An Expat Guide to the US Healthcare System

Expat Guide to US Healthcare System

The US healthcare system is extremely unique and it is crucial that expatriates who are relocating to the U.S. are fully educated on how the healthcare system operates, the costs of receiving medical attention and how they can access professional medical help when they need it

Hospitals and medical facilities in the US are of an extremely high quality and the majority of centers offer high-tech equipment and professional services. However, while the care on offer is reliable, the costs involved are significant and the healthcare fees are some of the most expensive in the world. This means that, while America’s wealthy have access to high-quality healthcare, the poor and unemployed may struggle to get assistance when they need it and it is estimated that approximately 15% of the population in the U.S. have no access to health insurance, and subsequently healthcare, whatsoever.

Costs of healthcare and medical insurance

There is no such thing as free treatment in the U.S., even state hospitals charge fees for their services. As such, it is imperative that expatriates living in America have full health insurance at all times, as without it you will struggle to get access to medical assistance when you need it.

In the event that you do not have health insurance and you are admitted to a hospital, you will probably be expected to pay a large deposit in order to receive assistance. If you’re not able to pay this money the hospital may refuse to accept you. However, it is the law that hospitals must provide patients with emergency care and, as such, any hospital with which you seek help should stabilize your condition. While this may help you in an emergency situation, it is important to note that you will not be eligible for any follow-up treatment or help if you do not have the funds to pay for it.

All of this means that your top priority before relocating to the U.S. should be to arrange adequately health insurance for yourself and all family members. If your employer does not arrange this for you, you will need to find a reliable insurer yourself. There are any different types of health care plans on offer and you should research them all in detail before selecting the policy that is right for you. For further information, see this free guide to expat health and travel insurance. You carry proof of your insurance with you at all times when in the U.S. so that you can be assured of quick access to medical attention in the event of an emergency.

If you are relocating to the U.S. see our expat guides to America. They contain specific information about the cost of healthcare and the cost of insurance you will need in order to ensure that you are adequately covered throughout your stay in the country.


In the U.S. there are many different types of doctors depending upon the service they provide. Many people have what is known as a “primary-care physician.” This is your regular go-to doctor who will help with everyday illnesses and will refer you to specialists in the event you need more expert help. Selecting a primary-care physician can be difficult, as many doctors in large cities will have their own specialism, such as pediatrics, family medicine and gynecology. The best method to approach this, is to consider your unique needs and try and find a primary-care physician that is best suited to meeting them.

If you are relocating to the U.S. it is important that you start the search for a primary-care physician immediately, as you never know when you may fall ill and need the services of a doctor. In addition, many practices do not accept new patients and an increasing number of doctors are choosing to only take patients who pay cash, as the large insurance companies are taking longer to pay practitioner’s bills. It is therefore important you have done your research up-front, in order to ensure that you will be able to get the right help for your needs exactly when you need it.

Once you have selected a primary-care physician you should make an appointment to register yourself with the clinic. When you first visit the surgery you will be asked to complete a form and will need to provide details of your social security number and health insurance.

If you fall ill you should always try and make an appointment before visiting your primary-care physician. Never go to an emergency room for treatment unless it is an emergency, as the costs of receiving assistance there are extremely high and you will be using resource that may be better directed at people who need urgent help.

Depending upon the type of medical insurance you have, you may need to pay for medical services yourself when visiting your doctor before reclaiming them from the insurer. It is therefore important that you always have sufficient funds set aside in your bank account to be used in the event that you need access to money at short notice.


Dentists in the U.S. are private practices and access to dental treatment is very rarely covered by expat healthcare insurance policies (with the exception of emergency dental treatment).

The cost of dental treatment in America is extremely high and you should always openly clarify any costs associated with treatment before you agree to commence. Given the costs involved with routine dental work, it is advisable that expatriates get full check-ups before leaving their home country.


There are both public and private hospitals available in the U.S.

The care and assistance available in private hospitals in America is generally of a very high quality and you can expect a good level of care if you are admitted. However, this comes with a price tag and the cost of a hospital room for just one night can be in excess of $1000 USD, excluding treatment, X-rays and medication. It is for this reason that a visit to a hospital could turn into a financial disaster for uninsured expatriates.


You will find a wide range of medication is available in the U.S. at hospitals, pharmacies, grocery stores and drug stores. Medication has two classifications: Freely-available, which you can purchase over the counter; and prescription only, which you cannot purchase without a prescription that has been written by a doctor.

If you have arranged health insurance, your insurer may cover the cost of any drugs issued to you at a pharmacy, although you may be expected to contribute a nominal fee. The majority of insurers will expect you to pay for the medication yourself and then claim the costs back from them at a later date by sending proof of purchase to them.

Pharmacies generally follow the same opening hours as other shops in the area and you can usually expect them to be open between 9am and 9pm, seven days a week. There is also at least one 24-hour emergency pharmacy available in each area so that you can get access to help if you need it in an emergency.

Author: ExpatInfoDesk