Insurance & Healthcare
The U. S. Department of State requires all Exchange Visitors to have medical insurance, provided by an approved insurance company, which covers them for sickness and accidents throughout their program duration. Valencia requires all international students to purchase medical insurance through the college to ensure that the U.S. Department of State insurance coverage requirements are met. Even with health insurance, you must pay a portion of every medical bill called a "co-pay" or a “deductible.” Certain medical conditions and procedures are not covered at all, including treatment for illnesses or conditions you had before coming to the U. S. These are known as “pre-existing conditions.” It is very important to read your insurance policy carefully before you need to use it so that you understand what costs your health insurance will cover.
Health care in the U. S. is complicated, even for U. S. residents. The American health care system is different from many other countries, where the government may pay all or part of an individual's health care costs. Medical care is very expensive in the U.S., and people are expected to pay for it themselves. Even a few days in the hospital can cost thousands of dollars. There will be separate bills from the hospital, from every doctor who examines the patient, for every laboratory procedure, and for all medicines. Americans purchase health insurance to protect them from these high health care costs, and all Exchange Visitors are required to have it. Do not view health insurance as an additional, unnecessary expense! Without it you would have to pay thousands of dollars in medical bills if you had a serious accident or illness that required hospitalization.
In the U. S. it is customary to ask your doctor questions about your diagnosis and treatment. You may want to have a friend accompany you to a medical appointment in order to help listen and ask questions, assist with translation (if necessary), and provide overall support. Many medical offices and pharmacies in the Orlando area have Spanish speakers on staff and sometimes they can assist speakers of other languages. So do not be afraid to ask if someone there can talk with you in your native language so that you can ask questions and make sure you understand everything they tell you.
Where to Get Medical Care
For most illnesses and injuries, people go to a walk-in clinic, where an appointment is not necessary. These clinics are staffed by fully qualified doctors and nurses who treat problems such as sore throats; coughs; cold or flu symptoms; eye, ear, or skin infections; nausea and vomiting; sprains and fractures; urinary problems; and body aches and pains. X-rays and other diagnostic procedures are often done on the premises. Walk-in clinics are also known as “urgent care centers,” but they should not be confused with a hospital emergency room.
A hospital emergency room is the most expensive place to obtain medical care. Your insurance is likely to pay for it only if you have a serious, life-threatening medical emergency such as a traumatic injury, breathing problems, high fever, serious burns, or if you have an urgent need during hours when walk-in clinics are closed. The waiting time for nonemergency care in a hospital emergency room can be very long, sometimes up to eight hours. In the event of an emergency, dial 911.
Use an ambulance to get to a hospital only if emergency medical procedures may be needed on the way. For serious but non-life-threatening health problems, use a less expensive form of transportation such as a taxi. Ambulance transportation costs hundreds of dollars. Your insurance will only cover part of the ambulance fee, and even then only if the ambulance was needed for a true medical emergency.
In order to keep the total cost of insurance as low as possible, your insurance is intended to protect you against big illnesses or injuries that would cost you thousands of dollars for hospital care. Therefore, for each injury or sickness, you are responsible for the first $100 of fees to each medical provider. For example, let’s say you have a cough and you go to a clinic that charges $226 for a basic visit. You may be expected to pay the entire amount and then submit a claim to the insurance company. In this case, insurance should reimburse you $126 of the $226. If you return a few days later for a follow-up visit about your cough, this time the insurance should reimburse you the whole $226. On the other hand, if you return to the same clinic the next week for a stomach ache, this is a new illness and you will be reimbursed only $126 of the $226 fee.
In the above example, if you went to a clinic that charged $69, you would pay that amount to the clinic. Insurance would not reimburse you because you are responsible for the first $100 for each injury or sickness. However, you should still file a claim to the insurance company for this visit, because if you had to return to the clinic for a follow-up appointment, the insurance company would know that you had already paid $69 of your $100 deductible for that illness.
Be prepared to pay the entire bill with cash or a credit card any time that you receive medical care or buy prescription medicine. Bring your health insurance ID card with you, because sometimes the medical provider will call the insurance company to verify that you have insurance. In that case, the medical provider may bill the insurance company for their portion of the cost and charge you just for your part. Get a detailed statement of your bill before you leave the medical office; you will need this to submit your claim to the insurance company.
Please note that only “medically necessary” expenses are covered. Routine physical exams and dental care are not covered, but there is coverage for emergency dental treatments. Eye examinations for the purpose of prescribing eyeglasses or contact lenses are not covered, unless they are needed due to an accidental injury that occurred while covered by insurance.