Health Knowledge Sharing
Event Time: August 12 (Sunday) 13:30-16:30
Inquiry Hotline: 400-138-2929
Event Address: 28th Floor, Tower B, China Resources Building, No. 6A Shandong Road, Shinan District, Qingdao
Many people moving to the United States are familiar with its social systems and lifestyle culture, but have only a superficial understanding of U.S. medical insurance. In light of this, the Visas Consulting Group immigration team will discuss the most common types of U.S. medical insurance, introduce their respective characteristics, and explain which types are more convenient for medical visits.
As everyone knows, the medical process involves both patients and doctors. Regardless of your insurance type, understanding the doctor's perspective may help you choose the right medical insurance and ensure a smoother medical experience. The U.S. medical insurance system is highly complex and consists mainly of two parts: social medical insurance and private medical insurance.
Social Medical Insurance
The U.S. Congress passed the Social Security Amendments of 1965, authorizing the government to establish social medical insurance. This primarily refers to "Medicare" (the red and blue card), managed by the federal government for retired seniors and the disabled, and "Medicaid" (also known as the white card in California), operated by state governments for low-income residents. Additionally, veterans can apply for Veterans Affairs (VA) medical insurance.
Above is the federal government's Medicare insurance card, which the Chinese community likes to call the "red and blue card." Medicare consists of two parts: Part B, which covers physician fees, and Part A, which covers hospital costs. The basic requirements for applying for Medicare are being a U.S. citizen aged 65 or older, or a green card holder who has lived in the U.S. for at least 5 years (along with other conditions). Medicare serves retired seniors, disabled individuals, and kidney patients requiring long-term dialysis. There is no household income limit for applying for Medicare, but monthly premiums must be paid, and after receiving medical services, there are deductibles and coinsurance.
Above is the California low-income Medicaid insurance card; because it is white, it is also known as the "white card." Medicaid is largely similar across U.S. states and primarily serves low-income pregnant women, children and adolescents under 19, retired individuals aged 65 and older, the blind, and seniors requiring nursing home care.
Medicaid beneficiaries enjoy free medical services, but their status, age, residency duration, income, and assets must meet specific requirements. Due to the current economic situation in the U.S., applying for this type of insurance is becoming increasingly difficult. Many retired seniors who came from China sponsored by their children have obtained Medicaid.
Some seniors or disabled individuals may qualify for both Medicare and Medicaid; these patients can enjoy dual insurance coverage. As mentioned above, Medicare patients need to pay monthly premiums, deductibles, etc., but if the patient also has Medicaid, the state government where the patient resides will cover these costs. Under current circumstances, these individuals do not need to spend a penny of their own money for doctor visits, hospitalizations, or nursing home stays (most patients actually have no money). From a doctor's perspective, because they have dual insurance and the patient does not need to pay, the patient's motivation to see a doctor is high, and doctors see more patients, resulting in higher income. Many doctors prefer patients with both Medicare and Medicaid. Medicare and Medicaid are collectively referred to as "Medi-Medi," which many doctors and patients call the "Gold Card."
Private Medical Insurance
Private medical insurance in the U.S. is operated by private insurance companies and mainly includes PPO (accounting for 34%) and HMO (accounting for 31%). PPO stands for Preferred Provider Organization, and its advantage is the freedom to choose doctors. You do not need a referral from a primary-care physician (PCP) and can see a specialist directly. The main issue with PPO is that the insurance premiums are relatively expensive, and patients must bear a portion of the registration fee ($15 to $30 co-payment) when seeking medical care. Each year, before the insurance company pays for medical expenses, the patient must first pay $250 to $1,500; in other words, PPO has deductibles and coinsurance.