Expats living in the U.S. can get international health insurance to cover their medical expenses no matter where they travel. Most international plans will be less expensive than a health plan from a local U.S. provider. Cigna, Bupa, and GeoBlue offer these types of plans.

Are you an expatriate living or working in the U.S. and you aren’t sure what options you have for health insurance? Are you hoping to better understand where you can find the best coverage for your needs?

This webpage will not only explain how the U.S. healthcare system works and what health insurance options exist for expats but will also introduce you to four of the best international health insurance providers for expats living in the U.S.

Recommended International Health Insurance Plans for Expatriates Living in U.S.

Health Insurance for Expats Living and Working in the U.S.

Health insurance in the U.S. is voluntary for citizens, expats, and tourists alike. However, to save yourselves from high medical costs in the U.S, health insurance is highly advisable, especially for expatriates, many of whom cannot benefit from the government-subsidized schemes.

The USA is world-famous for its superior quality of healthcare services. The country is also renowned, however, for its sky-high medical treatment costs. With high levels of annual medical inflation, healthcare costs for even the most basic medical services in America can be extremely high.

Why is Healthcare So Expensive in the U.S.?

Receiving medical treatment in the United States is quite costly, perhaps most directly due to the structure of U.S. private healthcare hospitals, insurers, and professionals. The U.S. is dominated by private hospitals seeking to earn a profit, doctors that earn high salaries, and rising drug costs.

Some of the key factors that contribute to the extremely high healthcare costs in the U.S. are:

• The complexity of the healthcare systems. Every private insurance company, private hospital and clinic, and the government-funded plans have different rules, out-of-pocket costs, and billing processes. Administration expenses needed to facilitate these differences contribute to high healthcare fees.
• Rising drug costs. U.S. costs for pharmaceutical medications are on the rise, and they are considered the number one cause for overspending on medical expenses in the United States. This is a result of low regulation in drug prices in the U.S.
• High physician salaries. Primary care doctors in the U.S. make on average USD $277,000 annually and specialists make USD $394,000 annually. This is much higher than most countries. For example, primary care physicians in the Netherlands average USD $117,000 annually with specialists at USD $253,000.
• Hospitals seeking to earn a profit. Private hospitals dominate U.S. healthcare, and these hospitals often inflate their prices to earn money. While it is costly to run a hospital, U.S. hospitals often charge unreasonably high prices for care, far exceeding the true cost of procedures or tests.
• Medical professionals have to protect themselves against lawsuits. Sadly, there is an unhealthy culture in the U.S. where physicians, nurses, and medical professionals are often blamed when illnesses or injuries don’t heal. It is fairly common for doctors to be sued by angry patients.
  

  To protect against this, doctors are often expected to run unnecessary tests to make sure they rule out certain illnesses or risks to a patient’s health, even if those risks are highly unlikely. These additional tests and scans can cost a lot of money.

To learn more about the average costs of healthcare in the United States, read our blog post Understanding the Cost of Health Insurance in America.

How the U.S. Healthcare System Works: Explained for Expats

Around 80% of healthcare centers in the U.S. are run by private organizations, though there are some government-owned healthcare institutions. Expats living in the U.S. should expect to seek treatment in privately owned clinics and hospitals and to share the cost of the medical care they receive.

When expats need treatment, they can select a medical practitioner who is approved by their health insurance company. Typically you are expected to first see a general healthcare provider and then receive a referral for a specialist if you require more specific treatment.

Most often you are able to pick your provider, so long as they are approved (or considered in-network) by your health insurance provider. If you receive care from an unapproved physician or clinic (an out-of-network physician), you will pay the full expense of your care out of your own pocket.

If you need emergency treatment, you should go directly to the Emergency Department in your nearest hospital or to an UrgentCare clinic. To request emergency assistance, call 911.

Private Healthcare in the U.S.

Private healthcare institutions dominate the healthcare industry in the U.S., and most Americans and residents rely on their employers to give healthcare benefits in their employment plan. Expats can get health insurance through their employers as well, or they can select their own insurance plan.

If you plan to work in the U.S. for less than 6-10 months, you should read about these short-term health insurance options for a H-1B visa.

Payments and Cost-Sharing in the U.S.

