What is Medicare Part F Supplementary Insurance

Health insurance in the USA

In contrast to Germany, there is no uniform state health system in the USA, but various private and state providers. A milestone for the American health care system was the health care reform called Obamacarefrom 2010, as it completely reorganized access to health insurance.

The American insurance market

The medical care of Americans is provided by several separate insurance systems and is in private and state providers divided up:

providers# US citizens (2017)
Privateon the employer156 million
individually via the "Marketplace"(often freelancers and self-employed)21 million
stateMedicaid (socially deprived) & CHIP (their children)65 million
Medicare (Pensioners from 65 and disabled)43 million
TricareVeterans Administration (Soldiers and relatives)5 million
uninsured28 million

Since healthcare costs in the US are among the highest in the world, insurance premiums are also very expensive. Since many US citizens cannot afford this, a large part of the population does not have health insurance at all. American law, however, guarantees that hospitals doin medical emergencies everyoneprovide medical care regardless of individual solvency.

However, insurance often does not cover all costs, so many Americans doPay medical services yourself or.to pay have to. Uninsured Americans are generally expected to pay for their own medical care in the event of illness. It is therefore not surprising that the most common reason for personal insolvency is medical bills after hospital stays.

What has Obamacare changed?

Thanks to the 2010 health reform, millions of previously uninsured Americans could afford health insurance, in part through government grants. The so-called law"Affordable Care Act" included the following changes:

  • Compulsory insurance for all US citizens
  • no exclusion of people with Pre-existing illness by the health insurance companies
  • Parents are allowed to do theirs children up to the age of 26 years co-insure
  • Penalty fee in the amount of 2% of household income if not insured
  • Introduction of the state-regulatedObamacare Exchanges ("Health Insurance Marketplace")

With compulsory insurance introduced for the first time in 2014, the proportion of uninsured persons has decreased significantly. For comparison: in 2010, just under 47 million US citizens were still without insurance, in 2018 "only" 28 million. Received through the reform socially needy significantly better access to the system and have since been supplied via a risk pool.

Those who are not insured through their employer or one of the government programs can now obtain insurance coverage online via the government's central web portal (Marketplace) at fixed registration times. The new insurance policies must also be specificMinimum benefits as basic security cover.

President Trump's reform plans

Although the increasing insurance coverage through the "Affordable Care Act" was clearly demonstrable, the Trump administration is working on an alternative to Obamacare and would like to reverse the reform. However, this requires the approval of Congress.

With a new tax law at the end of 2017, thepenalties for non-insured persons againabolished, which also eliminates the need to have health insurance. This regulation will take effect from 2019. What further steps will be taken and what an alternative to Obamacare will look like remains to be seen at the moment.

What types of insurance are there?

The majority of US citizens have health insurance through their employer. Since this is also the contractual partner of the insurance cover, the insurance usually ends if you lose your job. Become common Group health insurance Completed for the entire company, with employers and employees sharing the costs, similar to the one in Germany. The latter often have to pay for the services they use or take out additional private insurance.

If insurance cover is purchased directly via the marketplace, there are different types of insurance, depending on the region in which you live, which are tailored to different needs. When purchasing health insurance, you can usually choose between the following three types:

  1. Traditional "fee-for-service" health insurance: Usually the most expensive choice, but offers the greatest flexibility in the choice of service provider (free choice of doctor)
  2. Health Maintenance Organizations (HMO): Network that employs its own doctors as contractual partners; Members pay a fixed monthly fee and can only visit doctors in the network
  3. Preferred Provider Organizations (PPO): Network of doctors and hospitals; Members can also go to doctors outside the network with a deductible

Emigrating to the US: Which Health Insurance Is Right?

Choosing appropriate health insurance is an important consideration for anyone looking to settle in the United States. For the first time in the USA, long-term travel health insurance can be taken out so that all American insurance options can be checked on site in peace.

Anyone who is not insured through an employment relationship in the USA can buy the insurance cover individually on the marketplace. The different policies should be compared precisely there, as they consist of different packages and often do not include, for example, dental services. As a rule, you can choose between four tariffs (bronze, silver, gold and platinum).

When comparing theInsurance conditions You should pay particular attention to the following points:

  • Do I have the right to choose my doctor, hospital or pharmacy freely?
  • Is treatment by specialists (such as ophthalmologists and dentists) also insured?
  • Does the insurance cover special treatments such as pregnancy, physiotherapy or psychiatric care?
  • Are home nursing or nursing home expenses part of the coverage?
  • Does the insurance cover any medication that doctors may prescribe for me?
  • How high are the deductibles and co-payments?
  • What is the maximum amount I will have to pay myself to cover the costs?
  • Am I also insured for a temporary or long-term stay in my home country?

Retention of private German health insurance

People who were legally insured in Germany automatically lose their insurance cover when they leave the European social security system. However, it can be a Expectancy insurance with the German health insurance company, so that membership is temporarily suspended and can be resumed under the old conditions when you return to Germany.

There are also many reasons in favor of taking out a private German health insurance, since German insurance law offers some significantly better conditions compared to the USA. Those insured with a German private health insurance in the USA are still subject to the German Insurance Contract Act, which applies to all providers and companies in Germany.

International travel insurance for visits from Germany

Anyone who travels to the USA as a tourist or has relatives from Germany visiting their new homeland can also visit a doctor at short notice in the event of illness or the emergency room in emergencies. It is extremely advisable to have a private one before travelingInternational travel insuranceto be concluded for the USA, as an illness can otherwise be extremely expensive.

As a rule, all treatment costs must be paid on site and will be reimbursed by the travel insurance company afterwards. You should therefore always get a detailed receiptbe given, which lists all costs and therapeutic measures as well as diagnosis codes. If you want to be on the safe side, you should contact your travel insurance company in advance about any special features.

For other temporary but long-term stays of one year or longer (e.g. au pairs), adequate foreign health insurance should be available. Special travel insurance can be taken out for stays of up to 5 years.

In the following you will find some links to various international health insurances:

Hansemerkur - the travel insurance AG:
Here you can have various insurance premiums calculated for different types of trips (and lengths) and then easily book them.

Hansemerkur - international health insurance for up to 365 days
Apply for your insurance cover for stays of up to 365 days.

Hansemerkur - international health insurance for up to 5 years
Here you can take out international health insurance with a validity of up to 5 years.