Understanding Insurance

When you live and work in the US, it is necessary to have health insurance and more. This entry generated from EducationUSA gives a primer on what to learn about insurance.

This entry covers the following:
> Health Insurance
> Health Insurance Plan Exclusions

No one ever intends to have an automobile accident, lose valuable possessions through theft or damage, or become seriously ill, but sometimes through no fault of our own, these things do happen. The list below gives you an idea of what kinds of insurance you should have while in the United States. Ask your international student adviser where you can find out more about the various types of insurance.

Health insurance provides coverage for medical care in the United States. A more detailed look at health insurance, including the types of insurance available, can be found below.

Travel insurance covers you during your journey from your home country to the United States.

Life insurance insures your life. If you should die, benefits are paid to the person you name as your beneficiary.

Personal belongings insurance insures those items you bring to the United States with you against loss, theft, or damage. It is not advisable to bring expensive jewelry or other valuable personal belongings with you to the United States.

Automobile insurance covers your automobile and injuries to persons in the event of an accident. If you are going to have an automobile in the United States, most states require that you carry automobile and liability insurance. If you rent a car, the fee generally includes insurance coverage.

Health Insurance
The United States does not have a government medical plan or health care service that covers the whole population. Instead, most people have private health insurance.

The U.S. Department of State requires students on J-1 exchange visitor visas to have insurance coverage that includes health and accident, medical evacuation, and repatriation of remains. The U.S. government has no specific health insurance requirements for students on F-1 and M-1 nonimmigrant visas. However, most educational institutions have set their own mandatory health insurance requirements to ensure that international students do not become a "public charge" — that is, they do not become dependent on the U.S. government to take care of them. International students usually are required to prove they have a certain amount of health insurance (determined by the university) before they will be allowed to enroll in classes.

If a health premium seems too high for your budget or if, as a healthy young person, you think that health insurance is an unnecessary expense, consider the costs that could be incurred in the United States as outlined below.

Hospitals, doctors, and other medical costs vary throughout the country, but emergency room care averages about $200 per visit. Hospital rooms vary in price depending on the hospital and the region of the country, but currently one overnight stay in a hospital room averages $200 to $1,000 per day, not including charges for doctors and other medical services. Maternity care and delivery cost between $5,000 and $8,000. Overall, national figures indicate that the average cost for a one-week stay in a U.S. hospital is often as much as $8,000. In other words, this is about half the cost of attending some U.S. colleges or universities for an entire year.

Health Insurance Plans: Although health insurance covering your stay in the United States can be purchased in your home country, experience has shown that many of these plans do not adequately cover your health care needs during your U.S. stay. In addition, many U.S. health care providers are reluctant to bill foreign insurance companies for health care charges. They prefer to receive payment directly from the patient and to let the patient seek reimbursement from the foreign insurance company. Unless you are certain that the policy is equal to or better than the policies of U.S. health care insurance companies, and that your home-country health insurance policy can be billed in the United States, you should probably purchase health insurance when you arrive in the United States.

Major medical insurance: This insurance is designed to take care of expenses resulting from a prolonged illness or serious injury. These policies generally involve a "deductible" clause — that is, you pay a certain amount, and the insurance company pays any additional charges or, sometimes, only the major percentage of those charges. Typically, the deductible is $500 to $1000, depending on the policy and the type of coverage. Maximum benefits (the limit the insurance company will pay) vary greatly and generally range from a low of $5,000 (which is not enough coverage) to $1 million or more (which is usually more than most healthy international students need). You should purchase insurance that provides at least $25,000 in major medical coverage. It would be advisable, however, to purchase $50,000, $75,000, or even $100,000 worth of coverage, especially if you plan on bringing your spouse or other dependents with you.

Most basic health and medical insurance policies specify certain limits, that is, a certain maximum amount the insurance company will pay for certain services. The patient must pay charges in excess of the stated limits.



Health Insurance Plan Exclusions
It is important to read your health insurance policy carefully, especially the section that deals with "exclusions," so that you will know in advance what the insurance company will pay for and what it will not pay for. Below are some areas that are generally not covered by basic health insurance plans:

Maternity care: You must purchase insurance for maternity care separately and, generally, before pregnancy occurs. Most maternity insurance policies allow only two days' hospital stay.

Dental services: If you need dental work done, it is a good idea to have it taken care of before coming to the United States.

Eyeglasses: If you wear eyeglasses, have your eyes examined before you leave home and bring an extra pair of glasses and the prescription (written in English) with you. Except in the case of injury to the eye, eye care is generally not covered by health insurance.

Existing conditions: Most insurance companies will not reimburse you for treatment of a condition that existed prior to the effective date of your insurance policy. If you require care for an ongoing medical condition, look closely at any insurance policies you are considering. Medical care in the United States can be very expensive without insurance.

Prescription medications: Many insurance companies do not provide coverage for prescription medications, which can be very expensive in the United States. Even if they do provide some coverage, a "copayment" or standard fee (often $10 to $15) is usually required from you for each prescription on a monthly basis.