How US healthcare works
No universal public system: private health insurance, almost always offered by the employer, is the gateway to doctors and hospitals.
Good to know
- No federal law requires insurance any more, the tax penalty applying only to 2018 and earlier; but without insurance every procedure is paid in full. The employer's plan, taken out at hiring, remains the normal route for an expat family. Source
- The monthly premium is only part of the cost: add the annual deductible, the copay at each visit and an annual out-of-pocket maximum. HMO plans require a primary doctor and a closed network; PPOs let you see a specialist directly, at a higher cost out of network. Source
- Florida KidCare, the state's public children's insurance programme, covers uninsured under-19s subject to income limits; a non-citizen child must document lawful presence in the US, only the child's status being considered, not the parents'. Source
- The French state covers no medical costs abroad, neither hospitalisation nor repatriation; the Caisse des Français de l'étranger (CFE) offers voluntary membership that can be combined with local insurance. Source
- For non-emergencies, urgent care centres see you without an appointment, evenings and weekends, and cost far less than the ER; Nicklaus Children's also offers paediatric video consultations for non-urgent questions. Source