How the health system works
Everything rests on insurance, usually provided by the employer, and on its network of doctors and hospitals. Children also benefit from a state public programme, Child Health Plus, open with no immigration status condition.
Good to know
- No federal law still requires you to be insured, the tax penalty only applying to plan years 2018 and earlier; but without insurance every procedure is billed at full price and the United States has the highest medical prices in the world. The employer's plan, taken out on hiring, is the normal route for an expatriate 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 care doctor and a closed network; PPO plans let you see a specialist directly, including out of network, at a higher cost. Source
- Child Health Plus covers children under 19 living in New York State who have no other insurance: free for modest incomes, then a monthly premium of $15 to $60 per child depending on income, and the plan's full premium above four times the poverty level. Enrolment goes through the NY State of Health marketplace. Source
- The French State covers no health costs abroad, neither hospitalisation nor repatriation; the Caisse des Français de l'étranger (CFE) offers voluntary membership that combines with local insurance, and the consulate can help the most vulnerable families access it subject to means. Source
- For the non-vital, urgent care clinics (CityMD and others) take walk-ins, evenings and weekends, treat children and accept most insurance plans: far cheaper than a hospital ER visit, which is billed in hundreds or thousands of dollars. Source