. We have all considered the difference between the NHS vs US health system. I will not lie, picking a health plan and understanding how it works is super complex in comparison to the UK’s National Health System (NHS). There are MANY terms that we are just not used to, coming from the NHS.
Out of pocket…Deductibles…Co-pay…FSA…HSA…PPO…HMO? To name a few. What does it all mean?!
I spent my first few weeks constantly googling terms and asking my US colleagues to educate me!
We have all heard the horror stories of the huge medical bills, people being in debt, or not seeking treatment in the US due to the high costs of healthcare. It is no wonder why Brits would be worried when moving to the USA. However the US healthcare system does not need to be as scary, as it seems, as long you understand it and prepare. And whilst this will not be for the majority, you may even find that US healthcare is actually cheaper, yes cheaper! That was certainly the case for us. I will save this explanation for another post.
The next few healthcare posts will cover how to pick a plan and how to prepare for paying for medical bills.
On this post I will start with why medical insurance is needed.
Why Health Insurance is needed in the USA?
In the USA there is no universal healthcare that is provided. Unlike the NHS, in the UK, which is provided to all and is free at point of care. The NHS is not free. This is a very common misconception. It is funded by general taxes and tax payers money. If you never contribute by paying taxes, then you could say it is free for you. This means there is a more standardised level of care that is given to anyone in the UK irrespective of what you can afford. If you work, the money comes out of your salary. The more money you earn the more taxes you pay, and the more you contribute towards the NHS.
Back to the USA. At the point at which you need any form of medical service, quite simply, someone needs to pay for it and usually this means cover by a health insurance plan. This can be a private health insurance that you take out personally or, more typically, it is provided and subsidized by your employer. Which means you pay significantly less, for your health insurance.
If you do not have medical insurance you will need to pay it yourself.
Random Fact: 10% of the US population in 2019 were without insurance.
There are 2 government funded programs – Medicare and Medicaid. For elderly, disabled and those who are on a low income. Each pay I have a contribution that goes towards Medicare.
Therefore if you are moving to the USA you need health insurance, unless you are super wealthy, in which case you probably do not need to worry about health insurance!
I want to point out, medical care is not more necessarily more expensive here. This is a misconception. Medical services no matter where you are, have a cost. In the UK we are just less aware of it as we never see the bill for our medical treatment. Then depending on how much you pay in taxes can make it more or less expensive than the USA.
I will caveat this with – I am not talking about where cost of services may be inflated or fraudulently added. As I am aware this can happen when you have a system like the USA. I am talking on the assumption that cost of services are honest and somewhat fair.
Once I have had more experience, I will also share the comparison of the quality of healthcare you get in the USA versus the UK. What I do know already, is there is more flexibility here. The better the medical plan you have, the better the care and service you can get.
In the UK the quality of care and level of service can be a bit of a post code lottery. Also, you can only get the types of treatment and prescriptions that is covered by the NHS. The Aysha King case in the UK, from 2014, was an example of where parents of a child with Medullablastoma (brain tumour) wanted their child to receive Proton treatment but this was not provided by the NHS at the time.
In the USA there appears to be a everything from poor, to amazingly high standards of service and generally more types of treatment accessible. Waiting times tends to be a lot quicker here too!
Now you understand why a health plan is needed, my next post will cover how to pick a medical plan.
Watch my Vlog – NHS vs US Health System Introduction