How the healthcare system works
A private system where everything goes through insurance: it sets the network of doctors, your share of the costs and the authorisations. Employer insurance is the norm; failing that, you buy a plan on your state's marketplace.
Good to know
- There is no universal health insurance: coverage comes from the employer or an individual plan. In DC, every resident must maintain health coverage month by month, or face a penalty on their tax return. Source
- Read your plan before the first appointment: the monthly premium is not the end of it, every visit carries a copay or counts towards an annual deductible, and an out-of-network doctor costs far more. Children's well-child visits and vaccines are generally covered with nothing to pay.
- Without an employer, the federal healthcare.gov platform sends you to your state's marketplace (DC Health Link, Maryland Health Connection, Virginia's Insurance Marketplace); annual open enrolment starts on 1 November, and a move or a loss of coverage opens a special enrolment period. Source
- The French state does not cover your healthcare costs in the United States: you must take out local insurance before arriving, as travel insurance does not cover a relocation. The Caisse des Français de l'étranger (CFE) is a voluntary scheme that complements it, with a means-tested category applied for at the consulate. Source
- For a child, the community paediatrician is the family doctor: they follow, vaccinate, treat infections and refer to specialists. In between, neighbourhood urgent care clinics take fevers and minor injuries without an appointment, far cheaper than the ER. Source