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International Student Insurance

The hows and whys of the American healthcare system.

US Healthcare System

Care is Excellent, but Expensive

For those who can afford treatment or have adequate insurance, healthcare in the United States is unparalleled. With trillions of dollars spent each year on healthcare, it’s no secret the US spends more money per capita on health than any other country in the world. This means that international students and US citizens alike have potential access to the world’s largest networks of specialists, hospitals, clinics, and technology, for a price. Researchers have found that the average charge for an emergency room visit in the US is approximately $1,233 - 40% higher than what the average American pays for rent each month.*

*Source: Taken from “How Much Will I Get Charged for This?” Patient Charges for Top Ten Diagnoses in the Emergency Department”

Lack of a Nationalized Healthcare System

Unlike many countries around the world, the United States doesn’t have a nationalized healthcare system and instead expects individuals to purchase health insurance to help cover the majority of their healthcare costs, or pay for these services out of pocket. 

Access to a Variety of Providers

There are many ways to seek treatment in the United States, including traditional providers like urgent care centers, walk-in clinics, student health centers, private doctor’s offices and hospitals, with additional hybrids appearing constantly. 

Health Insurance is Assumed

The US healthcare system was not designed on the idea that individuals would pay out-of-pocket for their healthcare. It’s assumed that you have health insurance, show your insurance card to seek treatment, pay a co-pay of some kind and then expect a follow-up bill for any uncovered costs. Without insurance, even being seen by some providers can be difficult, and if you are able to seek treatment, it will be much more expensive. Insurance companies also work closely with providers to agree upon deeply discounted rates and help their members receive medical care for a fraction of the cost. With this in mind, a hospital may traditionally charge $800 for a given treatment, but will only charge a contracted insurance company $300 for the same services. Without health insurance, you could easily be left with the entire $800 bill.

Direct Billing

Providers in the US are used to taking a small payment from the patient at the time of service, and directly billing the insurance company for the remaining portion. 

Your Individual Insurance Plan

International student insurance is being provided by ISI. Benefits of your individual insurance plan include:

■ Customer service lines are available with each insurance plan, allowing you to contact the insurance plan directly about benefits and claims.

■ They typically include medical evacuation, repatriation of remains, and emergency reunion benefits, coverage in all 50 states (and often internationally, outside your home country), and typically allow students to purchase insurance for the exact period they need.

■ These individual insurance plans are typically designed to cover students for new accidents and illnesses, and by cutting down on long term benefits like wellness, the prices are much more affordable. Many options allow students the flexibility to choose their own deductible, and often promote their lowest deductibles ($100 or less).

■ Many students like the ability to choose an insurance plan that meets their health needs, as well as their budget. With the knowledge that all students are unique, this allows them the freedom to choose the most appropriate plan for themselves and their family, regardless of what may be offered to other students.

Dependent Insurance Options

Although CNM does not require insurance for dependents, it is very important, as dependents are often more in need of regular medical care.

Policy Maximum

The policy maximum is the overall coverage that each student will receive for all eligible claims. Coverage for these plans typically range from $100,000 to $1,000,000.

Out-of-Pocket Payments

Insurance will have out-of-pocket expenses, particularly deductibles, separate ER deductibles, copays and coinsurance to consider. After the deductible, the insurance plan may cover a percentage of eligible expenses (known as coinsurance). Most insurance plans will cover between 80% - 100% of an international student’s eligible expenses after the deductible, assuming he or she visits an in-network provider. The percentage of coverage will likely be lower if students elect treatment at a non-participating or out-of-network provider.

Provider Network

Insurance plans have a network of doctors, hospitals and clinics that can be used by students. While they are not often required, these providers have agreed to discounted rates and often accept direct billing from the insurance company.

Mental Health

Mental health has become increasingly important for international students studying in the US, and is usually covered for both inpatient and outpatient care. 

Medical Evacuation and Repatriation of Remains

Emergency medical evacuation and repatriation of remains, sometimes referred to as return of mortal remains, is essential to any health insurance policy for international students and scholars. All international students should have this coverage. Emergency medical evacuation provides transportation to the nearest facility equipped to handle treatment, generally determined by the overseeing physician, which can also include their home country if medically necessary. In case of death, repatriation of remains provides transportation for the body to be brought back to the home country. Both benefits are typically coordinated by the insurance company who works with family members to coordinate these arrangements.

Healthcare Reform

PPACA, or the Patient Protection and Affordable Care Act, was signed into law on March 23, 2010 by President Obama. As Non-Resident Aliens, international students on F, J, M and Q visas are not subject to the individual mandate for their first 5 years in the US. 

What is the Individual Mandate?

The individual mandate is the requirement built into the law that everyone must have qualifying health insurance (“minimum essential coverage”), or pay a penalty. 

Taken from: http://www.gpo.gov/fdsys/pkg/FR-2014-10-06/pdf/2014-23510.pdf