Expat Guide to USA Healthcare and Insurance

Key takeaways:

• The U.S. has no universal healthcare—insurance is essential to access affordable medical care.

• Healthcare costs are high without coverage, with even routine visits or emergencies running into thousands of dollars.

• Expats can choose from employer plans, ACA marketplace plans, or private international insurance depending on visa status and length of stay.

Understanding healthcare in the U.S.

Unlike many countries, the United States does not have a universal healthcare system. Instead, healthcare is primarily delivered through a mix of private providers, employer-sponsored plans, and government programs for eligible groups (like Medicare for seniors and Medicaid for low-income residents).

For expats, this means that you must arrange your own health insurance—whether through an employer, a government exchange, or a private provider. Without it, even a short hospital visit can cost thousands of dollars out of pocket.

Who needs U.S. health insurance?

Anyone living in the U.S. for an extended period—whether on a work, study, or dependent visa—should obtain health insurance. This includes:

• Professionals on work visas (H-1B, L-1, O-1, etc.)

• International students (F-1, J-1, M-1)

• Spouses and dependents of visa holders

• Green card holders

• Long-term visitors

While short-term travel insurance may cover emergencies, it’s not a substitute for full health coverage if you’re planning to live, study, or work in the U.S.

Common healthcare options for expats

How much does U.S. healthcare cost?

Without insurance, even basic care in the U.S. can be costly. Here’s a look at typical out-of-pocket costs:

Healthcare terms to know

Here are some terms you’ll encounter when choosing a U.S. health plan:

• Premium: The monthly cost of your insurance plan

• Deductible: The amount you must pay out of pocket before insurance kicks in

• Co-pay: A fixed fee for visits or prescriptions

• Out-of-pocket maximum: The most you’ll have to pay in a year before insurance covers 100%

• Network: A list of doctors and hospitals your insurance works with

Do expats qualify for government healthcare?

Generally, no. Most expats are not eligible for Medicare or Medicaid, which are reserved for U.S. citizens or permanent residents under specific conditions (age, income, disability). However, green card holders may qualify after meeting residency requirements.

Frequently asked questions (FAQs)

1. Can I use my home country insurance in the U.S.?

Usually not. Most foreign health insurance plans don’t offer sufficient coverage for U.S. care unless you have a global insurance policy.

2. Do I need insurance before arriving in the U.S.?

Yes, it’s strongly recommended. Some visa types (like J-1) even require proof of insurance before entry.

3. Are there expat-specific health insurers?

Yes. Companies like Cigna Global, Allianz Care, and IMG offer international health plans that include U.S. coverage.

4. What if I only need coverage for a few months?

Consider short-term or travel insurance, but note these plans don’t meet ACA requirements and may not cover pre-existing conditions.

5. Can I get health insurance without an SSN?

Some private insurers and international plans allow you to apply without a Social Security Number, but government-subsidized plans generally require one.

Additional tips for expats navigating U.S. healthcare

• Review plan networks carefully: Many plans won’t cover out-of-network care except in emergencies.

• Keep all paperwork: Insurance ID cards, EOB (Explanation of Benefits) forms, and medical receipts are important for claims or reimbursement.

• Use urgent care centers when appropriate: For non-emergencies, urgent care is far cheaper than emergency rooms.

• Telehealth options: Many plans offer virtual doctor visits for minor illnesses or mental health support.

Need to send money for U.S. healthcare coverage?

Paying premiums or funding health-related expenses from abroad? Xe can help.

With Xe, you can:
✅ Send USD directly to insurers or U.S. bank accounts
✅ Avoid inflated currency conversion rates
✅ Transfer securely to over 190 countries

Send money to the U.S. with Xe and protect your health with peace of mind.

This content is for informational purposes only and should not be considered financial, legal, or immigration advice. Requirements for opening a U.S. bank account may vary by bank, visa type, and residency status. While we aim to provide up-to-date and accurate guidance for expats, always check directly with your chosen bank or a licensed advisor for the most current policies. Xe is not responsible for decisions made based on this article.