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Expat Exchange - Enrolling in the Public Healthcare System in the United States
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Enrolling in the Public Healthcare System in the United States

By Betsy Burlingame

Mondly by Pearson
Mondly by Pearson

Summary: A primer on how to enroll in the public healthcare system in the United States.

If you're planning to enroll in the public healthcare system in the United States, this article covers the requirements for foreigners to be able enroll in the public healthcare system, the steps involved and more.

The United States does not have a universal public healthcare system like many other countries. Instead, it operates a mixed system of private insurance, public programs, and out-of-pocket payments. The quality of healthcare in the U.S. is generally high, but it can be expensive, especially without insurance. It is not mandatory for all residents to have health insurance, but it is strongly recommended due to the high costs of healthcare. Many people in the U.S. have private health insurance, often provided through their employers, while others use public programs like Medicaid and Medicare.

Public Healthcare Programs in the U.S.

Medicaid and Medicare are the two main public healthcare programs in the U.S. Medicaid provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicare, on the other hand, is for people aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

However, not everyone is eligible for these programs. Eligibility for Medicaid depends on income, family size, disability, and other factors. Eligibility for Medicare is based on age or disability status. Most immigrants must wait five years after receiving "qualified" immigration status before they can enroll in Medicaid, although some exceptions apply.

Healthcare for Foreigners in the U.S.

Foreigners in the U.S. are not automatically eligible for public healthcare programs. In general, to be eligible for Medicaid or Medicare, a foreigner must have lawful permanent resident status (a "green card") and have lived in the U.S. for at least five years. Some exceptions apply, such as for refugees and asylees.

Many foreigners in the U.S. instead use private health insurance, either provided through their employer or purchased individually. Some may also qualify for health insurance through the Health Insurance Marketplace during the annual Open Enrollment Period, or outside that period if they qualify for a Special Enrollment Period.

Steps to Enroll in Public Healthcare

  1. Check your eligibility: Before you can enroll in a public healthcare program, you must first check if you are eligible. This will depend on factors like your immigration status, income, and length of time in the U.S.
  2. Apply for a program: If you are eligible, you can apply for Medicaid or Medicare. This can usually be done online, by mail, or in person at a local office.
  3. Wait for approval: After you apply, you will need to wait for approval. This can take several weeks or even months.
  4. Choose a plan: If you are approved, you will then need to choose a healthcare plan. This will depend on your specific healthcare needs and budget.
  5. Start using your coverage: Once you have chosen a plan, you can start using your coverage. This means you can visit doctors, get prescriptions, and receive other healthcare services at a lower cost.

It's important to note that even with public healthcare coverage, you may still have to pay some costs out of pocket, such as copayments for certain services or prescriptions. Also, not all services may be covered, so it's important to understand what your plan covers.

Alternative Options for Healthcare

If you are not eligible for public healthcare programs or if you find the coverage insufficient, there are other options. Many people in the U.S. have private health insurance, often provided through their employers. You can also purchase individual health insurance through the Health Insurance Marketplace. There are also community health centers that provide free or low-cost care, regardless of immigration status.

Healthcare in the U.S. can be complex and expensive, but with the right information and planning, you can find a solution that works for you. It's important to research your options and understand the costs and benefits of each before making a decision.

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About the Author

Betsy Burlingame Betsy Burlingame is the Founder and President of Expat Exchange and is one of the Founders of Digital Nomad Exchange. She launched Expat Exchange in 1997 as her Master's thesis project at NYU. Prior to Expat Exchange, Betsy worked at AT&T in International and Mass Market Marketing. She graduated from Ohio Wesleyan University with a BA in International Business and German.

Some of Betsy's articles include 12 Best Places to Live in Portugal, 7 Best Places to Live in Panama and 12 Things to Know Before Moving to the Dominican Republic. Betsy loves to travel and spend time with her family. Connect with Betsy on LinkedIn.


Mondly by Pearson
Mondly by Pearson

Mondly by Pearson
Mondly by Pearson

Wellesley, a Beautiful Suburb west of Boston, Massachusetts

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