||Insurance Services for Immigrants
Why do you need Health Insurance?
Health care costs in the United States of America and other developed countries are very expensive. The U.S. government does not offer socialized medical care for foreigners or new immigrants, so in the absence of insurance you or your sponsor (the individual who provided you with the I-134 sponsorship affidavit) will have to pay for health care.
Health insurance policy coverage protects you financially in the event of sudden illness, injury or accidental death.
The healthcare plans available for US citizens are usually not available to foreign citizens, visitors and some temporary workers. Besides, most mainstream health plans require immigrants to have resided in the US for a certain length of time. To address the above there are various medical plans designed specifically for new immigrants, temporary workers and visitors to USA.
Basics of Immigrant Health Insurance Plans
Group Insurance Plans
If you are traveling in a group (typically 5 or more in number) you can consider purchasing a group insurance policy. Group insurance is generally the least expensive kind. In many cases, group insurance policies are not available for online purchase and you will work with an agent for its purchase.
Temporary workers on a project assignment, tourists traveling abroad in large groups, cultural groups performing overseas, missionaries, religious groups engaged in social work, and adventure tour groups could take advantage of the lower costs of group insurance. A foreign employer can obtain a group policy for employees who travel frequently to the US as well.
Individual Insurance Plans
New immigrants to the US or those traveling individually can buy individual policies. Please compare the various policy options and shop carefully because coverage and costs vary among the policies. Most policies are available online for purchase and some are renewable.
Some tips when shopping for individual insurance:
Both Group and Individual plans typically require a monthly (sometimes on a daily or 15 day basis) periodic fee called the 'premium'.
- Shop carefully: Policies differ widely in coverage and cost. Contact different insurance companies, or ask your agent to provide you information about several policies from several insurance companies so that you can compare the policies.
- Make sure the policy protects you from large medical costs: Make sure it provides the kind of coverage that is right for you. You do not want unpleasant surprises when you are sick or in the hospital.
- Check to see that the policy is renewable up to your anticipated time to the required US immigration status or length of stay in a foreign country.
- Be informed of the pre-existing condition clause.
You will pay a certain amount of money called the 'deductible' for each illness or policy period before the insurance payments begin.
Most plans also require a 'co-insurance' payment. After you have paid your deductible amount for the policy period (or for that illness, depending on the policy), you share the bill with the insurance company. For example, you might pay 20 percent while the insurer pays 80 percent of the covered expenses. Your portion is called 'coinsurance'.
Coverage amounts are available up to various maximum amounts; they range from $10,000 to $1,000,000. The coverage for the70+ age group tends to be limited to $50,000 or less.
You can also purchase additional policy riders or options for hazardous sports and terrorism acts.
Definitions of the health insurance terms used are included in the section called Health Insurance Terms.
Before you buy any health insurance policy, make sure you know what it will cover and what is not covered. To find out about individual health insurance plans, you can call appropriate insurance agents, insurance companies, and plan administrators.
What are the types of plans available?
Several types of plans are available offering global or USA only coverage. Policy premiums are influenced by several factors including the maximum benefits limit, the deductible selected, age group of the insured and other options (hazardous sports coverage, terrorism coverage) selected.
Comprehensive Coverage Program
These policies are characterized by providing benefits up to the policy maximum coverage limit. Typically there are few benefit limits based on the type of covered medical service. These policies usually require the insured to pay a co-insurance; for example a policy co-insurance may require the insured to pay 20% of the first $5000 of the covered expenses and then the policy covers 100% of the covered expenses.
Coverage includes expenses for treating illness, sickness, injuries, repatriation, emergency re-union, return of minor, trip interruption, baggage loss, dental, emergency evacuation, accidental death etc.
Scheduled Benefits Program
Scheduled benefits programs are characterized by benefits limits for each type of medical service. For example a policy with a maximum benefit limit of $50,000 can stipulate a maximum of $350 for Emergency Room visits, Diagnostic Tests (i.e. X-Rays, lab tests) to be $500.
The total payable benefits for all covered medical services will not exceed the policy maximum benefit limit for each Injury or for the policy period.
Coverage includes expenses for treating illness, sickness, injuries, repatriation, dental, emergency evacuation, accidental death etc.
Filing for Claims
Typically the policies expect you to pay the doctor or the hospital and then you collect the benefits from the insurance company by submitting a claim form. In case of a major procedure or expensive service the hospital and the insurance company will discuss directly and settle the covered expenses between themselves (thereby you don't have to make large payments).
Please keep receipts for services obtained, drugs and other medical costs. You are responsible for keeping track of your own medical expenses. Claim forms are typically downloadable from the agent's or insurance company's website.
Most policies encourage you to use doctors and hospitals within the provider network to keep your out-of-pocket expenses to a minimum. The advantage of using an in-network provider is that the hospitals will charge the Usual & Customary Rates accepted by the insurance company.
Health Insurance Terms
For more health insurance terms please visit the glossary at http://www.nriol.net/nriol/insurance/glossary.asp
- The amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.
- Covered Expenses
- Most immigrant insurance plans do not pay for all services. Some may not pay for prescription drugs. Others may not pay for routine physical examinations. Covered services are those medical procedures the insurance company agrees pay for.
- Usual Customary Rate (UCR)
- Most insurance plans will pay only what they call a reasonable and customary fee for a particular service. If your doctor charges $1,000 for a hernia treatment while the insurance company pays most doctors in your area charge only $600, then you will end up paying the $400 difference. To avoid this additional cost, use a doctor/hospital within the provider network for the policy or ask your doctor to accept your insurance company's payment as full payment.
- The amount of money you must pay each year to cover your medical care expenses before your insurance policy starts paying.
- Exclusions are those conditions or circumstances for which the policy will not provide benefits.
- Provider Network
- Provider Network is a group of doctors, hospitals, specialists who have pre-negotiated rates with the insurance company for providing medical services and procedures. Using in-network provider keeps your costs to a minimum.
- Pre-existing Condition
- A pre-existing condition is a health problem that existed or manifested before the date your insurance became effective.
- The amount you or your employer pays in exchange for insurance coverage.
- Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.
- Renewable Policy
- Renewable polices enable you to continue coverage after the initial time period by paying the required premium for their extension.
Understanding and Choosing a Plan
Understanding health insurance coverage for visitors, immigrants and foreigners in the USA can be very complicated. There are many plans available, and deciding which one is best for you is not easy. Invariably, you will have to compromise in some areas. Whether it is cost, variety of services covered or access to the doctors of your choice, you probably will not get the perfect plan. The following guidelines will help you to understand your options.
What factors matter to you?
In choosing a plan, you have to decide what is most important to you. All plans have tradeoffs. Ask yourself these questions:
You might also want to think about whether the services a plan offers meet your needs. Call the plan for details about coverage if you have questions. Consider:
- How comprehensive do you want coverage of health care services to be?
- How do you feel about driving a few dozen miles for in-network doctors or hospitals?
- How much are you willing to spend on premiums and other health care costs?
- How much are you willing to spend on co-insurance or out of pocket expenses?
Compare, Select & Purchase a Plan
- Life changes you may be thinking about, such as starting a family.
- Pre-existing chronic health conditions or disabilities that you or family members have.
- Expenses for care and return of accompanying children to home country if you get hospitalized.
Understanding health insurance for new immigrants, visitors and temporary workers can be complicated. There are many plans with various coverage limits, options and restrictions. Deciding on a policy that best suits your needs is not always easy.
The above site enables you to compare all the major insurance policies, select and purchase a policy that best meets your specific needs. Immediate coverage is offered and medical examinations are often not required.
You can call 877-593-5403
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