How will Medicare work for everyone

Medical Care In The United States And What It Costs

The American health system briefly explained

Until 2013, health insurance was not mandatory in the United States. But since the introduction of Obamacare, people who are not insured through their employers have to take out private insurance, the contributions of which depend in particular on the annual income of the household.

This rule has been relaxed a little since January 1, 2019: People who have not taken out health insurance recognized by the American authorities, the state no longer faces fines, as was the case before. This came after the amendment to the Federal Tax Cuts and Jobs Act.

There are other, often complex, forms of health insurance because the United States does not have a collective social security system. These include:

Medicaid, medical care for low-income households (up to 138% of the poverty line)
Medicare, for medical care for certain groups of people such as the elderly and the disabled

Most Americans are insured by their employer. Since 2015 Employers with more than 50 employees must take out health insurance finance their employees with a minimum working time of 30 hours per week, unless they can provide evidence of individual health insurance.

> More information: The international health insurance for the USA

How much do medical treatments cost in the United States?

The American system is one of the most expensive in the world. Here are some examples of costs: (1)

  • $ 320 for a visit to the medical specialist in California
  • $ 28,000 for a natural, no-complication birth in New York
  • $ 49,000 for an appendix operation in Florida


It goes without saying that taking out health insurance is essential with these high costs.

To take out American insurance
there are several options:

  • PPO (Preferred Providers Organizations) offer special tariffs especially for special networks
  • ** HMO (Health Maintenance Organizations) are cheaper but require their policyholders to have a limited list of doctors and health facilities;
  • II (Indemnity Insurances) are “classic health insurance” and are often the most expensive solution. Your tariff depends on the respective insurance tariffs and benefits.


When concluding a contract, pay attention to the copay offer, i. H. on the deductible for treatments. Most American health insurances also provide a deductible. H. a franchise amount for a deductible before reimbursement. Note: Some contracts do not cover treatment in another state; a very important note for people traveling!

According to the Henry Kaiser Family Foundation, the annual cost of American individual health insurance is $ 6,251 and $ 17,545 for a family of four (2).

> Zoom: International insurance for the USA with comprehensive protection and flexible benefits

Expats in the United States: Benefits of Getting International Health Insurance

Taking out international health insurance offers German expats on the other side of the Atlantic an important advantage:

You can health insurance for expats with comprehensive insurance coverage which you will efficiently cover for medical costs from the first euro you spend.

What is the advantage of these options? A clear and understandable reimbursement system, comparable to that of the German health insurance systems - but at the same time you are completely free to choose your doctor and have services that are very practical for expats (medical reports, treatment network, repatriation etc.).

(1) Data from APRIL International Care, August 2018
(2) Average annual premiums paid by employers

Discover the American Dream with APRIL International

A simple business assignment or emigration? APRIL International accompanies you every day across borders. Discover the different coverage options of our MyHealth International insurance solution for optimal health insurance coverage for you and your family in the USA.