The COVID-19 pandemic has significantly impacted travel and immigration to the United States. Please refer to this article for the most up-to-date information and links to official sources.

Ask almost anyone who has lived in the United States, and they will have a health insurance story to tell you. Even if they don’t, they most certainly know someone who does.

Health insurance is notoriously expensive and complicated in the U.S. Unlike Canada, most of Europe, and many other countries where universal health care provides a basic level of coverage to all citizens, the U.S. has a mixture of private and two kinds of government-run programs. Basic coverage in California and Florida can cost $450 per month, while similar plans in New York can cost upwards of $600 per month.


The public programs, known as Medicare and Medicaid, are specifically designed for the elderly, people with disabilities, and low-income families and individuals. Everyone else needs to obtain private plans, either through their employer or on their own. Without one, you will still get treated in an emergency, but you are responsible for all of your medical expenses—and the bills can be astronomical.

Even when you do have an insurance plan, you may still get surprise bills. Most insurance plans require you to make co-payments at every doctor, and co-insurance—the percentage you pay alongside your insurer— can come as a surprise to many foreigners who are not used to this system.

Here’s a guide to help you prepare for navigating the labyrinth of the American health insurance, and a few tips on what to do before your move to potentially save on medical costs.

How does insurance work in the US?

Private health insurance is either offered through your employer or school, or you have to buy it on your own. You can select a plan that suits you best from the ACA’s Health Insurance Marketplace. The ACA, which stands for the Affordable Care Act—it’s nicknamed “Obamacare”—provides subsidies to those who can’t afford high premiums of insurance plans. The size of the subsidy depends on the individual’s income. Some states like California, Colorado, New York, and Massachusetts run their own healthcare exchanges.

The world of health insurance also has its own language and an extended glossary. It helps to learn a few of the essential terms in order to understand the plan you’re buying:

  • Premium: The monthly cost of your plan.
  • Deductible: The amount you pay out of pocket before your insurance kicks in.
  • Co-Insurance: The percentage of costs you still need to pay after your insurance kicks in.
  • Co-pay: What you pay the doctor at every visit.

Cost of health insurance varies widely, and it depends on the types of benefits you choose. Usually plans with higher premiums cover more of your medical expenses. In 2018, premiums averaged $440 per month for individuals, and $1,168 per month for families.

How do I get covered?

If you are employed by a U.S. company, you are likely covered through an insurance plan offered by your employer. Some employers pay for the plan in full, while others may pay part of the fee and require you to pay the remaining cost.

If you have a work visa but plan to be self-employed, you will need to purchase health coverage yourself. You can find a plan in the ACA’s Health Insurance Marketplace during the enrollment time, typically running from November to December for the following year. If you arrive to the US outside of the enrollment period, you may still qualify to apply because of your special circumstances.

If you are a student or exchange visitor (F-1 and J-1 visas):

For international students on F-1 visas, most schools require proof of health insurance prior to enrollment, and typically automatically enroll students into their own student health insurance plan upon registration at the start of the semester.

The U.S. requires all exchange visitors (J-1 visa holders) and their accompanying spouses and children to have medical insurance. You can obtain an insurance plan through your university.

Healthcare Moving Check list

By planning ahead, you may be able to save some medical expenses. Here’s a general timeline to keep you on track:

  • 12 months

    You should try to address any existing health issues and medical needs. Also schedule any surgeries or procedures you may need before you move.

  • 6 months

    Contact your employer or school to make sure you understand what your insurance options are. If you still need to find coverage upon your arrival, contact your current health insurance provider. You may be able to arrange coverage from an insurer in your home country for your first year abroad. This will give you ample time to find your US provider after your arrival.

    Alternatively, you may consult insurance expert to learn about international plans that will cover you in your destination country.

  • 3 months

    Pay a visit to your dentist. If you wear glasses, don’t forget an eye checkup. Even if your future American plan includes dental and vision care, you may still save money on co-payments if you take care of it at home.

  • 1 MONTH

    If you are on any medications, renew your prescriptions and get your refills to cover you for when you are in the U.S.

HSBC commissioned this article. The views and opinions expressed are those of the author and do not necessarily reflect the views and opinions of HSBC.