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United States of America (USA) - Insurance
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Unlike many European, and other nations, the USA is a private insurance-driven health care system.
Health care services are available to the uninsured on a “pay as you go” type of arrangement. Costs vary by state, as does the cost of insurance plans.
Insurance plans have a variety of offerings and coverage, ranging from basic doctor visits to every health care interaction, prescription coverage, dental and vision services. Insurance plans all have a “deductible” and will involve “co-pay.” The deductible, just like vehicle insurance, is the amount you have to pay “out of pocket” before the insurance company will start to reimburse health care expenses. The co-pay is the amount you will need to pay to the health care provider at each interaction; for example, you may be required to pay your family doctor $25 per person per visit. It is worth noting that not all treatments or procedures are covered by health insurance, so it is important to check your policy before undergoing any “experimental” treatment or non-standard procedures.
Most people in the USA receive health insurance through their employers, but employment is no longer a guarantee of health insurance coverage. In recent times, as the US moves to a more service-based economy, health insurance coverage through an employee has become less accessible.
In addition, health insurance premiums have risen significantly over recent years and many small employers cannot afford to offer health benefits. Companies that do offer health insurance often require employees to contribute a larger share toward their coverage. As a result, an increasing number of Americans have opted not to take advantage of job-based health insurance because they cannot afford it.
For certain low-income families and individuals who can not afford health insurance, government programs like Medicaid and Medicare are available. Medicaid is a means-tested program designed for families and individuals who meet certain criteria; each state has its own set of criteria, and just because one is considered “poor” does not mean one will be eligible for Medicaid. Medicare provides health insurance to people aged 65 and older.
Nearly 46 million Americans, or 18 percent of the population under the age of 65, were without health insurance in 2007. The percentage of people (workers and dependents) with employment-based health insurance has dropped from 70 percent in 1987 to 62 percent in 2007. This is the lowest level of employment-based insurance coverage in more than a decade. However, the large majority of the uninsured (80 percent) are native or naturalized citizens.
For those purchasing health insurance on their own, instead of through an employer, there are a number of health insurance companies to choose from, including Allstate, Blue Cross and Blue Shield, Fortis, and Kaiser Permanente, just to name a few. Expats may want to consider purchasing international health insurance from a company like BUPA. International health insurance premiums tend to be cheaper than most local insurance companies (although be aware that the US has the most expensive medical care in the world, so premiums are adjusted for this). International health insurance is particularly useful if you will be spending a long time away from your home country or if you will be traveling to many different countries, as the coverage follows you wherever you go. For expats who will be spending a short amount of time in the US, general travel insurance should cover most medical needs.
Life insurance in the US is a plan whereby you insure your life for a sum and on your death, a lump sum is payable to your beneficiary. There are some exemptions in the underwritings of most life insurance policies and the following are not reasons to pay out on the death of the insured: suicide, war, fraud and any civil matter of which caused a commotion.
There are two life-based aspects to life insurance.
· Protection Policies – pays out a lump sum on the death of the insured
· Investment Policies – The capital sum is invested in the hope of growth for the eventual pay-out on the death of the deceased. There are variables to these policies.
There are a number of points to highlight in terms of ownership of the policy. The insured might not be the owner of the policy. A wife may be the insured, but the owner of the policy may be the husband who is paying the premium.
The cost of an insurance plan will vary depending on many factors. Actuaries pore over mortality rates and will come up with a policy with a fee for you to pay a monthly sum on. Information will be required on your lifestyle, your health and any risk factors you may have such as chronic illnesses. Which plan you choose will largely depend on your life expectancy and how much you’re willing to pay on a monthly basis.
The insurers reserve the right to investigate any suspicions they may have around any death before any pay-out is made. A death certificate is always required and every corner will be scoured before any pay-out is awarded to the beneficiary.
Home Insurance – Buildings & Contents
Home insurance, be it buildings or contents, is an absolute must in any country and you will want to ensure your goods and home are protected. Home contents insurance is based on the value of your goods and how secure your home is. The more you protect your home, the less likely a risk an insurance provider will feel your home is. The area can determine your premium and there are added benefits to home contents insurance such as protecting items away from the home and outdoor garden equipment.
Buildings insurance protects your home from fire and other damage, although there are some exclusions: such as war and acts of nature (force majeure). Your insurance advisor will guide you through these grey areas.
Vehicle insurance is a legal requirement in the United States and penalties are high if you are found to be driving without motor insurance. Car insurance is provided on the value of the car. It is also a requirement that the driver is legally allowed to drive the car. Premiums will be based on the driver’s driving history, how long he/she has been a license holder and where the car is parked at night. There are factors such as the age of other named drivers which can affect the price of your premium.
You can choose from a range of cover options such as fully comprehensive or a lower cost which will give you a third party cover. Third party cover will cover damage to another vehicle if you’re the liable party, but any repairs to your car will have to be funded by you. Fully comprehensive insurance covers all costs and for an extra fee you can have a legal clause in the event of a lawsuit.
Professional Indemnity Insurance
This insurance is based on a professional service you provide. If you’re a lawyer, an accountant, a financial advisor or in any capacity where you provide a service to the public such as selling goods to the public, it is wise to get yourself professionally indemnified. This policy will protect you in the event of a lawsuit against you and will pay out if the claimant wins a case. It is a vital insurance and will protect you. You should always have your certificate of indemnity insurance on display in your office or at least carry a copy with you if you visit clients.
It is worth talking to your bank if you require professional indemnity insurance while living in the US.
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Expat Health Insurance Partners
Cigna has worked in international health insurance for more than 30 years. Today, Cigna has over 71 million customer relationships around the world. Looking after them is an international workforce of 31,000 people, plus a network of over 1 million hospitals, physicians, clinics and health and wellness specialists worldwide, meaning you have easy access to treatment.