What Canadians need to know about healthcare in the USA

5 people gathering hands

As a Canadian, you’ve likely heard stories about the American healthcare system—some good, some bad, and some downright confusing. You’re probably accustomed to the comforts of universal healthcare in Canada—walk into a clinic, show your health card, and you’re taken care of. But what happens when you cross the border into the United States with movers Toronto offers, the land of the free and the home of the brave? Things can get slightly different here. Whether you’re planning to travel, study, or work in the United States, understanding the intricacies of healthcare south of the border is crucial. Keep reading to get some practical tips on what you need to know about healthcare in the USA.

The insurance-centric model

In Canada, healthcare is largely publicly funded, meaning that basic healthcare services are free at the point of use. The American system, however, is predominantly private and insurance-based. There are costs for medical procedures, hospital stays, and prescription medications often running into the thousands or even tens of thousands of dollars, even for those with insurance coverage. This means that without insurance, medical care can be prohibitively expensive. Even with insurance, the terms and conditions can be complex, and out-of-pocket costs can accumulate quickly. Therefore, if you are moving from Canada to US, make sure to research the best insurance policies.

A person talking via laptop about what she should know about the healthcare in the USA
The US healthcare is different from the Canadian one. Connect with people you know and do thorough research before you decide to move.

The importance of health insurance

If you’re planning to spend any significant amount of time in the U.S., obtaining health insurance should be at the top of your to-do list. Many employers offer health insurance as a part of their benefits package, but if you’re self-employed, a student, or unemployed, you’ll need to shop for a plan independently. There are various types of plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Catastrophic plans, each with its own set of rules, coverage options, and costs.

The emergency room quandary is not always the best option

In Canada, heading to the emergency room for immediate care is standard practice. In the U.S., however, ER visits can be incredibly costly, even with insurance. Therefore, for those who are moving from Toronto to New York, this might be a big change. It is recommended you look for other options in case of a disease. For non-emergency situations, consider going to an urgent care center or setting up an appointment with a general practitioner to save money.

Prescription medication can be costly

Prescription drugs are another area where costs can vary dramatically between Canada and the U.S. While Canada has measures in place to control drug prices, the U.S. does not, making some medications significantly more expensive. In Canada, the Patented Medicine Prices Review Board helps regulate the cost of prescription medications, making drugs like insulin or asthma inhalers more affordable; for example, a vial of insulin can cost around CAD $30.

A doctor prescribing medications
What you should know about healthcare in the USA is that medications can be more expensive than in Canada.

In the United States, however, the lack of price regulation can lead to staggering costs for the same medications. That same vial of insulin could cost upwards of USD $300, depending on the state and insurance coverage.  If you require prescription medication, it’s advisable to sort this out before your trip or look into American insurance plans that offer good prescription coverage.

Navigating in-network and out-of-network care

In the U.S., the concept of “in-network” and “out-of-network” care is crucial. In-network refers to healthcare providers that have agreements with your insurance company, making services more affordable. Out-of-network care is typically more expensive and may not be covered by your insurance at all. Always check whether a healthcare provider is in-network before scheduling any appointments. Moreover, understanding American healthcare jargon can be a challenge. Terms like “deductible,” “co-pay,” “premium,” and “out-of-pocket maximum” are essential to grasp to navigate the system effectively. Make sure you familiarize yourself with these terms and how they apply to your chosen insurance plan as soon as you put your items in storage units Toronto has to offer. The sooner you learn this the better you will be able to understand how everything works once you are in the USA.

The Affordable Care Act

The Affordable Care Act (ACA), commonly known as Obamacare, aimed to make healthcare more accessible and affordable for Americans. While the ACA has expanded coverage to millions and introduced subsidies to make insurance more affordable, it’s important to note that it hasn’t achieved universal healthcare, leaving some gaps in coverage and affordability.

Two doctors treating a patient
The US provides a special affordable program that Canadians can benefit from.

What else Canadians should know about healthcare in the USA?

Apart from the things mentioned above, there are some other useful things to know. Remember, the healthcare in the USA may cause a headache for Canadians at first. Here is a handy list of practical advice to have in mind:

  • Get insured: Never go to the U.S. without adequate health insurance.
  • Understand your plan: Know the terms and conditions, including what is and isn’t covered.
  • Emergency care: Use urgent care centers for non-emergency situations to save money.
  • Prescriptions: If possible, bring more medications with you, until you manage to get a prescription.
  • Travel insurance: Consider getting travel insurance that covers health for short trips.
  • Documentation: Always keep relevant healthcare and insurance documents handy.

Preparation is the key to achieving successful medical care in the US

The American healthcare system can seem daunting. This is especially true when compared to Canada’s more straightforward approach. However, being informed and prepared can make all the difference. By understanding the basics and planning accordingly, you can ensure that your health is taken care of while you’re in the United States. This and other useful things to know about healthcare in the USA will make the transition much easier. So, the next time you find yourself humming “O Canada” while packing your bags for a trip south, remember to also prepare for the healthcare journey that lies ahead. Safe travels!