Health Coverage in Chicago
The health coverage is partially provided by the federal state through only two state healthcare programs that target specific people:
- Medicare is a public healthcare program for American people who are over 65 years old. The main requirements are that you must have subscribed for at least 10 years; you must be at least 65 years old and an American citizen.
- Medicaid is a public healthcare coverage for low income families. It is financed both by the federal state and the states.
In the US, a global healthcare coverage system does not exist as it idoes n Europe and other countries with socialized medicine. In the US, the health coverage is mainly provided by companies for their employees or by individuals themselves who subscribe directly to a private health insurance. In other words, the United States health care system relies mainly on private health insurance, which is the primary source of coverage for most Americans.
If you are an expatriate employed by a US Company or an expatriate employed by an affiliate company from another country, your employer has to provide health insurance coverage. If this is not your case because you are an expatriate on your own, it is highly recommended to subscribe to a private health insurance. Indeed, the health care fees are extremely expensive.
Types of Health Insurance Plans
As an expatriate in the US, you have to understand the healthcare insurance vocabulary:
- Group plans versus individual plans: if you have health coverage through your work or union, you have group coverage. If you subscribe to a private health insurance, you have individual coverage. A group plan usually costs less and gives you more benefits than individual coverage. For example, many individual plans do not offer prescription drug coverage or coverage for pregnancy. It is usually better to get health coverage through a group if you can.
- Health Maintenance organization (HMO): this kind of plan means you have to commit to basics rules such as:
- Select a Primary Care Physician (PCP): This doctor gives you most of your care and refers you for other services when you need them. Usually, you must see this doctor first before you can see a specialist. Your primary care doctor must be in the HMO’s network.
- Commit to a medical group: Your medical group is the group of doctors and other providers that your primary care doctor is in. The medical group has a contract with the HMO to provide your care.
- Commit to a network of medical providers: Each HMO has a network of doctors, medical groups, labs, hospitals, and other providers who work for the HMO or have a contract with it. You must get approval from your HMO to get care from a provider outside the network, unless it’s an emergency, or you need urgent care and are outside your plan’s area. Most of the providers you see are also in your medical group. Usually HMO have their provider directory online, so you can check if a healthcare provider is or not in your network. If not, call them and check with them.
HMOs help to save on healthcare costs and it also simplifies the process. On the downside, it lacks of flexibility if you wish to see a healthcare provider outside of your network.
- Preferred Provider Organizations (PPO): PPOs look like HMOs but they are more flexible than HMOs. In a PPO you get most of your health care from a network of providers, just as you do in an HMO. But you can choose to go outside of the network and pay more. You can also have a primary care doctor in a PPO but it is not mandatory. It means that you can go to a specialist and get other services without seeing a primary care doctor first.
The choice of your health insurance plan is very important upon your arrival. According to your selection, you will be able to go to some health providers or not. It is advised to avoid hospitals that are extremely expensive (except if you have an emergency) and stick to your health insurance rules and network. Therefore, it is not necessary to affiliate you and your family to a specific hospital upon arrival as it is sometimes recommended to expatriates in other countries. The first step is to choose your healthcare insurance and plan. From there, you will be able to have access to specific hospitals, health care facilities and health care providers. Check with your Human Resources department to better understand your options.
Main healthcare insurances in Illinois
- Aetna http://www.aetna.com/
- Blue Cross Blue Shield of Illinois http://www.bcbsil.com/index.html
- Celtic http://www.celtic-net.com/
- Companion Life http://www.companionlife.com
- Coventry One http://coventryone.coventryhealthcare.com
- Humana One http://www.humana-one.com/
- My Health Alliance https://healthalliance.org
Online Resources for Health Insurance
- Ehealthinsurance https://www.ehealthinsurance.com
- Chicago Health Insurance http://www.chicagohealthinsurance.com/