So this is what US health insurance is all about.

In the United States, everyone needs to buy health insurance. What is a co-pay, and how can you buy affordable insurance if you have no income? This article from Jetta Immigration will answer your questions.

Is it possible to not buy insurance?

Although ObamaCare mandated that everyone must have health insurance, otherwise they would not only have to bear enormous medical costs out of pocket but also be subject to government fines, Trump overturned this rule after taking office. Currently, there are no fines for not having insurance.

Insurance for different groups of people

International students: Schools require students to purchase insurance, and proof of insurance is required for registration to be completed. Generally, purchasing student medical insurance directly from an insurance company that partners with the school is the simplest and most convenient procedure.

Low-income households: Depending on individual and family income, those with an annual income below the poverty line can apply for Medicaid, a free medical assistance program run by each state. The eligibility requirements vary from state to state.

Seniors aged 65 and older: Citizens/green card holders aged 65 and older can apply for Medicare (Medicare). If their income is low, they can also apply for Medicaid, which will cover the out-of-pocket expenses of Medicare.

If you have a job: If your employer provides insurance, you can register directly with the company (group health insurance). Otherwise, you will have to purchase individual health insurance yourself. You can scroll to the next paragraph to see where to buy it.

Explanation of insurance-related terms

Assuming everyone is familiar with health insurance, let's explain some of the often confusing terminology so you can understand how to buy the right insurance for you.

Fee Terminology

Premium: Regularly paid insurance premiums

Co-Pay: It's a bit like a registration fee; you have to pay it every time you visit an office, and the amount is usually around ten or twenty dollars.

Deductible: Similar to car insurance, this is the amount you are responsible for paying out of pocket. For example, if your deductible is 00, you must pay for the amount up to 00 yourself. Amounts exceeding 00 are shared proportionally between the insurance company and the insured. The higher the deductible, the cheaper the premium, and vice versa.

Coinsurance: This usually involves selecting a percentage and only appears after the deductible amount is reached. For example, if you select 30% coinsurance, and a medical expense is 0, the insured only needs to pay , and the insurance company will cover the remaining .

Out-of-pocket maximum/limit: Once the total amount you pay exceeds this limit, the insurance company will cover the rest. This is cumulative. For example, if your out-of-pocket max is ,000, and your total medical bills (including deductibles and coinsurance) this year amount to ,000, you only need to pay ,000, and the insurance company will cover the remaining ,000.

Types of insurance plans

HMO (Health Maintenance Organization): One of the most common plans, requiring you to choose a primary care physician (family doctor). To see a specialist, you must first obtain a referral from your family doctor (emergency and OB/GYN consultations can be done directly without a referral). These specialists must be doctors within the network. Premiums are usually cheaper.

PPO (Preferred Provider Organization): One of the most common plans, it eliminates the need to choose a family doctor, allowing direct access to specialists. You can see doctors both within and outside the network, but out-of-network doctors may incur higher out-of-pocket costs. Premiums are higher.

POS (Point-of-service): It is between HMO and PPO. You must choose a family doctor and you need a referral to see a specialist, but you can see doctors outside the network.

EPO (Exclusive Provider Organization): You can choose and only choose any doctor within the network, but referral is not required.

FFS (Fee for Service): Payment is based on the service provided. The advantage is flexibility; there are no restrictions on the choice of hospital or doctor. However, you must pay the full cost upfront and then claim a proportional refund from the insurance company. This type of insurance is relatively expensive.

HSA (Health Saving Account): This is a concept where you set aside a certain amount of your income to save for medical expenses (not through your company). This amount is tax-free. To open an HSA account, you must choose a high deductible insurance plan.

COBRA (Consolidated Omnibus Budget Reconciliation Act): If you suddenly lose your job or change jobs and are not covered by insurance for a period of time, COBRA will continue to provide insurance, but the premium will be slightly higher.

Where to buy

1) Government Health Insurance Marketplace: To purchase and apply for subsidies through ObamaCare’s health insurance marketplace, you must submit tax returns and proof of income to assess your eligibility.

2) Find an insurance brokerage firm: The advantage is that the insurance broker will help you evaluate the most suitable insurance plan for you, and there are now many Chinese-speaking insurance brokers, so you don't have to worry too much about not being good enough in English or not being able to understand the insurance terms.

3.) Buy insurance directly from a health insurance company: Avoid agencies and buy directly from the provider. Most insurance companies now have good websites where you can easily compare and purchase online, and they also have online customer service for timely assistance. Some good insurance companies in the US are listed below, but benefits vary by state.

Factors to consider when purchasing

1. Assess your personal health status: Do you have any chronic diseases? Do you need regular follow-ups? Do you need to go back to the doctor to pick up your medication?

2. Assess family circumstances: parents, spouse, children, etc., and determine the content of the family plan accordingly.

3. Budget: Without government subsidies, the insurance premium will easily exceed two to three hundred yuan per month on average.

4. Compare insurance plans: Is it a high deductible with a low premium, or a low deductible with a slightly higher premium?

5. Medical insurance in the United States does not include dental or vision insurance; these must be purchased separately if needed.