Health Insurance

Your Most Important Safety Net

By Addy Biron

We are all familiar with the mental challenges we face when arriving to a new country. Sometimes those challenges linger. We face a new environment and a different lifestyle that brings along foreign and often strange ways of doing things, often very different than the ones we were familiar with in our home country.

Every day, we stare at unfamiliar territories in all aspects of life such as financial matters, a new language, new terminologies, policies at work, and even mundane matters such as finding the closest supermarket or opening a new checking account. But the one matter we should take care of as soon as we enter the gates of the U. S is often neglected quite easily. We then find ourselves scrambling to find help at the last minute or waste valuable time when emergency strikes. It’s called health insurance; our most important safety net. With it you feel secure. Without it, you’re walking towards a potential financial and health crisis. And that cannot be truer than in the U.S, where in matters of health care coverage, you get what you pay for.

If you or a relative came from a country that offers its citizens universal health coverage or where the government subsidizes many of the health care costs, here in the States you’ll find a completely different picture. Millions of uninsured walk our streets mainly because they can’t afford the expensive insurance plans. So before you make any grand new American purchases like a big house, that 323i, or send your kids to expensive schools, make sure you have your basic needs covered first. And health coverage should top that list.

If you’ve never been sick before or have never carried a chronic disease, the thought of doctors and hospitals have probably never entered your mind. Back in your home country, if any health matter would arise, you’d most likely pick up the phone and call one of your relatives for a reference on a specialist or a clinic. But when you leave your comfort zone and move to a new country, suddenly things don’t seem all that comfortable to adjust to when it comes to understanding health care policies, procedures, or where to go for help.

Imagine you wakeup at 2am in the morning to the sounds of your child coughing and sweating in bed, and you ask yourself “Where do I go?” Probably to the nearest ER but are you certain about the reputation and services of that hospital? Do you know how long it will take them to admit your child? Are the hospital procedures such as blood work, X-Rays or ambulatory services covered under your insurance plan? With all the mayhem of moving to a new country, such as finding a place to live and acclimating yourself at your new university or office, sometimes critical and personal matters such as ensuring you have health insurance, and understanding what is covered under the plan, are left to be taken care of only after an emergency occurs, and that will cost you dearly, both to your health and to your wallet.

Here’s some food for thought in case you have just arrived to the U.S or know of a friend or relative who is planning to relocate here;

Hopefully this point is old news for you in case you already have health insurance but if you know of a friend or a relative who is planning to move to the U.S, make sure they check with their health care service provider back home whether their plan covers them in the U.S for at least a few weeks or months. It’s much more comforting to arrive to a new country knowing that at least one hot item, such as health insurance is checked off the list until they settle down. If their health insurance plan does not cover out of country health services, they may want to consider getting a temporary supplemental health coverage plan before they arrive to the U.S. at least for the first few weeks or months.

Depending on the reason of your move, you may experience different ways acquiring your health care insurance plan. The simplest and most common is through your employer. Depending on the size and structure of the company, they could offer you various plans from companies such as Blue Cross Blue Shield, United Health Care, Aetna, Cigna and others.

Your employer will show you your monthly charges for health and dental coverage and what your deductibles would be for a doctor visit or for prescription medications. Certain plans tend to carry expensive deductibles but they are also known to cover many expensive procedures and tests, offering you a wider safety net for whatever may strike you down the road. When it comes to co-payments, they can be anywhere from a few dollars to $20 or more per doctor visit. For those of you with married with children, a family plan may be available to insure your spouse and your kids so there’s no need to insure them separately. If you’re curious about how much you are not paying because you are covered by a high end insurance plan, here are a few examples to put things into perspective;

A doctor visit whether it’s for a quick 5 minute consultation or a longer appointment can range anywhere from $200 to a few hundred if you’re seeing a specialist such as an ophthalmologist, a GI doctor, or a physical therapist.

Scans such as CT, MRI, or PET scans can cost up to $5,000 and more. Blood tests cost anywhere from $350 and higher depending on what is ordered.

An overnight hospital stay can start anywhere from $500 a night to $1000+ a night. That’s more expensive than a room at the Ritz Carlton. And bellboys are not included. Let’s not even mention the cost of a surgery or a complicated exam.

If you’re moving to the U.S to pursue a degree, your college most likely already communicated with you about the various health care and dental plans.

After you’ve registered and have a plan, there are some simple and quick steps you should take to ensure you can have peace of mind and focus on happier matters at hand.

Always carry your insurance card with you and order additional ones for your family members. Many clinics and hospitals won’t admit you without proof of insurance.

Select a general practitioner or a specialist in case you have a condition that needs to be monitored on an ongoing basis. Your insurance company will mail you information on doctors in your area, or you can log on to the health care carrier’s website and search for one. Better yet, ask around. There’s nothing like a recommendation from a friend or a colleague. When searching for a doctor, you will notice that many are affiliated with certain area hospitals. If you know of a certain hospital that has an outstanding reputation in the areas you may need additional treatment or consultation on, seek a general practitioner who is affiliated with that hospital.

Have a health care proxy. This is a person who will need to make any critical health care decisions of your behalf if you are physically unable to do so on your own. Contact your health care provider for all the necessary paper work.