Most insurance plans cost a monthly or annual premium, and these fees will be automatically deducted from your paycheck if you receive your insurance through an employer. While your insurance plan will cover some of the cost of your medical care, you will share some of the cost as well.

Most often this will include a small out-of-pocket copay you pay at the time of treatment, a co-insurance set percentage (such as 15% or 20%) that you cover for certain types of care, and an annual deductible limit that states how much money you must pay before the insurance company covers all medical fees for the rest of the year.

Public Healthcare Schemes in the U.S.

Medicare and Medicaid are two public healthcare programs the U.S. government runs. These plans make healthcare substantially more affordable for those who qualify, though expats most likely will not. Most U.S. expats and residents use private healthcare and insurance.

Health Insurance Options for Expats in the U.S.

The vast majority of residents in the U.S. pay for healthcare through a private insurance plan, and expatriates living in the U.S. will need private coverage as well. There are a few government-funded public health insurance programs available, but most expats will not qualify for these.

The U.S. does not have a universal healthcare scheme like other countries around the globe where the government pays the cost of your care. Instead, every time you receive medical care in the U.S., either you or your insurance company has to pay for it.

Expats residing in the U.S. should expect to rely on the private health insurance they receive from their employer or purchase privately.

Private Health Insurance in the U.S.

Most Americans and expats residing or working in the U.S. purchase private health insurance or receive private health insurance for themselves and their families through their employers. Depending on the benefits provided by their employer-sponsored insurance, expats can purchase add-ons.

For example, if your plan only has inpatient benefits, you can purchase a plan to also cover outpatient treatment. You can add plans with coverage for pre-existing medical conditions, maternity care, and even dental care.

It is advisable for expats to purchase locally compliant U.S. health insurance through a private insurance company or a private international health insurance plan. Since the cost of U.S. healthcare is so high, a U.S. plan can cost more than an international and globally portable medical plan.

The average annual cost of a local U.S. private insurance plan in 2022 was USD $9,817. This is drastically higher than the annual average cost of a private international health insurance plan which is USD $5,500.

Public Health Insurance Schemes

The U.S. government funds several public insurance schemes for low-income and elderly residents in the U.S. Medicare and Medicaid make healthcare more affordable for U.S. citizens and legally present immigrants. Most expats living in the U.S. will not qualify for public health insurance.

If you are interested in getting a Green Card and becoming a legal resident of the U.S., read our blog post about health insurance options for Green Card holders and applicants.

Medicare in the U.S.

Medicare is a social insurance program funded at the federal level. It covers the healthcare costs for adults over 65 years old. Medicare covers about half the healthcare expenses of those enrolled. The rest of the costs are either paid out-of-pocket by the insured or by a private insurance plan.

Medicaid in the U.S.

Medicaid is the social healthcare program in the U.S. for low-income individuals, pregnant women, elderly people, and disabled people. This federal and state program offers free healthcare to qualifying individuals and families. Most expats will not qualify.

Best International Health Providers for Expats in the U.S.

Among the very best international health insurance providers for expats living and working in the U.S. are Cigna Global, Bupa Global, Allianz Care, and GeoBlue. We will introduce each below.

Read our full list of the Top 10 International Health Insurance Providers here.

Cigna Global

Cigna Global is a top-notch company for expats in the United States because they offer access to 24/7 multilingual services, a global network of 1.5 million hospitals, and medical care in over 200 territories. Cigna offers international plans for global professionals, families, retirees, and more.

Here’s an overview of Cigna’s expat health insurance plans:

1. The Cigna Silver plan is designed to provide the core medical benefits expats need in the U.S. This includes coverage for inpatient and day patient care, palliative care, transplant services, mental and behavioral healthcare, and out-of-area emergency hospitalization care.
2. The Cigna Gold plan adds benefits for emergency treatments, advanced imaging, rehabilitation, home nursing, treatment for obesity, and congenital conditions.
3. The Cigna Platinum plan provides full coverage for inpatient care, palliative care, transplant services, hospital accommodations for a parent or guardian, acupuncture, and much more.

