As we all know, finding a suitable medical institution for medical care in the United States is a very complicated matter. To prevent the huge medical expenses in the United States and reduce your financial burden, you must first sign up for medical insurance that suits you before seeing a doctor, and then choose a relevant medical institution provided by the insurance company to see a doctor, so that you pay a small part of the bill yourself. , the rest will be borne by the insurance company, and the claim will be filed at the end.
The Patriot Exchange Program for visiting scholars' insurance is not limited to a designated medical network, allowing individuals to seek treatment from any hospital or doctor. The benefits remain the same regardless of the healthcare provider chosen. However, it's important to note that not all hospitals and doctors may offer direct billing services. Whether direct billing is available depends on the policies of each hospital and is not determined by the insurance company. Additionally, different doctors within the same hospital or even the same doctor may make different decisions based on individual cases.
Use the medical network to find doctors in hospitals near you and make an appointment. When seeking medical treatment, please bring your insurance card (ID Card) and any photo ID so that the hospital can confirm your identity. If you go directly to the hospital without an appointment, you are considered to need to go to the Emergency Room. If the emergency room is not an injury emergency or a hospitalization emergency, you will have to pay an additional $250 deductible. Urgent Care usually does not require an appointment and is reasonably priced. Use the link below to find an Urgent Care near you. In addition, the Student Health Center of most schools can serve international students and visiting scholars. When you see a doctor in the school infirmary, you only need to pay a $5 registration fee and no deductible.
The freedom is higher, with premiums and out-of-pocket ratios also higher, allowing for reimbursement of most medical service expenses. Policyholders are not required to designate a primary care physician, and referrals are not needed for specialist visits. When receiving medical services within the network, the individual's out-of-pocket costs are lower. However, when receiving services outside the network, the policyholder typically pays a higher percentage, often around 50%. Our STAC use the UnitedHealthcare PPO network, one of the largest medical provider networks in the United States. This includes over 1.4 million doctors, 6,797 hospitals, more than 45,000 clinics, 67,000 pharmacies, and 1,800 convenience clinics.
HMO ( Health Maintenance Organization )The premiums are relatively cheap, and the proportion of out-of-pocket medical expenses of the insured is low. The goal is to improve the health of the insured through health management, emphasizing preventive and comprehensive coordination of medical services. The plan requires policyholders to designate a family doctor and only reimburses services provided by clinics and doctors within the HMO network, and will not reimburse any out-of-network services except for emergencies. In addition, except for emergency departments and obstetrics and gynecology, all specialist consultations need to be referred by a family doctor, otherwise the medical expenses will not be reimbursed.
Primary care physicians, often referred to as general practitioners or family doctors, typically handle basic medical care needs. They can address minor issues such as colds, viral infections, or chronic conditions, conduct annual check-ups, or administer vaccines. They can also perform blood tests and diagnose chronic diseases. If a problem falls outside their scope of practice, they will recommend seeking assistance from a specialist. Specialist doctors usually require appointments in advance, and their office hours are typically similar to those of working professionals, from 8:00 AM to 5:00 PM.
Urgent care centers, such as CityMD, MultiCare, and Medrite, are commonly found chain stores where you can go for medical attention when you're unable to schedule an appointment with your doctor or when your doctors office is closed. These centers offer walk-in visits without appointments and can treat a variety of illnesses and injuries, including vomiting, diarrhea, colds, fevers, rashes, infections, minor cuts requiring stitches, mild allergic reactions, sprains, lab tests, and even minor fractures. They also typically have X-ray equipment and facilities for laboratory and blood tests.The average cost of treatment at urgent care centers is relatively affordable, and the wait times are usually shorter compared to emergency rooms. Most urgent care centers operate on weekends, holidays, and evenings, and some may have specific hours of operation but there are also centers that operate 24 hours a day.
Emergency rooms are designed to handle life-threatening emergencies such as chest pain, stroke, loss of consciousness, head injuries, severe bleeding, or major fractures. The costs associated with emergency room visits are relatively high, sometimes even double the price of urgent care centers, and the wait times can be longer. Even with medical insurance, patients may still need to pay high copayments or additional deductibles when seeking treatment at an emergency room. Therefore, advisable to avoid going to the ER unless absolutely necessary.
Remember, only visit the emergency room in situations where your life or long-term health is at risk to avoid substantial expenses.  Emergency rooms typically operate 24 hours a day, 7 days a week, and appointments are not required.
If the following treatments are not precertified, eligible medical expense coverage may be reduced by 50%:
●Chemotherapy
● Skilled Nursing Facility
●Home Health Care
●Inpatient Care
● Radiation Therapy
●Surgery or Surgical Procedures
If the following items are not precertified, they may not be covered:
●Interfacility Ambulance Transfers
●Emergency Medical Evacuations
●New Emergency Treatment Occurring Outside the United States not Covered by U.S. Plans
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STAC mainly provides first-class insurance services and claims after-sales services for exchange visitors with J1visa and their families J2 visas during their study period in the United States. stacinsurance1984@gmail.com
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