Navigating the US Healthcare System

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If you’ve just relocated to the United States for work, you might not think about finding a doctor or accessing healthcare until you need it. Regardless of whether you have a simple sore throat or a more complex condition, navigating the healthcare system in a new country can be intimidating. 

Here are some things to know about seeking medical care in the US:

Insurance

Healthcare in America can be expensive, and health insurance exists to help make those costs more manageable. You likely have insurance coverage as part of your employer’s benefits package, and the premium costs (monthly charges for coverage) are deducted from your paycheck. If your employer does not offer insurance, you can purchase a policy on your own and pay the premium bill monthly.  

Whichever type of coverage you have, review your policy and look for a few key things: copays or coinsurance, which will tell you how much you can expect to pay out of pocket for healthcare visits and testing, as well as your network. 

Healthcare providers are part of a network; not all providers belong to all networks. Seeking care from an out-of-network provider or facility, such as a hospital, can incur additional charges. Health insurance is an extremely complex topic, and if you have specific questions about your policy or coverage, you can call the customer service phone number on the back of your member ID card for assistance. And remember—always bring this card with you to your appointments.  

Primary Care Providers

Most Americans have a primary physician they go to for everyday conditions like colds, routine exams, and vaccinations. These are called primary care providers, or PCPs. Typically, you have a longstanding relationship with this provider; most people see their PCP for years.  

Many Americans seeking a new PCP will ask friends, family members, and coworkers for recommendations. In addition to handling routine physical examinations and minor illnesses and injuries, these providers assist with prescriptions and refills, health screenings, and referrals to specialist providers if needed.  

Primary care providers include family practice doctors, OB-GYNs for women’s health, and pediatricians for children’s health. Your primary care provider may be a doctor, but they may also be a physician assistant or nurse practitioner, who are licensed to see patients and prescribe medications. 

Emergency Rooms

Emergency rooms (ERs) are specialized departments within American hospitals that are equipped to triage and provide acute care to patients with life-threatening conditions. 

You should only visit an emergency room when you or someone you love is at risk of death or permanent injury—think of things like trouble breathing, heart attacks, strokes, or broken limbs. In the United States, if you are faced with a life-threatening emergency and need immediate care, dial 9-1-1. This will connect you to an operator who can dispatch an ambulance for immediate care and transport to the hospital. If you drive yourself to the emergency room, expect a long wait if your condition isn’t severe. This is because ER providers prioritize patients in greatest need first. Sometimes, a trip to the emergency room will also result in a hospital admission and stay for additional testing and treatment. 

Urgent Care

America has additional treatment facilities called urgent care clinics. These serve as middle-of-the-road options for care between primary care physicians and emergency rooms. Americans often use them to avoid going to the ER or when they need care outside of their PCP’s office hours.  

Urgent care providers can treat many of the same things primary care physicians do, and people frequently visit for minor illnesses and injuries. Some also provide limited diagnostic testing and vaccinations. Many American drugstores and standalone pharmacies also have in-store treatment centers that function like urgent care facilities. Patients can book appointments online and visit their neighborhood location for quick care.  

It’s important to note, though, that when you visit an urgent care center, you may be referred to an emergency room if your condition is deemed too serious—a severe allergic reaction, for example. 

Even when you’ve researched, figuring out the US healthcare system can be challenging. Global LT’s Language Experiences, which are a benefit that our language students receive, focus on topics like healthcare so you have all of the information you need in your new location. If you want to see what our Language Experiences are all about by signing up for language lessons, let us know! 

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