Allianz Care

Allianz Care specializes in health, life, critical illness, and disability for expats, families, and employers globally. Their plans offer flexibility, worldwide expertise, and innovative services. Allianz Care’s global network of 1.9 million medical providers covers the U.S.

Here’s an overview of Allianz Care’s expat health insurance plans, though it isn’t exhaustive:

1. The Allianz Care plan covers a semi-private hospital room, oncology, medical evacuation, nursing at home, rehabilitation, emergency outpatient care, and more.
2. The Allianz Care Plus plan covers a private hospital room, which has the same benefits as the Care plan, as well as additional emergency dental care.
3. The Allianz Care Pro plan increases the benefit limits from the Care Plus plan and adds coverage for preventative surgery and laser eye treatment.

GeoBlue

GeoBlue offers some of the most extensive and affordable travel medical insurance plans in the market. U.S. expats will particularly like GeoBlue because their plans can be customized to cover you in the U.S. and in other countries at the lowest rates possible.

Here’s an overview of GeoBlue’s expat health insurance plans:

1. Xplorer Essential is best for expats who don’t need coverage in the U.S. while living abroad. If you intend to return to the U.S. for short trips only, this plan has an optional U.S. coverage add-on.
2. Xplorer Premier is best for U.S. residents living out of the country for at least 3 months of the year and who want comprehensive coverage within the U.S. for up to 9 months of the year. Flexible options allow coverage in the U.S. and your country of origin as you travel back and forth.

How to Find the Best Private Health Insurance in the U.S.

Pacific Prime is a leading international health insurance broker, and we work with the top health insurance companies to offer a wide selection of the best plans. We have 20 years of experience in matching expats living in the U.S. with policies that best meet their budget and healthcare needs.

We offer expat health plans that can be tailored to meet specific requirements and include benefits for inpatient, outpatient, maternity, dental, pre-existing medical conditions, and emergency evacuation coverage. Our plans can have guaranteed renewability for life, and they are globally portable, meaning they cover you no matter where you travel.

In addition to having the best insurance policies, Pacific Prime also offers unparalleled service and outstanding claims support. Contact us today so we can help you find the best U.S. insurance plan for your budget and healthcare needs.

You won’t want to miss our blog post that explains why expats use brokers to get international health insurance.

Health and Safety Tips for Travelers in the U.S.

Here are some general safety tips for travelers visiting the U.S.:

• Choose safe transportation
• Get travel insurance and short-term health insurance
• Be aware of your surroundings
• Inform your friends and family where you are
• Try to blend in
• Prepare for emergencies
• Know the current travel and health restrictions
• Be mindful of food hygiene, such as washing fruits and vegetables
• Drink responsibly
• Know the common diseases contracted while traveling and how to prevent them
• Respect local customs

Frequently Asked Questions

What do expats in the U.S. do for health insurance?

Most expats living and working in the U.S. get private health insurance. This can be an international health insurance plan that covers you no matter where you travel around the globe, or it can be from a local U.S. private insurance company that only covers within the U.S.

Can expats in the U.S. get insurance through their boss?

Expats working in the United States can get health insurance through their employer. This is the most common way for U.S. residents to secure their coverage. If your employer doesn’t offer this benefit, or if you’re self-employed, you will want to purchase a private health insurance plan.

Can expats living in the U.S. get Medicare?

Expats living in the U.S. who are not legally permanent residents cannot get Medicare. This is because Medicare is only available for citizens and legal immigrants who have changed their LPR (legally permanent resident) status. Most often, this is done through getting a Green Card.

Conclusion: Compare Plans and Quotes Now

We offer one of the most practically useful tools in every expat’s insurance journey. Our insurance quote generator is an obligation-free resource everyone can use to find, compare, and save their favorite international health insurance plans and quotes all in one place.

With this tool, you can compare over 50,000 plans without having to go to each insurance company's website one by one. This will save you time and stress, and it can even save you money.

Get started today or speak online with one of our insurance experts to get their help and experienced advice. You can also call 1-800-868-1451. Happy insurance hunting!

Recommended Reads:

• Foreign Visitors’ Health Insurance Guide
• U.S. Health Insurance for Visitors
• Finding the Best Worldwide Medical Insurance Coverage
• Living Abroad? What to Know About Health Insurance