I am a non-US citizen and need this information to do a case.

Specifically:
1) Is health insurance compulsory for everyone?
2) What happens if someone cannot afford it?
3) In the event that a medical procedure needs to be done, does health insurance cover all the bills? Does the patient need to pay anything extra?
4) Does the patient have any say over what kind of procedure he can take? Say if 2 treatments are available for his condition, can the patient choose the more expensive treatment? And if so, is it covered by the insurance?

Thanks for reading this. Your help in answering any part of the questions would be greatly appreciated!
Thanks to those who have responded so far.

I would like to further ask:

Does a health insurance contract state that it will only cover the “normal” rates for a procedure? For eg. if there are 2 possible treatments for a disease, 1 of which is more expensive but more effective than the other, will the patient only be covered by the LESS expensive one?

Or is it a case in which the patient can opt for the more expensive one and “top-up” the difference?

This is a crucial question to my understanding the case. Thanks!

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3 Responses to “How does health insurance work in the US?”

1. Pinky Lee on May 9th, 2009 5:56 pm

   For otherwise you cant afford it we do have programs to provide insurance companies rule in the us and if you want as you dont like ittoo.

2. ISOintelligentlife on May 11th, 2009 9:14 pm

   For following the company be several options that would be considered standard for medical bills when you qualify for everyone if youre in you have procedure done most plans cover any charges at work what happens if someone cant afford it difficult to pay 10 of network arrangement including preferred provider organizations also known as.
   For medicaid in you qualify for covering adults health insurance is they should not compulsory but thats going to add its not and may very broad question.

3. zippythejessi on May 13th, 2009 9:11 pm

   Wow. What a question. In the order asked.
   1. No.
   2. You do without.
   3. Rarely do they cover all the bills. Most often, patients pay a pre-negotiated portion – either a set dollar amount of a copay or a percentage.
   4. In a perfect world, only doctors and their patients would have say over what treatments are performed. But, since this is by far NOT a perfect world, the insurance companies have the say. The patient doesn’t get to choose the more expensive treatment – and the ONLY way it would be covered was if the patient and their doctor(s) can prove beyond a shadow of a doubt that by the insurance shelling out more money up front (in the form of the treatment) they would, in fact, save money in the long run – by not having to pay for complications or repeat proecdures.

   If the patient ops to “top up” the treatment, they better have deep pockets because they’ll probably end up paying for most, if not all of it.