Health Insurance

One of the main things you must consider for living in the States is health Insurance.

And trying to understand how they work is one of the most challenging things I have gone through since I moved to the States.

Our situation is also different because we need insurance that could cover our needs also worldwide since Paulo travels often to Latin America or within the Sates, and there is health insurance that only is going to cover the needs within the State you live in. So, we have Global Health Insurance.

One of the main things to consider is the health Insurance the company you work for, offers.

Normally the company pays for the basic policy and if you want to upgrade it, you should have to pay this increased amount back to the company. Some companies also pay for the close family (spouse and children) but others allow you to include them into the company policy (cheaper than an individual one) but you should pay them back.

Also since this is a company benefit, it will be reflected in your payroll.

Some of the things to consider when you choose a Health Insurance and Healthcare terminology

· Premium/Contribution - Amount you pay via paycheck for health insurance every bi-weekly. You pay part of the premium (bi-weekly contribution) and the company pays the rest.

· Deductible - The amount you pay out-of-pocket within a calendar year before your health insurance begins to pay for covered service. (e.g. a $400 calendar year deductible means that you will pay the first $400 of your healthcare costs each calendar year)

· Copay - Copays or copayments are fixed amounts charged for covered in-network services, usually paid at the time you get the service.

· Coinsurance - The percentage you pay for covered services, usually after reaching your plan deductible. For example, if the plan’s allowed amount for an overnight hospital stay is $1,000 and you have already met the plan deductible, your coinsurance payment of 10% would be $100.

· Out-of-pocket max - The most you have to pay for covered medical expenses in a plan year through copay, deductible, and coinsurance before your insurance plan starts to pay 100 percent of covered medical expenses.

· Policy maximum per year

· Hospitalization/ER

· Intensive Care

· Cancer Care

· Doctor/Gp Visits

· Prescription Medication

· Wellness Checkups

· Mental health

· Dental Insurance (normally is another insurance but highly recommended since the dentist are very expensive here)

· Vision Insurance

You also must consider if the services are

· In-network - These providers (doctors, specialists, hospitals, etc) have negotiated special, lower rates .

· Out-of-network - These providers can charge a different rate for their services - their prices may be higher and covered differently by our plans.

Our experience so far is not very satisfying. We are now in a complaint process with our insurance since they don’t want to cover some wellness visits, even saying in our policy they are included. $970 that we have already paid to the health provider not to get in the dark with the score credit…

Also, the price for a doctor’s visit varies from $350-$700… So please be careful with the healthy Insurance you choose and the out-of-pocket policy.

Here you can ask for a budget and find out the best insurance suits you

In Silicon Valley, the main places to go are

Kaiser Permanente (which has its own Health Insurance and everything in one place)

Palo Alto Medical Foundation

Stanford Health Care

So, this is the maximum I can explain, I can understand, and always from my experience.