Overview of the U.S. healthcare system
The U.S. healthcare system is divided into several parts.
(1) Public Health Insurance (Public Health Insurance)
For veterans, active military personnel, Indians and so on the establishment of the public health care system. U.S. federal and state health insurance programs provide health insurance for about 30% of Americans, including the elderly, disabled, children, the poor, and veterans. These publicly-funded health insurance programs focus on vulnerable populations to ensure social justice.(2) Social Security (Medicare and Medicaid)
Medicaid for the Poor in the U.S.:
Medicare for the Poor (Medicaid):Medicare:
Medicare is the U.S. federal government's health insurance program for people 65 years of age or older, younger than 65 but with long-term disabilities, or with permanent kidney failure. The applicant must be a U.S. citizen or permanent resident, and the applicant or spouse must have paid Medicare taxes to the state for at least 10 years (40 quarters). The Medicare program is administered by the federal government and is uniform across all states.(3) Individual Health Insurance
In the United States, health insurance for working people is provided by commercial insurance organizations. There are historical reasons for the predominance of commercial insurance in the United States. U.S. politics has three distinctive features: federalism (decentralization), limited government, and liberal ideology. So having some employers provide basic health insurance for their employees is more in line with the general political and economic philosophy of Americans.2. General Knowledge of Health Insurance
Disadvantages of the U.S. Health Care System:
As we have come to understand the U.S. health care system, we know that the public health care system in the U.S. is characterized by a lack of health care insurance, and that the public health care system in the U.S. is characterized by a lack of health care insurance, and that the public health care system in the U.S. is characterized by a lack of health care insurance. The Medicare and Medicaid public **** programs are designed for seniors, people with disabilities, and low-income families and individuals. Everyone else is required to have private insurance, either through an employer or on their own. If you are uninsured, you will be responsible for your own medical expenses, and the bills can be astronomical. Private health insurance is either offered by your employer or school, or you have to buy it on your own. You can choose the plan that's best for you from the ACA's f="">Health Insurance Marketplace: the Affordable Care Act, also known as Obamacare. The Affordable Care Act, also known as "Obamacare," provides subsidies for people who can't afford high insurance premiums. The amount of the subsidy depends on a person's income. States such as California, Colorado, New York and Massachusetts have their own health insurance marketplaces.Medicare plans for non-U.S. citizens are generally one of the following:
(1) If you are employed by a U.S. company, you may be covered through an insurance plan offered by your employer. Some employers will pay the full cost of the insurance program, while others may pay part of the cost and require you to pay the remainder. (2) If you have a work visa (H1B visa) but plan to start your own business, you will need to purchase your own health insurance. During the enrollment period, you can find a plan on the Affordable Care Act's Health Insurance Marketplace. If you arrive in the U.S. outside of the enrollment period, you may still be eligible to apply for a plan due to your unique circumstances. (3) Students or Exchange Scholars (F-1 and J-1 visas): Most schools require proof of health insurance prior to enrollment, and usually automatically enroll students in a student health insurance plan at the beginning of the semester. The U.S. requires that all exchange scholars and their accompanying spouses and children have health insurance. You can obtain an insurance plan through your university.Third, the organization of commercial health insurance
The U.S. health care system consists of two major components, one is the government-led Medicare, Medicaid, Children's Health Care, and Veteran's Health Care system (VA), after the implementation of Obamacare in 2014, the total * * * ** covers 38% of the U.S. population; the other is commercial insurance, which covers 53% of the U.S. population. Next Tiger Tiger focus on the absolute population accounted for 53% of the commercial insurance a *** which organizations:One is the Health Maintenance Organization (Health Maintenance Organization, referred to as HMO). This organization grew rapidly after the enactment of the Health Maintenance Organization Act of 1973. This type of insurance plan is relatively inexpensive, and the out-of-pocket expenses of the insured are low. The goal is to improve the overall health of the insured and reduce medical expenses through health management. Health Maintenance Organizations (HMOs) provide more preventive services than other insurance plans. Participants must choose a primary care physician as their "gatekeeper" for medical care, responsible for treating common illnesses and providing referrals when needed. The insurance company pays the PCP on a capitation basis, which provides an incentive for the doctor to improve the health of the subscriber and reduce the cost of the visit, thereby making a profit on the balance. Health maintenance organizations often have their own network of doctors and hospitals, and in non-emergency cases, participants can only seek care within the network, and insurance companies can refuse to pay for care if they go outside the network.
The second is the Preferred Provider Organization (PPO). Preferred Provider Organizations (PPOs) do not require patients to sign up with a primary care physician, so enrollees can go directly to a specialist. Although Preferred Provider Organizations also have their own network of doctors and hospitals, they allow enrollees to go outside the network, but at a higher deductible (40%). Preferred Provider Organizations are more flexible than HMOs and have higher guarantee fees and deductibles. In general, the monthly premiums for preferred provider organizations are twice as high as those for HMOs. Preferred Provider Organizations also have less control over physicians and typically pay twice the rate of Medicare.
Third is the Point-of-Service (POS) organization. This is a form of insurance that combines the features of a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO), offering more options for care than an HMO, but at a lower cost than a PPO. The designated service organization also has its own network of health care providers and requires the participant to choose a primary care physician.
We'll use a chart to illustrate the differences between these insurance plans:
HMO POS EPO PPO Requirement to designate a family doctor YES YES YES NO NO No No Seeing specialists to be recommended YES NO NO NO Pre-approval required Usually not required Usually not required YES YES YES Reimbursement for out-of-network medical expenses NO YES (family doctor referral required) NO YES Premiums and out-of-pocket costs Low In-Network Low in-network, high out-of-network Low High, especially out-of-network Characteristics Low overall cost, medical benefits such as no annual physical exams Low premiums for HMOs, but also gives members more freedom of choice In-network providers can be reached at member rates In-network providers can be reached at member rates I hope that you can understand more about the U.S. healthcare system from this article, and I hope that you will find it useful. I hope you can understand the U.S. healthcare system through this article, and I strongly recommend that international students who are studying in the U.S. for more than a few months learn more about the U.S. healthcare system, and international student insurance organizations, and U.S. health insurance plans.