Have an emergency contact on record. Let your doctor or your health care provider know of your emergency contact information. I also recommend adding the contact to your cell phone and title it “ICE” which stands for In Case of Emergency. It’s good to have an ICE contact available to emergency personnel. You never know when your relatives need to be aware of an emergency situation.

Once you’ve obtained a health insurance plan, make sure you know what medical services your plan covers and what it doesn’t cover. Just because you’re paying high health care coverage costs doesn’t necessarily mean you are 100% covered for all services. Some carriers cover all services, but some cover a certain percentage leaving you with the burden to pay off the rest.

Pills and medications are picked up at local pharmacy stores. I recommend choosing one as your central hub for all prescription drugs and preferably a nearby pharmacy. That way you don’t need to register each time you go to a different pharmacy. And if your doctor prescribed you a medication with refills, you can refill through the pharmacy’s automated phone service – the beauty of American customer service. To save time, I would also recommend having your doctor send over the prescription to the pharmacy over the phone. That way by the time you get to the pharmacy, your medication will be ready to be picked up.

Know that when it comes to medications, certain health care plans don’t cover certain prescription drugs, so ask your doctor or the pharmacist if he or she knows whether your plan covers your medications. In some instances your doctor may prescribe you a generic brand that is as good as the more expensive brand. The patient’s co-payment for medications can range from a few dollars to over $30 a medication, depending on your insurance plan.

If you thought the entire registration process for insurance is the toughest step in your health care experience, you may be wrong. Even though this country possesses the most advanced health care technology and resources and some of the finest professionals in the health care industry, there’s still the human interaction during doctor visits that may throw you off because you’re still adjusting to a new culture and maybe a foreign language. The U.S is a leading nation in many industries, but when it comes to the hospital experience, it is often not that much better than the ones you’ve experienced in your home country. In fact, in many instances, it’s probably worse. Here are a few things to remember in case you are in need of medical attention;

Just because there are abundant hospitals and physicians in your new hometown, it doesn’t mean it makes it easier to get an appointment or be seen and admitted quicker. Even with all the grand multi million dollar hospital facilities and thousands of white coats roaming the hallways, you may still wait for quite sometime to be seen by your doctor, often more than an hour over the scheduled appointment time. If you’re appointment is at 2pm, don’t be surprised to be seen at 4pm. Additionally, don’t be surprised to wait three or more weeks for a scheduled MRI or a dermatology appointment. It’s sometimes easier to get a ticket to a Red Sox-Yankees game than seeing a doctor.

ERs in this country are a mess. Hundreds of people get admitted every day, the ER treatment areas are cramped, staff is short and they take care of the most needy first such as trauma patients (car accidents, severe wounds, heart attacks, etc). If you’re coming for an x-ray because you broke you arm, be prepared to wait at the ER. During the day, you may want to get the exam at the hospital’s outpatient unit, in this case at the radiology department.

In the U. S. many hospitals are referred to as teaching hospitals. They maintain a staff of interns who shadow the doctors to learn and observe. If you are admitted into one, don’t be surprised to see a whole team of doctor plus 10 enter your room to examine you. Sometimes the interns will visit you very early in the morning to ask you basic “how are you” questions which they then report back to the doctor before the official team visit. From experience, this can be a very annoying habit because at any given day, any intern on the team can question you and they tend to ask the same old questions over and over again. Try to be patient, and if they drive you crazy, be honest and tell them.

If you are struggling with English or with all the big medical terms and references, ask to have a translator help you during your doctor visit or hospital stay. Many hospitals offer translators who speak fluent French, Italian, Russian, Spanish, Japanese, and other languages.

Make sure you keep any co-payment receipts in case of a payment dispute. Additionally, if you carry a chronic condition, which requires multiple hospital admissions, doctor visits, prescription drugs, or need of other medical items, Uncle Sam may help you out during tax filing season. Certain uncovered medical bills can be claimed as deductibles on your tax returns if they meet the IRS requirements. Seek more advice from a tax professional or from the IRS.

Lastly, if you plan to go on a vacation or a visit back home, contact your health insurance carrier to make sure you are covered in case of any unexpected hospital admissions or appointments during your trip. I recommend bringing back any receipts, letters, or anything in writing that details the care you received overseas in case you are confronted with surprising bills from your health care carrier.

The last thing you want is to deal with enormous unexpected health care costs because you didn’t know the process or know what to look for. Now you know a little bit more and we hope that the transition to the U.S. will go smoothly, and hopefully you won’t be visiting a hospital anytime soon.

Addy Biron was raised in London, Paris, and Tel-Aviv.  An advertising executive and Emerson College graduate, he lives in Boston where a great deal of time has been spent battling and overcoming Non-Hodgkin’s Lymphoma.  When Addy’s ready to seize the day, you can find him bicycling the Charles River or lounging like a Mediterranean lizard on the beaches of Hull and Manchester-by the-Sea.

You can contact Addy at www.myspace.com/addybythesea

*Costs detailed in this article are purely estimates from the writer’s experience with health care providers. They may not reflect your own individual health care costs.

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