Those who have been living in the US long enough will understand one thing very clearly: the saying “Without insurance in the US, one illness can ruin the family” is absolutely not an emotional scare.
It is essentially a practical reminder so that we do not fall into a disadvantaged position and proactively protect our families.
In Vietnam, many people are used to the fact that when their body gets sick, they go to the doctor and pay cash directly. Medical costs can be high, but are generally still within the “estimated” range of financial capabilities.
In the US, healthcare operates under a completely different system.
Just once you have to step into the emergency room ER, once admitted to the hospital for treatment, once do high-tech imaging tests such as CT scan, MRI, or have to undergo surgery and stay under observation for a few days… the total cost of the bill can escalate rapidly to dizziness. And if that situation arises when you are uninsured in the US, you will be the only one bearing the bulk of that huge financial burden.
Therefore, once you decide to live in the US, health insurance in the US is absolutely not something “it’s okay to have, it’s okay not to have it”. It should be a core part of your basic financial management plan.
1. Buy health insurance through the company (Employer-Sponsored Insurance)
Many people in the US have insurance through their employer, which is your job.
Usually every year the company will have an Open Enrollment period for you to choose or change insurance packages.
If you just started a job, got married, had a baby, lost your old insurance… you may also have the opportunity to sign up outside of that time.
When choosing insurance through a company, don’t just look at the monthly premium.
Please review other information carefully
- How much is Deductible?
- How much is copay when going to the doctor?
- How much is Coinsurance?
- What is the out-of-pocket maximum?
- Are your doctors, hospitals, and medications in the network?
There are lower monthly insurance plans, but the deductible is very high.
This means you pay less each month, but when you actually go to the doctor or need tests, you may have to pay more.
2. If you don’t have insurance through your company, check out Marketplace
Marketplace is where many people buy personal insurance or family insurance if they do not work for an employer.
You can go to HealthCare. gov to view insurance plans, compare prices, and see if you qualify for cost assistance.
Many people may qualify for reduced premiums or reduced costs depending on income and family size.
When filling out the application, the system will ask about your family information – how many members and estimated income that year to see if you qualify for support or not.
3. If income is low, check for Medicaid or CHIP
Medicaid is a free insurance program for people who are low-income or qualify under state regulations.
CHIP is a program that insures children in qualifying families.
Eligibility for Medicaid/CHIP may vary by state.
The important point is that Medicaid and CHIP can be registered year-round, it is not necessary to wait for Open Enrollment season.
If you have young children, are pregnant, recently lost your job, or your income has changed a lot, don’t ignore this option.
4. When choosing an insurance package, don’t just ask: “Which package is the cheapest?”
Instead, ask: “Which plan is right for my family’s health, finances, and risk profile?”
For example:
– If you are young, healthy, rarely go to the doctor, and rarely take medicine, you can consider a lower premium package but a higher deductible.
– If you have a chronic disease (diabetes, high blood pressure, etc.), need to go to the doctor regularly, take medication regularly, plan to get pregnant, or have young children or need to go to the doctor, you should look more closely at copay, deductible, coinsurance, out-of-pocket maximum, and network.
– The cheapest package for each month is not necessarily the cheapest for the whole year.
5. Words you need to understand before buying insurance (I talked about it in detail in the previous article, you can read it for more detailed reference)
If you live in the US, you should understand these concepts:
- Premium: the amount you pay each month for insurance.
- Deductible: the amount you typically have to pay out of pocket before insurance begins to share the cost of many services.
- Copay: a fixed amount you pay when going to the doctor or using a certain service, for example $30, $50, $75.
- Coinsurance: the percentage of costs you have to pay after reaching the deductible, for example 20%.
- Out-of-pocket maximum: the maximum amount you have to pay during the year for services covered by insurance. Once this level is reached, insurance typically pays 100% of the remaining eligible services for the year.
- Network: system of doctors, clinics, hospitals, pharmacies with which insurance has a contract. Going out of network can cost a lot more, or not be covered at all.
This is why I always say: before choosing insurance, don’t just look at the monthly price. Read the benefits of that package.
6. What should I do if I don’t have insurance?
First, don’t panic.
Please check in this order:
– Firstly, are you eligible to buy insurance through work?
– Second, are you in the Open Enrollment period?
– Third, do you have any events that qualify for Special Enrollment, for example, recently lost insurance, recently moved states, got married, divorced, had a child, adopted a child, or changed income?
– Fourth, are you or your child eligible for Medicaid or CHIP?
– Fifth, if you buy insurance yourself on the Marketplace, carefully read the benefits, because not every package that sounds like “insurance” will protect you as fully as you think.
7. The most important thing: don’t wait until you’re sick to find out
Health insurance in America is like a seat belt.
On a normal day, you might find it annoying, expensive, and unnecessary.
But when something happens, you understand why it is important.
No one buys insurance because they want to use it.
I buy insurance because if one day I need it unfortunately, I don’t have to worry about getting sick and worrying about medical bills collapsing my family’s finances.
In America, understanding health insurance is not a matter of “knowing the paperwork.”
It’s a financial survival skill. And if you have just arrived in the US, are going to school, working, have young children, or are struggling to know where to start, start by understanding your insurance package first.
Don’t wait until you have the bill in hand before asking: “Why is insurance still so expensive?”
In America, having insurance doesn’t mean it doesn’t cost money.
But not understanding insurance, or not having it when you need it, can cost you a lot.
Note: I do not sell insurance and do not represent any insurance company. This article is just to share educational information from the perspective of a doctor, based on knowledge and experience of more than 10 years of studying, training and working in the medical system in the US. Insurance rules and benefits may vary by state, income, family situation, and specific insurance plan, so you should still check directly with your employer, Marketplace, Medicaid office, licensed broker/agent, or insurance company.
What do you think about these shares? Please comment to let me know.
Please share if you find it useful!
Dr. Christina Nguyen
Phoenix Medical Academy
